Allergy/Immunology Flashcards
1 parent with atopy = ? % risk for allergic disease?
2 parents with atopy = ? % risk for allergic disease?
50% and 75%
Which allergies are often outgrown by 5 yo? Which ones are not?
Milk, Egg, and Soy are usually outgrown. Tree nuts, peanuts, and seafood usually not outgrown.
What dose of epinephrine for anaphylaxis in < 30kg? >=30 kg?
0.15 mg if < 30 kg; 0.30 mg if >=30 kg.
What is the most likely cause of chronic urticaria (>6 months)?
Food
What type of allergic reaction caused by poison ivy?
Type 4, delayed hypersensitivity
What type of allergic reaction causes anaphylaxis?
Type 1, IgE mediated
Albuterol increases or decreases serum potassium
Decreases
When is ipratroprium (anticholinergic) indicated in acute asthma exacerbation?
Give for severe exacerbation with albuterol for first 1-2 hours
What role does magnesium sulfate have in asthma exacerbation?
Bronchodilator. Can decrease admission rates.
Patient with nighttime awakenings >2x/month, sx requiring SABA >2days/week (not daily)
Mild Persistent asthma
Patient with daily symptoms, daily SABA use, night time awakenings >1x/week but not nightly
Moderate persistent
Patient with daily sx, daily SABA use, nightly awakenings
Severe persistent
What are salmeterol/Formoterol classified as? When are they indicated?
LABA; Indicated as addition to low-dose ICS in >5yo with moderate persistent asthma
Long term tx of moderate persistent asthma
Low dose ICS –> increase to medium dose if 0-4 yo. Keep low dose and add LABA if >5 yo. May then increase to medium dose if not working.
Long term tx of severe persistent asthma
High dose ICS + LABA
Cholinergic rhinitis secondary to foods or cold air. Tx?
Ipratroprium
Infant < 3yo, blood streaked stool (no diarrhea). Not ill. Tx?
Food protein induced proctitis. Tx with protein hydrolysate formula (or breastfeeding mothers eliminate milk from diet)
Infant 1 week to 9 months old with severe vomiting, diarrhea, toxic appearing, dehydrated. Heme positive stools. Dx? Tx?
Food protein induced enterocolitis. Tx by discontinuing causative agent. Resolves by 2-3 yo.
3 month old with recurrent thrush, otitis media, diarrhea, dermatitis. Dx? Tx?
SCID. Dx with fluorometric analysis of T,B,NK cells. Tx BMT
Male infant with low levels of IgM, severe eczema, bloody diarrhea/bruising
Wiskott-Aldrich Syndrome
Male with absence of lymphoid tissue, recurrent encapsulated infections, Elevated T cells, low to absent B cells. Tx?
Brutons X-linked agammaglobulinemia. Tx IVIG
Kid with recurrent upper and lower respiratory infections, recurrent herpes and zoster infections. Tx? Increased risk of what cancer?
CVID. Tx with IVIG. Increased risk of lymphoma, EBV associated
6 mo to 1 yo M with recurrent otitis media, sinopulm infections, diarrhea. High incidence of opportunistic infections.
X-linked Hyper IgM Syndrome
Male infant with PCP pneumonia, no HIV infection
Think X-linked Hyper IgM Syndrome
