Immune Flashcards
What is the percentage of people with asthma who have allergic rhinitis?
80%
What are the immuno pathologic phases of allergic rhinitis?
The early phase,, sensitizing phase and the late phase
Mention some chemicals released mast cells during the early phase of allergic coronitis
Histamine
Tryptase
PGD2
Cytokines
Leukotrienes
The antigen presenting cells presents the Ag to TH0 on?
MHC II
TH2 in sensitizing phase secretes?
IL 4/13 to Bcells
IL 5/ 3 to esosino
IL3 / 4 baso
CD4+ and CD25+
Th2
Th1 and Th2 communicate thru what factor
IFN-gama
Which cells are responsible for the late phase reaction of allergic rhinitis
Eosinophils and basophils
Th2 stimulates?
B cells
Esinophils
Basophils
Mast cell
What are the acute symptoms of allergic rhinitis?
Rhinorrhea, sneezing and nasal congestion
Histamine is released from
Mast cells and basophils
How does gender affect asthma and allergic rhinitis predisposition
Male risk factor in children
Female risk factor in adults
Total serum IgE and esinophil
Neither sensitive nor specific for allergic rhinitis
FEV1 increase more than…… after administering a bronchodilator in asthmatics
12% (200ml)
Classification of bronchial asthma is based on
- Allergic or non-allergic.
- Frequency of symptoms and FEV1
Differential diagnosis of asthma
- COPD
- Cardiac.
- Airway of obstruction (tumor?)
- Drug induced (ACE-I)
- Vocal cord dysfunction.
- Pulmonary infiltration with esosinophil
After the age of 65 most people with obstructive airway disease will have …. And ….
Asthma and COPD
Reliever asthma medication’s
Rapid acting inhaled B2 agonist
Systemic glucocorticoids
Anticholinergics
Theophylline
Short acting oral B2 agonist
Medications that work both as reliever and controller of asthma
Systemic steroids and theophylline
Beclometasone dipropionate for asthma ttt
Inhaled steroid
Low: 200-500
Medium: >500-1000
High: >1000
What do you give? Patient transferred to acute care facility in an asthma life-threatening exacerbation while waiting
SABA
Ipratropium
Oxygen
Sys steroid
Mild to moderate asthma exacerbation is assessed as?
Patient talks in phrases
prefers sitting
not agitated
respiratory rate increase but less than 30 pulse rate between 100-120
oxygen saturation is 90 to 95%
PEF is more than 50%
Mild to moderate acute asthma attack managed by?
SABA 4-10puffs/20min for 1hr
Prednisolone 40-50mg in adults
Control oxygen as target is 93-95%
Note: prednisolone to be continued after discharge for 5-7 days to prevent late reaction
Anaphylaxis ttt
- Epi 1:1000 IM
Adult dose: 0.01ml/kg (0.3-1ml) every 5 to 15 min as needed - Oxygen 8-10L/min (lower dose in copd)
- H1 antagonist
- IV fluids and colloid for hypotension
- Hydrocortisone 250-500mg IV, if mild case give oral prednisolone 20mg
- B2 nebulizer for bronchospasm
