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DIT Level 2 > Immuno quick associations > Flashcards

Immuno quick associations Flashcards

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1
Q

Grandual onset of nonproductive cough, dyspnea on exertion (significant desat), fever
CXR: B/L central infiltrates
Elevated LDH
CD4 less than 200

A

Pneumocystis jirovecii pneumonia (PCP)

Tx:
TMP-SMX (bactrim) or IV pentamidine if sulfa allergy
Add prednisone if pO2 less than 70 or A-a 35 or more

ppx: TMP-SMX or pentamidine

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2
Q

Pain with swallowing
Endoscopy - pseudohyphae
CD4 less than 200

A

Candida esophagits

Tx: PO or IV fluconazole, nystatin swish and swallow, oral amphotericin

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3
Q

Cough, night sweats, weight loss +/- bloody sputum
CXR: cavitary lesions
CD4 less than 200

A

TB

Treat: RIPE
PPD positive at 5 mm induration

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4
Q

Headache, confusion, fever, focal neurological symptoms, seizures
CT/MRI: multiple ring enhancing lesions
CD4 less than 100

A

Reactivation of Toxoplasmosis

Tx: pyrimethamine + sulfadiazine + leucovorin
OR Pyrimethamine + clindamycin

ppx: TMP-SMX or primaquine

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5
Q

fatigue, wt loss, fever, diarrhea, abd pain, HSM

CD 4 less than 50

A

Mycobacterium avium intracellulare complex (MAC)

Tx: MACrolides - clarithromycin or azithromycin with ethambutol +/- rifabutin

ppx: azithromycin or clarithromycin weekly dose

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6
Q

Headache, mental status changes
LP: elevated pressure, large encapsulated yeast on india ink stain
CD 4 less than 50

A

Cryptococcal meningitis (Cryptococcus neoformans)

Tx: IV amphotericin B + flucytosine -> oral fluconazole

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7
Q

yellow retinal lesions with hemorrhage with rapid vision loss
And/Or
painful ulcers in esophagus/intestines
CD 4 less than 50

A

CMV

Tx: ganciclovir or valganciclovir
fosgarnet has some activity

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8
Q

Prolonged diarrhea, malaise, wt loss, abd pain
O&P in stool
HIV positive patient

A

Parasitic disease:

Giardia lamblia - metronidazole
Cystoisospora belli - TMP-SMX
Cryptosporidium spp. - Nitazoxanide

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9
Q

Cough, fever, dyspnea
CXR: b/l reticulonodular infiltrates or diffuse infiltrates
Blacks: disseminated dz -> meninges, skin, LN involvement
CD4 less than 250

A

Coccidiodomycosis (Coccidiodes immitis)

Tx: fluconazole or amphotericin B

ppx: can use fluconazole, but HAART regimen more effective

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10
Q

Fever, wt loss, fatigue, abd pain, GI bleeding, skin lesions, dyspnea, meningitis, adrenal insufficiency
CXR: b/l infiltrates
Urine/serum antigen tests +
CD4 less than 150

A

Histoplasmosis (Histoplasma capsulatum)

Tx: amphotericin B or itraconazole

Ppx: itraconazole

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11
Q

Progressive CNS demyelination
PCR on CSF positive for JC Virus
CD4 less than 100

A

Progressive multifocal leukoencephalopathy (PML)

Tx: HAART

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12
Q

Vascular tumors on skin and internal organs (lungs -> hemoptysis)
CD4 less than 250

A

Kaposi’s sarcoma

HHV 8

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13
Q

Abnormal pap smear

CD4 less than 200

A

Cervical cancer

HPV

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14
Q

Headache, confusion, focal neurological symptoms
MRI: ring enhancing lesion
CD4 less than 100

A

Non-Hodgkin lymphoma - primary CNS lymphoma

some associated with EBV

Tx: chemo

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15
Q

weight loss >10% from baseline, chronic diarrhea, weakness, fever
CD4 less than 100

A

Wasting syndrome

Tx: HAART, improved nutrition
Appetite stimulants - megesterol

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16
Q

Intelectual decline, ataxia, apathy

CD4 less than 200

A

AIDS dementia

Tx: HAART

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17
Q

ART class causes lactic acidosis

A

NRTI

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18
Q

ART class causes GI intolerance

A

Protease inhibitors

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19
Q

ART class causes rash

A

NNRTIs

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20
Q

ART class causing hyperglycemia, DM, lipid abnormalities

A

Protease inhibitors

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21
Q

ART drug causing bone marrow suppression with megaloblastic anemia

A

zidovudine

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22
Q

ART drug potentially fatal hypersensitivity reaction

A

abacavir

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23
Q

ART drug with neuropsychiatric sxs - depression and vivid nightmares

A

efavirenz

24
Q

ART drug causing hyperbilirubinemia, jaundice

A

atazanavir

25
Q

ART drug that is teratogenic

A

efavirenz

26
Q

ART drug that inhibits CYP450

A

ritonavir - boost mechanism

27
Q

ART drug that can cause kidney injury and bone loss

A

Tenofovir

28
Q

Congenital heart defect + low calcium + recurrent infections

A

Digeorge syndrome - thymic aplasia

29
Q

Chronic mucocutaneous candidiasis + chronic diarrhea + failure to thrive

A

SCID

30
Q

Negative nitroblue tetrazolium test

A

Chronic granulomatous disease

31
Q

Poor smooth pursuit of eyes + elevated AFP after 8 months

A

Ataxia telangectasia

32
Q

Partial albinism + recurrent URIs + neurological disorders

A

Chediak-HIgashi syndrome

33
Q

Hypersensitivity reaction associated with IgE binding Ag, mast cell degranulation -> histamine and bradykinin release -> vasodilation, increased vascular permeability

A

Type 1

Tx:
Antihistamines
Leukotriene inhibitors
Bronchodilators
Glucocorticoids
34
Q

Hypersensitivity reaction associated with antibodies binding to cellular surface antigens -> activation of compliment, macrophages, and NK cells

A

Type 2

Tx:
Antiinflammatories
Immunosuppressants
Plasmaphoresis

35
Q

Hypersensitivity reaction associated with antibodies binding soluble antigens -> immune complexes deposited in tissues -> activation of complement

A

Type 3

Tx: anti-inflammatories

36
Q

Hypersensitivity reaction associated with T cells binding antigens -> IL2 and IFNy activate macrophages -> tissue damage

A

Type 4 - “delayed”

Tx:
Glucocorticoids - topical or systemic
Anti-inflammatories

37
Q

Hypersensitivity reaction associated with allergic rhinitis, urtricaria, asthma, angioedema, anaphylaxis

A

Type 1

Tx:
Antihistamines
Leukotriene inhibitors
Bronchodilators
Glucocorticoids
38
Q

Hypersensitivity reaction associated with SLE, RA, polyarteritis nodosa, poststreptococcal GN, serum sickness

A

Type 3

Tx: anti-inflammatories

39
Q

Hypersensitivity reaction associated with autoimmune disorders without deposition of immune complexes such as:

Autoimmune hemolytic anemia
Hemolytic disease of the newborn
ITP
Acute rheumatic fever
Goodpasture syndrome
Bullous pemphigoid
Pemphigus vulgaris
Graves disease
Myasthenia gravis
A

Type 2

Tx:
Antiinflammatories
Immunosuppressants
Plasmapheresis

40
Q 
Hypersensitivity reaction associated with:
Chronic transplant rejection
Graft-vs-host disease
MS
Hashimoto thyroiditis
PPD tests
Contact dermatitis associated with poison oak/ivy
latex
A

Type 4 - “delayed”

Tx:
Glucocorticoids - topical or systemic
Anti-inflammatories

41
Q

transplant rejection occurs within initial 24 hours, anti-donor antibodies, untreatable
Caused by poor organ matching

A

Hyperacute transplant rejection

42
Q

Transplant rejection occurs 6 days to 1 yr after transplant, anti-donor T cell proliferation, reversible through immunosuppression

A

Acute transplant rejection - Type 4 HSR

43
Q

Transplant rejection occurs more than 1 year after transplant due to fibrosis and hyalinization of blood vessels, immunosuppression may delay it

A

Chronic transplant rejection

44
Q

Adult with frequent bronchitis, pneumonia, sinusitis, otitis media with giardiasis or spruelike intestinal malabsorption. Labs: Ig levels decreased, decreased response to antigen stimulation by B cells

A

Combined Variable Immunodeficiency

Tx: Abx for infections
Maintenance - regular infusion of IVIG

Risk: pernicious anemia, seronegative arthritis

45
Q

Young boy with decreased or absent tonsils, adenoids, lymphnodes, spleen. Increased sinopulmonary infections. Normal T cell count

A

X linked (Bruton) Agammaglobulinemia

Tx: regular IVIG

46
Q

Recurrent sinupulmonary infection beginning at 6 mo, PCP, varicella, candida infections in young child.

A

SCIDs

Tx: treat infections as they arise
Definitive Tx: Bone marrow transplant

47
Q

Recurrent sinopulmonary infections, atopic diseases, sprue-like condition with fat malabsorption

A

IgA deficiency
Risk anaphylaxis with blood transfusions

Risk: vitiligo, thryroiditis, RA

48
Q

Recurrent skin infections with Staph - cold abscesses

A

Hyper IgE Syndrome

Tx: dicloxacillin or cephalexin
ppx abx

49
Q

Immunodeficiency - T cells low + thrombocytopenia and eczema

A

Wiskott-Aldrich Syndrome

Tx: Bone marrow transplant

50
Q

Lymph nodes with purulent material leaking out, aphthous ulcers, inflammation of nares. Granulomas may become obstructive in the GI or urinary tract. Odd combination of infections with: Staph, Burkholderia, Nocardia, Aspergillus

Lab: nitroblue tetrazolium or dihydrorhodamine testing abnormal

A

Chronic Granulomatous Disease

51
Q

Low B cell, normal T cells in adults

A

CVID

52
Q

Low B cells, normal T cells in young male children

A

X linked (Bruton) agammaglobulinemia

53
Q

Low B cells and T cells, AIDS defining illness in young child

A

SCID

54
Q

atopic disorders, celiac disease, anaphylaxis with blood transfusion

A

IgA deficiency

55
Q

Cold abscess in skin - staph

A

Hyper IgE syndrome

56
Q

Normal T cells and B cells, low platelets, eczema

A

Wiskott-Aldrich Sn

57
Q

LN with purulent material leaking from them - Staph, Burkholderia, Nocardia, Aspergillus

A

Chronic Granulomatous Disease

DIT Level 2 (49 decks)

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