Hypersensitivity Disorders Flashcards
Food-Dependent, Exercise-Induced Anaphylaxis (FDEIA)
This occurs only when the patient exercises within 2 - 4 hours of ingesting food, but in the absence of exercise, the patient can ingest the food without any apparent reaction. This disorder appears to be more common in females than males, with the highest prevalence in the late teens to mid-30s.
Paper wasp nest
Carba mix
The common source of exposure is rubber accelerators
Difference between scleritis vs. episcleritis
Scleritis is differentiated from Episcleritis by symptoms of severe pain ( often described as deep and boring). Additionally, all redness of episcleral origin will blanch within 20 minutes of application of a single drop of 10% phenylephrine. 40% of patients with Scleritis also have a systemic disease like RA.
Key Fact: The mainstay of treatment for all types of Scleritis has typically been oral nonsteroidal agents, oral steroids, or oral immunosuppressive agents. Steroid eye drops are considered to be infective.
Which immunoregulatory abnormality is present in AD?
Increased expression of CD23 on B cells and monocytes.
What immunopathologic abnormality is seen in AD?
Keratinocyte apoptosis causes acantholysis and spongiosis.
Airway smooth muscle:
Contraction
Histamine, cys-LT, kinin, prostanoid, endothelin
p-Phenylenediamine
Permanent hair dye, henna
What is the only member of the lipocalin class that is a food allergen is the cow’s milk protein?
Bos d 5
(Cow’s milk Bos d 4 - 8)
Yellowjacket nest
Which medication that can be used as an alternative therapy in antihistamine refractory chronic urticarial is preferred in urticarial vasculitis, delayed pressure urticarial, and angioedema?
Dapsone
There is limited evidence on the use of dapsone in chronic urticaria, especially in neutrophilic urticarial. Dapsone is preferred in the treatment of urticarial vasculitis, delayed pressure urticarial, and angioedema. Patients on dapsone should be monitored for anemia, neuropathy, and methemoglobinemia.
Unlike in irritant contact dermatitis, the borders of the lesions in allergic contact dermatitis are _________ defined. In ACD, additional lesions __________ appear on other parts of the body that have not come into contact with the allergen.
Poorly; can
“Wet work”
2 hrs/day, or use occlusive gloves longer than 2 hrs/day, or clean the hands very often (eg 20 times/day or less if cleaning procedure is aggressive)
Which cytokines are secreted less by Th1 cells in AD?
IFN-gamma
LTPs
Removal of outer layers by physical or chemical peeling leads to loss of LTPs located in the outer layer. Thus, peeling fruits makes them safe for consumption by certain individuals with LTP allergies.
Preparation of pasteurized, ultrahigh temperature treated fruit juices is NOT sufficient to make them safe for individuals with LTP fruit allergies as the fruit LTPs retain a native-like structure.
Lifetime therapy with venom immunotherapy
- Honeybee allergy
- Life-threatening reaction
- Significant systemic reaction from sting or IT
- Increased baseline tryptase
Which pathogen is most often associated with AD?
HAE with normal C1 INH
- It is more likely to affect females
- It is less likely to manifest before puberty
- Patients tend to have fewer attacks, with more attack-free intervals
- The distribution of attacks includes a higher percentage of facial and tongue episodes, a lower percentage of abdominal episodes, and fewer multiorgan attacks.
White-faced Hornet
Yellowjacket
Steroid Potency
Age-appropriate indications when treating pediatric patients:
- Fluticasone 0.05% cream, up to 28 days of in children age > 3months
- Fluticasone lotion in children age > 12 months
- Mometasone ointment in children > 24 months.
Loss-of-function mutations in FLG are strongly associated with a risk of ______ when
occurring with atopic dermatitis.
asthma
CIU nonresponders
CIU nonresponder basophils do not degranulate to ex vivo IgE receptor activation and have elevated levels of IgE receptor regulating inhibitor phosphatases, SHIP-1 and SHIP-2.
Sweat bee
What is the lifetime prevalence of atopic dermatitis in U.S. schoolchildren?
17%
Paper wasp
The highest incidence of asthma at a given age has been observed in children with the onset of AD before?
3 months