allergy/immunology Flashcards
risk of atopy if one parent has atopy
50%
risk of atopy if both parents have atopy
70%
risk factors for asthma persisting into adulthood
onset < age 3
IgE elevation
parental hx
atopic dermatitis
percent of children with mild asthma who outgrow sx
60%
percent of children with severe RSV who develop recurrent wheezing
50%
when is skin prick testing not reliable
antihistamine use
antidepressants
eczema
–> do IgE testing (higher cost, higher false positive)
firt line tx for allergic rhinitis
nasal steroids
nasal polyps, aspirin intolerance, asthma
aspirin exacerbated respiratory disease
rhinitis triggered by emotion, pollution, cold drafts, rapid temperature change, humidity change
vasomotor rhinitis
rebound reaction to adrenergic nose drops
rhinitis medicamentosa
how old to develop allergic rhinitis
> 3 yo
tinging in/around mouth when eating a specific food
oral allergy syndrome
who should be sent for food testing
severe eczema
persistent asthma
fruits to avoid in latex allergy
avocado banana chestnut fig kiwi peach tomato
which food allergies are often outgrown
milk, eggs, soy
when to test for peanut allergy before introduction of peanuts
severe eczema or egg allergy –> skin or IgE testing
if > 0.35, go to allergist
when to introduce peanuts into diet
4-6 mos
6 mos for infants with mild to mod eczema
timeframe for chronic urticaria
> 6 weeks
tx of chronic urticaria
2nd/3rd gen antihistamines
who needs allergy testing after bee sting
only systemic allergic reaction
how to remove bee stinger
ASAP
scrape with credit card/fingernail - do not squeeze
deep abscesses, pneumonia, osteomyelitis, urinary/bowel obstruction
CGD
XL
NBT or phagocytic burst test
ppx with bactrim and itraconazole
NO live vaccines
leukocytosis, indolent skin infections, perirectal abscesses, no pus in infections
LAD
dx: flow cytometry
easy bruising, oculocutaneous albinism, recurrent sinopulmonary and skin infections
Chediak Higashi
AR
dx: smear - lysosomal granules in WBCs
Staph, Strep pyogenes, pneumococcus
recurrent sinopulmonary infections, anaphylaxis to transfusion
IgA deficiency
most common primary immunodeficiency
small lymphoid tissues, recurrent sinopulmonary/encapsulated infections
Brutons X-L agammaglobulinemia
humoral deficiency
dx:immunoglobulin levels, B/T subsets
tx: IVIG
recurrent respiratory and GI infections, HSV and VZV; increased autoimmunity and lymphoma
CVID
B and T cell defect
tx: IVIG
boy with frequent otitis, sinopulmonary infections, diarrhea, opportunistic infections; lymphoid hypertrophy, PCP infection
Hyper IgM
XL
T cell defect –> class switching problem
dx: immunoglobulin levels
tx; IVIG
eosinophilia, eczema, recurrent skin and sinopulmonary infections
Job = Hyper IgE
staph aureus, chronic thrush, abnormal facies, fractures
tx: antibiotics, steroids
decreased immunity, outgrown by 3-6 years
transient hypogammaglobulinemia of infancy
low IgG, normal IgM
ataxia, conjuncival discoloration, developmental regression, frequent sinus infections
ataxia telangiectasia - AR
neonatal tetany, congenital heart disease, low set ears
DiGeorge - 22q11 AD/de novo no parathyroids, small/absent thymus 20% with ID incr freq of learning disabilities and psych
FTT, chronic diarrhea, recurrent opportunistic infections
SCID
dx: CBC with leukopenia, absence of T cell function
tx: BMT
ADA deficiency is one form
eczema, recurrent sinopulmonary infections, easy bleeding/bruising
WAS
XL
cellular deficiency
encapsulated and opportunistic infections
most common cause of death in WAS
lymphoma
can kids with complement deficiency get vaccines
yes
