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Immune Flashcards

1
Q

What is the percentage of people with asthma who have allergic rhinitis?

A

80%

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2
Q

What are the immuno pathologic phases of allergic rhinitis?

A

The early phase,, sensitizing phase and the late phase

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3
Q

Mention some chemicals released mast cells during the early phase of allergic coronitis

A

Histamine
Tryptase
PGD2
Cytokines
Leukotrienes

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4
Q

The antigen presenting cells presents the Ag to TH0 on?

A

MHC II

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5
Q

TH2 in sensitizing phase secretes?

A

IL 4/13 to Bcells
IL 5/ 3 to esosino
IL3 / 4 baso

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6
Q

CD4+ and CD25+

A

Th2

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7
Q

Th1 and Th2 communicate thru what factor

A

IFN-gama

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8
Q

Which cells are responsible for the late phase reaction of allergic rhinitis

A

Eosinophils and basophils

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9
Q

Th2 stimulates?

A

B cells
Esinophils
Basophils
Mast cell

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10
Q

What are the acute symptoms of allergic rhinitis?

A

Rhinorrhea, sneezing and nasal congestion

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11
Q

Histamine is released from

A

Mast cells and basophils

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12
Q

How does gender affect asthma and allergic rhinitis predisposition

A

Male risk factor in children
Female risk factor in adults

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13
Q

Total serum IgE and esinophil

A

Neither sensitive nor specific for allergic rhinitis

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14
Q

FEV1 increase more than…… after administering a bronchodilator in asthmatics

A

12% (200ml)

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15
Q

Classification of bronchial asthma is based on

A
  1. Allergic or non-allergic.
  2. Frequency of symptoms and FEV1
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16
Q

Differential diagnosis of asthma

A
  1. COPD
  2. Cardiac.
  3. Airway of obstruction (tumor?)
  4. Drug induced (ACE-I)
  5. Vocal cord dysfunction.
  6. Pulmonary infiltration with esosinophil
17
Q

After the age of 65 most people with obstructive airway disease will have …. And ….

A

Asthma and COPD

18
Q

Reliever asthma medication’s

A

Rapid acting inhaled B2 agonist
Systemic glucocorticoids
Anticholinergics
Theophylline
Short acting oral B2 agonist

19
Q

Medications that work both as reliever and controller of asthma

A

Systemic steroids and theophylline

20
Q

Beclometasone dipropionate for asthma ttt

A

Inhaled steroid
Low: 200-500
Medium: >500-1000
High: >1000

21
Q

What do you give? Patient transferred to acute care facility in an asthma life-threatening exacerbation while waiting

A

SABA
Ipratropium
Oxygen
Sys steroid

22
Q

Mild to moderate asthma exacerbation is assessed as?

A

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%

23
Q

Mild to moderate acute asthma attack managed by?

A

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

24
Q

Anaphylaxis ttt

A
  1. Epi 1:1000 IM
    Adult dose: 0.01ml/kg (0.3-1ml) every 5 to 15 min as needed
  2. Oxygen 8-10L/min (lower dose in copd)
  3. H1 antagonist
  4. IV fluids and colloid for hypotension
  5. Hydrocortisone 250-500mg IV, if mild case give oral prednisolone 20mg
  6. B2 nebulizer for bronchospasm
25
Q

Non sedative H1 antihistamine examples

A

Cetirizine
Loratadine
Desloratadine
Fexofenadine

26
Q

Adjust dose in …… when giving sec generation H1 antihistamine

A

Renal or hepatic insufficiency

27
Q

H2 antihistamine examples

A

Cimetidine
Ranitidine
Famotidine

28
Q

Side effects of first generation antihistamine

A

Sedation and anti-cholinergic symp

29
Q

Omalizumab

A

Recombinant anti-IgE: decr release of inflammatory mediators

30
Q

Most recognized vasoactive mediators in urticaria-angioedema syndrome are

A

Histamine and bradykinin

31
Q

Mast cell mediated VS bradykinin mediated angioedema

A
  1. With wheals , allergic reactiom
  2. Without wheal, ACE-I induced ( non-hereditary ) or C1 inhibitor def (hereditary)
32
Q

Types of C1INH

A

Type 1 low level enzyme
Type 2 low function enzyme

33
Q

Icatibant

A

Bradykinin B2 receptor antagonist
In hereditary angioedema

34
Q

Ecallantide

A

Kallikrein inhibitor (hereditary angioedema ttt)

35
Q

Danazol

A

Androgenic steroid
Increas liver production of C1INH
Ttt of hereditary angioedema

IM Flashcards (5 decks)

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