Immunology Flashcards
What are the recommended treatments for a high-risk needle stick in a hospital worker?
Antiretroviral therapy with 3 drugs (Tenofovir, Emtricitabine, Raltegravir) for 4 weeks
Tx of oral/esophageal candidiasis?
Fluconazole
Tx of MAC?
Macrolides (Azithromycin or Clarithromycin) with Ethambutol +/- Rifampin
Tx of cryptococcal meningitis?
Amphotericin B IV + Flucytosine
-Then oral Fluconazole
Tx of CMV retinitis?
-Ganciclovir
Multiple ring enhancing lesions on head CT with CD4
Toxoplasmosis
-Tx: pyrimethamine + Sulfadiazine + leucovorin
What are some common symptoms of acute retroviral syndrome?
-fever, myalgia, fatigue, HA
Who gets anti-retrovirals?
Anyone with HIV
Which lab test can be helpful in a suspected acute HIV infection?
Viral load (too soon for Antibodies)
When should prophylactic ABX be given for MAC? What is given?
CD4
What does HAART include?
2 NRTIs and one other (protease inhibitor, integrase inhibitor, NNRTI)
Which antiretroviral class causes lactic acidosis?
NRTI (Abacavir, Zidovudine, Tenofovir)
Which antiretroviral class causes GI intolerance?
Protease inhibitors (-navir’s)
“Navir trust a protease”
Which antiretroviral class causes rash?
NNRTIs (Efairenz, Etravirine)
Which antiretroviral class causes hyperglycemia, DM and lipid abnormalities?
Protease inhibitors
Which antiretroviral causes bone marrow suppression and megaloblastic anemia?
Zidovudine (NRTI)
Which antiretroviral causes potentially fatal hypersensitivity reaction?
Abacavir (NRTI)
Which antiretroviral causes neuropsychiatric symptoms (depression and nightmares)?
Atazanavir (protease inhibitor)
Which antiretroviral is teratogenic?
Efavirenz (NNRTI)
Hypocalcemia and recurrent viral, fungal and protozoal infections? Test to diagnose?
- DiGeorge syndrome (thymic aplasia)
- 90% have 22q11 deletion detectable with FISH
Cause of recurrent candidiasis infections? Tx?
Chronic mucocutaneous candidiasis (T cell dysfunction)
-Tx: Ketoconazole
Chronic diarrhea, recurrent infections (candida, RSV, HSV, measles, flu, parainfluenza, PCP pneumonia) and failure to thrive?
SCID (normally 2/2 an adenosine deaminase deficiency)
Bruton agammaglominemia defect? At risk for?
-tyrosine kinase gene –> low levels of all immunoglobulins-at risk for bacterial infections
Features of ataxia telangiectasia?
ATAXIA Ataxia Telangiectasia Acute leukemia/lyphoma X-ray sensitivity IgA deficiency AFP (inc after 8 months old)
Symptoms of Wiskott-Aldrich syndrome?
WAITER Wiskott Aldrich Immunodeficiency Thrombocytopenia and purpura Eczema Recurrent pyogenic infections
Deficiency in NADPH oxidase? Susceptible to which bugs?
Chronic granulomatous disease
-S. aureus and Aspergillus
Test for chronic granulomatous disease?
-Negative nitroblue tetrazolium (NBT) test (NO yellow to blue-black oxidation)
Tf of chronic granulomatous disease?
PPX Bactrim and Itraconazole
Partial albinism, recurrent respiratory tract and skin infections and neurologic disorders?
Chediak-Higashi syndrome (defective LYST gene –> no enzymes in PMNs)
Eczema, recurrent COLD S. aureus abscesses, coarse facial features (may retain primary teeth)?
Hyper-IgE syndrome (Job syndrome)
What does the rash for contact dermatitis look like? Which hypersensitivity type is this?
- linear
- type IV (delayed)
Which type of hypersensitivity are involved in Multiple sclerosis and hashimotos thyroiditis?
Type IV
Transplant rejection within the initial 24 hours?
due to anti-donor antibodies. Poor donor matching
Transplant rejection 6 days to 1 year after surgery? What is it caused by?
- acute rejection
- anti-donor T call proliferation
- Immunosuppression can reverse this
Rejection >1 year after transplant?
Chronic rejection
Which medication should NOT be given with Azathioprine? Why?
Allopurinol
-Azathioprine is metabolized by xanthine oxidase
What is a SE of Hydroxychloroquine? When is this used?
- Visual disturbances.
- Used in RA, SLE and in transplant patients
Tx of Graft-versus-Host disease?
Steroids
Tacrolimus
Mycophenolate
SE of mycophenylate?
- leukemia and lymphoma.
- Teratogen
