Allergy / Immunology Flashcards
Anaphylaxis v Angioedema
Anaphylaxis - includes urticaria
-TX = epinephrine, antihistamine, steroids (methylprednisone)
Angioedema - no urticaria / pruritus
- TX = NO steroids, give C1 esterase inhibitor concentrate, ecallantide, icatibant
Ecallantide
Kallikrein inhibitor for angioedema
Icatibanr
Bradykinin B2 receptor inhibitor for angioedema
What 3 med classes can be used as ppx in angioedema?
1 - anti-fibrinolytics (tranexamic acid)
2- Androgens (danazol, stanozolol)
3- infusions of C1 esterase inhibitor
Common Variable Immunodeficiency
Normal B cell count but low productivity so dec in all immunoglobulins (IgA, IgM, IgG)
Recurrent sinopulmonary infections (bronchitis, pneumonia, OM)
Normal lymphoid tissues
Test - decreased response to antigen stimulation
Tx - IVIG
X-Linked Agammaglobinemia (Bruton)
Dec in both B cells and lymphoid tissue (tonsils, adenoids, LNs, spleen)
Tx - IVIG
Severe Combined Immunodeficiency
Deficiency in both B and T cells
PCP, varicella, Candida (like AIDS) + sino-pulmonary infections
Tx - bone marrow transplant
Anaphylaxis to Blood Transfusion
Think of IgA Deficiency - react to small amount of foreign IgA in blood
Do not give IVIG (contains IgA)
What is the main manifestation of Hyper-IgE Syndrome
Staph skin infections
PPX - w/ cephalexin
Wiskcott-Aldrish Syndrome Triad & Tx
1- immunodeficiency
2- thrombocytopenia
3- eczema
Tx = bone marrow transplant
Which organisms commonly cause infection in chronic granulomatous disease?
Staph, burkholderia, nocardia, aspergillus
2 Tests for CGD
1- nitroblue tetrazolium
2- dihydrorhodamine
**both show dec oxidative burst due to dec NADPH oxidase
Post Transplant Infections by Timing
< 1 mo - bacterial infections from operating room and hospital
1 - 6 mo - opportunistic infections (CMV, Tb, aspergillus)
> 6 mo - normal community acquired infections