HDM/MCM topics Flashcards
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?
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
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?
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
Type 2 Cytotoxic Hypersensitivity Reaction?
antibody mediated cytotoxic reaction that involves complement activation!!
ABO mismatch (wrong type of blood)
Newborn Rh hemolytic disease
Myasthenia Gravis
Graves Disease
Arthus Reaction?
also called what?
what kind of hypersensitivity?
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
Type 3 hypersensitivity reactions?
what do you see in the vignette?
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
serum sickness?
rattlesnake bites
Type 4 reaction examples?
poison ivy, ppd skin test
poison ivy is composed of what type of lesion?
linear vesicular lesions
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?
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
first line agent of RA?
why do we want to treat RA right away?
methotrexate
the longer that you have RA before you’re treated, the worse your prognosis is.
Juvenile RA?
**what’s important to note about this?
painless joint involvement
so swollen joint that isn’t painful, it’s just swollen. not red or hot.
can present with a limp too.
primary morbidity associated with juvenile RA?
**where do you send them if you find this?
inflammatory eye disease
you need to have them checked by an ophthalmologist
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
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
Lupus.. first line of treatment?
what tests would you see done for lupus?
Hydroxychloroquine (Plaquinal) –> first line of treatment
ANA, anti-dsDNA
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?
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
types of psoriasis to know?
what is most common?
plaque psoriasis –> on elbow and behind ears
nail psoriasis –> lines due to anxiety or pinning.
plaque
treatment for psoriasis?
topical corticosteroids, vitamin D analogs, Tazorac
Graves Disease
what happens
what are the levels of T3/T4 and TSH
hyperthyroidism
Thyroid stimulating antibodies activate the receptors to increase synthesis
T3/T4 goes up, TSH down.
most common symptoms of Graves?
sex?
heat intolerance, palpitations, diaphoresis, tremor, hyperdefecation
Females
Thyroiditis
another name?
what does it do?
what are the levels of T3/T4 and TSH?
what do you see elevated?
Tmt?
Hashimoto
hypothyroidism.. destroys cells of thyroid.
TSH goes up, TH down.
elevated TPO antibody levels
Levothyroxine (TH analogs)
Primary Immunodeficiency (1ID)?
1) what is it?
2) strongest predictor?
3) what are kids going to happen?
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
abnormal of just one … like IgA, or IgM, or something.. what is it called?
type of hypogammaglobulinemia
they’ll have recurrent infections or whatever
combination of IgA, IgG or whatever that are low?
common variable immunodeficiency
they’ll have recurrent infections or whatever
Phagocytic disorders
diagnosed by what age?
what is it associated with?
disease?
diagnosed by age 5
infection of umbilical stumps usually
catalase-positive organisms
chronic granulomatous disease
