Allergy/Immunology Flashcards

1
Q

Describe the presentation and treatment of anaphylaxis.

A
  • presents with a urticarial rash, respiratory distress, and hypotension
  • treat with airway management, epinephrine, antihistamines, and glucocorticoids
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2
Q

Describe the etiology, presentation, diagnosis, and treatment of angioedema.

A
  • most often due to a C1 esterase inhibitor deficiency
  • presents as sudden swelling in the absence of pruritus and urticaria, often after starting an ACEi or the occurrence of minor trauma
  • best initial test is for low C2 and C4 but most accurate is for low C1 esterase inhibitor activity
  • treat acutely with airway maintenance, C1 esterase inhibitor concentrate, the kallikrein inhibitor ecallantide, or the bradykinin antagonist icatibant
  • use antifibinolytics, androgens, or C1 esterase inhibitor infusions for maintenance therapy
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3
Q

What is the treatment for urticaria?

A

antihistamines or leukotriene receptor antagonists

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4
Q

Describe the presentation and treatment of allergic rhinitis.

A
  • presents with recurrent episodes of watery and itchy eyes, inflamed and boggy nasal mucosa, nasal polyps, and pale or violaceous turbinates
  • treat with avoidance, intranasal corticosteroids, antihistamines, anticholinergics, and desensitization
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5
Q

Describe the pathophysiology, presentation, diagnosis, and treatment of common variable immunodeficiency.

A
  • a defect in B cell differentiation leads to low levels of plasma cells and all Ig isotypes
  • presents with recurrent sinopulmonary infections, seronegative autoimmune disease, and normal amounts of lymphoid tissue
  • diagnosis is based on decreased response by B cells to antigen stimulation
  • treat with scheduled IVIG infusions
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6
Q

Describe the pathophysiology, presentation, and treatment of X-linked agammaglobulinemia.

A
  • an X-linked defect prevents maturation of B cells
  • presents with recurrent sinopulmonary bacterial and enteroviral infections with absent lymphoid tissue
  • treat with maintenance IVIG
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7
Q

Describe the pathophysiology, presentation, diagnosis, and treatment of SCID.

A
  • an IL-2R or adenosine deaminase deficiency leads to a deficiency of both B and T cells
  • presents with recurrent sinopulmonary infections and many AIDS defining infections (candida, PCP, varicella, etc.)
  • diagnosis is based on diminished TRECs, absent thymic shadow, and no germinal centers on lymph node biopsy
  • treat with antimicrobial prophylaxis and IVIG until a bone marrow transplant can be performed
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8
Q

Describe the presentation and treatment of IgA deficiency.

A
  • presents with the 4 A’s: airway and GI infection, atopy, autoimmune disease, and anaphylaxis to blood products
  • IVIG does not help and infections are treated as they areise
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9
Q

Describe the pathophysiology, presentation, and treatment of hyper-IgE syndrome

A
  • it is a disease caused by impaired neutrophil recruitment
  • presents with FATED: coarse Facies, Abscesses (staph), retained primary Teeth, increased IgE, and Dermatologic problems in the form of eczema
  • consider prophylactic antibiotics for Staph infections including dicloxacillin or cephalexin
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10
Q

What are the features of Wiskott-Aldrich syndrome?

A

WATER

  • wiskott
  • aldrich
  • thrombocytopenia
  • eczema
  • recurrent infection
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11
Q

Describe the pathophysiology, presentation, diagnosis, and treatment of chronic granulomatous disease.

A
  • a deficiency of NADPH oxidase prevents formation of reactive oxygen species like superoxide, leaving individuals susceptible to catalase positive organisms
  • presents with recurrent infection by Staphylococcus, Burkholderia, Nocardia, and Aspergillus
  • diagnosis is based on a negative nitroblue tetrazolium test and abnormal dihydrorhodamine test
  • patients need bactrim and itraconazole prophylaxis
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