alloimmunity/autoimmunity pt 2 Flashcards
type I hypersensitivity rxn
IgE
local and systemic anaphylaxis, seasonal hay fever, food/drug allergies
type II hypersensitivity rxn
IgG or IgM
RBC destruction after transfusion, hemolytic disease of the newborn
type III hypersensitivity rxn
IgG and IgM
post-streptococcal glomerulonephritis, RA, SLE
type IV hypersensitivity rxn
T cells
delayed hypersensitivity reaction
contact dermatitis, type I diabetes mellitus, MS, Steven-johnsons
anaphylactic shock symptomatology
pruritis, rash, hives
increased vascular permeability - angioedema, pulm edema, gen edema, rhinitis
peripheral vasodilation - flushed, redness, hypotension
smooth muscle contraction - bronchospasm, abd cramping
anaphylaxis mgmt
epi 0.3 mg IM
0.01 mg/kg/ dose IV q 5 mins
airway first!!!!
oxygen, fluids, stop offending agent
2nd line - Benadryl, Pepcid, steroids
radiocontrast media-asssociated anaphylaxis
non IgE mediated
prevent w prednisone, Benadryl , Pepcid
multiple myeloma characteristics
malignant proliferation of plasma cells derived from a malignant clone
RF: genetics, trisomy, radiation/chemicals, age/male
plasma cells become cancerous and form plasmacytoma, or multiple = multiple myeloma
MM symptomatology
leukopenia - infections
anemia
thrombocytopenia
pain (bone pain)
fractures and hypercalcemia
renal dysfunction/failure
MM diagnostics
serum protein electrophoresis
BMBx - >60% plasma cells
consider tissue biopsy of plasmacytoma
bone lesions on MRI/PET
also hyperCa, renal insufficiency, anemia
MM treatment
steroids - dex or pred
chemo
radiation
bisphosphonates
plasmapheresis for renal failure
SCT
MM supportive therapy
no live vaccines
prophylaxis? - acyclovir, fungal prophylaxis, bactrim
DVT prophylaxis (unless plt <50)
bisphosphonates, calcium/vitamin D supplementation
