Immunology

Question 1

What is FPIES?

Answer 1

Food Protein Induced Enterocolitis Syndrome
NOT an IgE mediated response
-2 hrs post food ->vomit profusely, may have some diarrhoea
-triggered by rice, cow’s milk, soy -> Avoid

Question 2

Foods commonly causing IgE mediated reactions

Answer 2

cow's milk 
egg
soybean
wheat
fish 
shellfish
peanut 
tree nuts 

(any fruit with high protein content can be allergenic)

Question 3

Antibiotic Allergy:

Penicillin allergy with a positive skin prick test

Answer 3

Likely High risk of immediate reaction

Question 4

Antibiotic Allergy:

Is the maculopapular rash of EBV IgE mediated?

Answer 4

NO, mechanism is not known

Question 5

Cefalcor
Serum Sickness
1. What is it?
2. Can it be given again post serum sickness?

Answer 5

1. Metabolism of cefaclor resulting in protein derivative which produces immunogenic complexes

Question 6

Penicillin allergy and cross reactivity with;

1. Cephalosporins
2. Monobactams

Answer 6

1. Cross reactivity is low (3-7% may be allergic to cephalosporins aswell)
2. Monobactams: safe for penicillin allergic patients

Question 7

Immunodeficiency

1. Warning of immunodeficiency
2. Screening investigations

Answer 7

1. See notes
2. FBC and Film, IgA and IgG and IgM levels

Lymphopenia and reduced Ig’s require further investigation