HDM/MCM topics Flashcards

1
Q

8 y/o presents with fullness in both ears, cough, no fever

CTAB

ENT, cobblestoning appearing on oral

what is it?

what will you see on a kid?

what kind of hypersensitivity?

A

allergic rhinitis –>

crease right across the nose = nasal salute line.. develops the allergic salute

allergic shiners (looks like 2 black eyes) –> Denny Morgan lines

type 1 hypersensitivity

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2
Q

What is a type 1 hypersensitivity

what is it mediated by?

Atopy?

signs and symptoms (4 things we’d see)

what is the most common thing of hypersensitivity that leads to death that is type 1?

treatment?

A

allergy or anti parasitic

IgE antibody mediated disorder

Atopy –> family predisposition to these allergic reactions

  • allergic conjunctivitis
  • allergic rhinitis
  • Atopic Dermatitis
  • food type allergies

*hypersensitivity to bee/wasp/hornet

epi pen

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3
Q

Type 2 Cytotoxic Hypersensitivity Reaction?

A

antibody mediated cytotoxic reaction that involves complement activation!!

ABO mismatch (wrong type of blood)

Newborn Rh hemolytic disease

Myasthenia Gravis

Graves Disease

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4
Q

Arthus Reaction?

also called what?

what kind of hypersensitivity?

A

person is exposed to an antigen, forms antibodies against it, and you have a deposition of those somewhere.

Bird Breeders lung

type 3 hypersensitivity

occurs 4-8 hours after antigen exposure

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5
Q

Type 3 hypersensitivity reactions?

what do you see in the vignette?

A

antigen bound to IgG or IgM

think of farmer’s lung (moldy hay)… cheese worker’s lung, mushroom worker’s lung, malt worker’s lung.

repeated exposure and you form IgG or IgM in target tissue with subsequent complement activation

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6
Q

serum sickness?

A

rattlesnake bites

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7
Q

Type 4 reaction examples?

A

poison ivy, ppd skin test

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8
Q

poison ivy is composed of what type of lesion?

A

linear vesicular lesions

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9
Q

Rheumatoid Arthritis

common in what age range and sex

what is the typical story from patients?

where is the pain happening?

what’s the difference between this and osteoarthritis?

A

common between 30-50

usually women

family history

present with pain and stiffness in wrist and proximal interphalangeal joints and metacarpophalangeal joint

morning stiffness and as they get going they get better

feel good in the morning and shitty at the end of the day

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10
Q

first line agent of RA?

why do we want to treat RA right away?

A

methotrexate

the longer that you have RA before you’re treated, the worse your prognosis is.

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11
Q

Juvenile RA?

**what’s important to note about this?

A

painless joint involvement

so swollen joint that isn’t painful, it’s just swollen. not red or hot.

can present with a limp too.

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12
Q

primary morbidity associated with juvenile RA?

**where do you send them if you find this?

A

inflammatory eye disease

you need to have them checked by an ophthalmologist

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13
Q

Systemic Lupus Erythematosus (SLE)

1) who is it more common in? sex and race
2) what does it present with (most likely associated with it) –> 4 of them

A

2x prevalent in black people, 10x more prevalent in females

episodic flares –>

butterfly rash (malar rash) on the face.

discoid rash “coin like” –> likelihood

unexplained seizures, psychosis, photosensitivity

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14
Q

Lupus.. first line of treatment?

what tests would you see done for lupus?

A

Hydroxychloroquine (Plaquinal) –> first line of treatment

ANA, anti-dsDNA

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15
Q

Psoriasis?

1) what is it?
2) what do they present with?
3) family history?
4) what age presents with it?
5) where is it mostly found?

A

chronic inflammatory skin condition.

erethematous scaly skin.

1/3 of patients have first degree relative with the condition.

age 15-30 most common ages

behind the ears, on the elbows, nail lines

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16
Q

types of psoriasis to know?

what is most common?

A

plaque psoriasis –> on elbow and behind ears

nail psoriasis –> lines due to anxiety or pinning.

plaque

17
Q

treatment for psoriasis?

A

topical corticosteroids, vitamin D analogs, Tazorac

18
Q

Graves Disease

what happens

what are the levels of T3/T4 and TSH

A

hyperthyroidism

Thyroid stimulating antibodies activate the receptors to increase synthesis

T3/T4 goes up, TSH down.

19
Q

most common symptoms of Graves?

sex?

A

heat intolerance, palpitations, diaphoresis, tremor, hyperdefecation

Females

20
Q

Thyroiditis

another name?

what does it do?

what are the levels of T3/T4 and TSH?

what do you see elevated?

Tmt?

A

Hashimoto

hypothyroidism.. destroys cells of thyroid.

TSH goes up, TH down.

elevated TPO antibody levels

Levothyroxine (TH analogs)

21
Q

Primary Immunodeficiency (1ID)?

1) what is it?
2) strongest predictor?
3) what are kids going to happen?

A

antibody disorders they have an absence or a malfunction of B cells

strongest predictor is family history

recurrent ear infections, sinus infections, pneumonia

if recurrent infections in a single anatomic or present in two or more sites, maybe immunodeficiency

22
Q

abnormal of just one … like IgA, or IgM, or something.. what is it called?

A

type of hypogammaglobulinemia

they’ll have recurrent infections or whatever

23
Q

combination of IgA, IgG or whatever that are low?

A

common variable immunodeficiency

they’ll have recurrent infections or whatever

24
Q

Phagocytic disorders

diagnosed by what age?

what is it associated with?

disease?

A

diagnosed by age 5

infection of umbilical stumps usually

catalase-positive organisms

chronic granulomatous disease

25
Q

HIV?

1) what’s the common symptoms?
2) what does it look like?
3) what is the big thing that you might think it’s mono?

A

presents with transient symptoms of fever, rash, malaise, sore throat

looks like flu (influenza like)

splenomegaly –> even though mono could be possible too.

26
Q

orders for HIV?

A

viral load –> most sensitive and specific (measure HIV DNA and HIV RNA using qPCR)

elisa (antibody response)

P24 antigen