Atopic, Rheumatic & Immunodeficiency Disorders

Question 1

What are the most common pediatric atopic disorders that a PCP is likely to encounter?

Answer 1

*atopic dermatitis (AD)
*allergic rhinitis (AR)
*asthma

Question 2

What are the most common rheumatic diseases a PCP is likely to encounter?

Answer 2

*juvenile idiopathic arthritis (JIA)
*systemic lupus erythematosus (SLE)

Question 3

What is the most common systemic vasculitis syndrome of childhood?

Answer 3

Henoch-Schönlein purpura (HSP)

Question 4

What is the most common cause of acquired heart disease?

Answer 4

Kawasaki disease (KD)

Question 5

Allergies are acquired alterations in the body with an immunologic basis. An allergen acts as an antigen that triggers an _______ response in genetically predisposed individuals.

Answer 5

immunoglobulin E (IgE)

Question 6

What are the 4 types of allergic reactions?

Answer 6

• Type I: An IgE-mediated reaction, in which the binding region on the IgE attaches to high-affinity receptors on basophils, mast cells, and eosinophils, resulting in inflammatory mediators and cytokine release.
• Type II: A cytotoxic reaction, occurring when IgM or IgG antibodies bind to surface antigens on normal tissue cells activating the complement cascade with resultant inflammation or causing cellular dysfunction or toxicity, leading to cell destruction.
• Type III: Immune-complex reactions result from IgG or IgM antibodies-antigen complexes that accumulate in the tissue and circulation, activating the complement cascade. This reaction also attracts granulocytes, which results in tissue damage.
• Type IV: Delayed T cell type reaction (hypersensitivity) involves the activation and proliferations of T cells and their migration to the site of specific antigen. The hypersensitivity reaction is mediated by the T cells and monocytes/macrophages rather than by antibodies. First, there is a local inflammatory and immune reaction at the antigen site that is followed by a secondary cellular response 48 to 72 hours after the initial antigen exposure. Damage to cells and tissues can result from interleukins and other lymphokines secreted by macrophages.

Question 7

What happens with a type I allergic reaction?

Answer 7

An IgE-mediated reaction, in which the binding region on the IgE attaches to high-affinity receptors on basophils, mast cells, and eosinophils, resulting in inflammatory mediators and cytokine release.

Question 8

What happens with a type II allergic reaction?

Answer 8

A cytotoxic reaction, occurring when IgM or IgG antibodies bind to surface antigens on normal tissue cells activating the complement cascade with resultant inflammation or causing cellular dysfunction or toxicity, leading to cell destruction.

Question 9

What happens with a type III allergic reaction?

Answer 9

Immune-complex reactions result from IgG or IgM antibodies-antigen complexes that accumulate in the tissue and circulation, activating the complement cascade. This reaction also attracts granulocytes, which results in tissue damage.

Question 10

What happens with a type IV allergic reaction?

Answer 10

Delayed T cell type reaction (hypersensitivity) involves the activation and proliferations of T cells and their migration to the site of specific antigen. The hypersensitivity reaction is mediated by the T cells and monocytes/macrophages rather than by antibodies. First, there is a local inflammatory and immune reaction at the antigen site that is followed by a secondary cellular response 48 to 72 hours after the initial antigen exposure. Damage to cells and tissues can result from interleukins and other lymphokines secreted by macrophages.