Allergy Immunology Flashcards
Erythema multiforme
- causes
- location
- HSV > mycoplasma, anticonvulsants, barbiturates
- dorm hands/feet + extensor
- usually not MM
Example of each type of hypersensitivity
1: Anaphylaxis
2: Autoimmune hemolytic anemia
3: Immune complex = serum sickness
4: Delayed T cell- contact dermatitis
Serum sickness
- type, organs, key lab
Serum sickness like
- difference
- common cause
- Type 3 - immune complex deposits
- Skin, Joints, Renal
- Low complement
SSL: no IC, no renal dz, normal complement
Common: cefaclor
Most common cause of anaphylaxis
Food > Venom > Meds
SJS - Common cause
- Clinical Sign
Sulfonamides
Anticonvulsants
Nicolsky sign
Poison ivy allergy
Rhus dermatitis
Linear vesicles
Penicillin Allergy
- cross reactivity w cephalosporin?
2%
Anaphylaxis diagnosis?
1) Cutaneous + either CVS/Resp
2) Likely allergen + 2 systems
3) Known allergen + hypotension
Anaphylaxis tx?
observation?
Epi IM 0.01mg/kg
if on B Blocker give glucagon
?steroids
Observe 4-6 hours
Biphasic anaphylaxis
- increased risk?
- length of time?
- Delayed epi
- More than one dose epi
- Severe sx
Up to 72 hr
Discharge management for anaphylaxis
- Epi autoinjector
- Anaphylaxis action plan
- Medical ID device
- Allergy referral
- Avoidance of trigger
- Consider 3 days of antihistamines/steroids
Hereditary angioedema
- deficiency in ?
- inheritance?
- presentation
C1 esterase inhibitor deficiency
Autosomal dominant
Episodic nonpruritic angioedema without urticaria
Humoral Defects
- examples
- characteristics
- IgA def
- XLA
- CVID
Sinopulmonary infections
Autoimmunity
Malignancy
Xlinked agamm
- Type
- Characteristics
- Humoral - No B cells
- No Ig’s
- No lymph tissue
- Sinopulmonary infections
- Enteroviral meningoencephalitis
Common Variable immune deficiency
- Type
- Age
- Characteristics
- Humoral
- Have lymph tissue
- Most common
- Often presents puberty
- Recurrent bacterial infections
- Autoimmunity
- Malignancy
How to test for humoral defect?
Number:
CBC + Diff
Ig’s
Lymphocyte subsets: CD 19
Function:
Ab titers
How to test for cellular defect?
Number:
CBC + Diff: total lymphocyte count
Lymphocyte subsets: CD 3(tot), 4, 8
Function:
Mitogen and Antigen proliferation studies
Complement deficiency
- Presentations
- Lab
Severe recurrent/invasive encapsulated bacteria infections
Rheumatic dz
Neisseria Meningitis
Lab: CH50
Wiskott Aldrich
- inheritance
- characteristics
- Labs
X linked
Eczema
Thrombocytopenia
Recurrent pyogenic infections
High IgA and IgE
Ataxia telangiectasia
- Characteristics
- Screening
Cerebellar ataxia
Telangiectasia
Recurrent infections
Oculomotor abnormalities
Screen: alpha fetoprotein
22q11
Cardiac - interrupted aortic arch Abnormal facies Thymic hypo/aplasia Cleft lip/palate Hypocalcemia
autoimmune polyendocrine syndrome type 1
Autoimmunity / polyendocrinopathy
- Addison’s disease and hypoparathyroidism most common
Chronic mucocutaneous candida infections
- Oropharyngeal, esophageal, nails, skin, vulvovaginal
Ectodermal dysplasia
- Pitted nail dystrophy
- Dental enamel dysplasia with thin enamel and pits
Chronic Granulomatous Disease
- Bugs?
Bacterial and Fungal infections
Absecesses and granulomas
S.aureus Aspergillis Nocardia Serratia Morcescenes Burkholdia cepacia Salmonella
How long do you wait after IVIG to give live vaccines?
11 months
Risk of anaphylaxis after giving IVIG in which immune deficiency
IgA deficiency
Indications for IVIG?
- Humoral and Combined Primary Immune Deficiency
- Absent levels of IgM or IgG (XLA, CVID, Hyper-IgM Syndrome, SCID, Wiskott Aldrich Syndrome, ataxia telangiectasia, antibody deficiency with normal immunoglobulins, selected cases of IgG subclass deficiencies despite antibiotic treatment
- Kawasaki
- B-Cell CLL
- HIV
- ITP
- Guillain-Barre
- TEN
- Graves Opthalmopathy
- CMV induced pneumonia in solid organ transplants
NOT NEPHROTIC SYNDROME
list 4 avoidant strategies for child with perennial allergic rhinitis
- Sealing the patient’s mattress, pillow, and covers in allergen-proof encasings reduces the exposure to mite allergen
- Bed linen and blankets should be washed every week in hot water (>54.4°C)
- Removal of pet from the home
- Stay in a controlled environment to avoid pollen and outdoor molds
- High-efficiency particulate air (HEPA) filters lower the counts of airborne mold spores.
2 most common allergies in infants
Eggs
Milk
What are the 8 live vaccines?
BCG, Influenza, MMR, Rotavirus, PO Typhoid, VZV, Yellow Fever, Smallpox
Weights for epipen jr and epipen
Epipen Jr 10-25kg
Epipen >25kg
Chronic Granulomatous Disease
- associations
IBD
Granuloma
Delayed shedding of the primary teeth
Hyper IgE syndrome
