Immunodeficiency Small Group Flashcards
Identify the clinical findings suggestive of antibody deficiency.
recurrent sinopulmonary infections or sepsis, infections with encapsulated organisms, chronic enteroviral meningoencephalitis
Identify the clinical findings suggestive of T cell deficiency.
opportunistic infections, recurrent and severe common infections, failure to thrive
Identify the clinical finds suggestive of complement deficiency.
recurrent disseminated Neisserial infections, autoimmune disease, bacterial sepsis
Identify which patient with frequent infections require immunologic evaluation.
4+ ear infections/ year
2+ serious sinus infections /year
2+ mo on antibiotics with little effect
2+ pneumonias /year
failure of infant to gain weight or grow normally
recurrent deep skin or organ abscesses
persistent thrush in mouth or fungal infection on skin
need for IV abs to clear infections
2+ deep seated infectious including septicemia
a family history of primary immunodeficiency
Identify, evaluate and form a tx. plan for patients with antibody deficiency.
immunoglobulin levels, specific antibody titers, flow cytometry, sweat test for CF, CXR, HIV test
replacement immunoglobulins therapy, care with IgA if patient is deficient (anaphylaxis)
prophylactic abx if not adequately controlled
Identify, evaluate and form a tx. plan for patients with T cell deficiency.
CBC with differential, flow cytometry, T-cell functional study and immunoglobulin level, consider other signs of atopy or distinctive facial features of DiGeorge, look for viral/protozoan signs of illness in sputum or stool
hematopoietic stem cell transplantation
enzyme replacement, gene therapy, avoid live vaccines, irradiate blood cell infusions to prevent WBC-associated graft v. host disease
Identify, evaluate and form a tx. plan for patients with complement deficiency.
CH50 measures entire classical complement cascade, AH50 the alternate pathway, recurrent Neisseria infections suggest terminal complement deficiency, measure C3 and C4 PE is often normal
educate patient to seek medical attention promptly, fever is automatic blood culture and empiric antibiotic treatment, admin meningococcal vaccine, barrier protection for GC STD
Identify, evaluate and form a tx. plan for patients with neutrophil deficiency.
CBC with differential, neutrophil oxidative burst assay, flow cytometry for adhesion molecules, , may have scars due to abscess removal, gingivitis/early tooth loss
tx: prophylaxic antibiotics, drainage of abscesses, treatment of primary problem if possible
Identify, evaluate and form a tx. plan for patients with neutropenia.
blood cultures to rule out bacteremia, spinal tap, CXR, UA, fungal assay to look for signs of infection
pending cultures, start empiric broad spectrum antibmicrobial tx, GCSF will boost neutrophil count and diminish infection risk, care with ACML
