Immunology Flashcards
1
Q
What is the DDx for secondary hypogammaglobulinaemia?
A
Drugs: - Corticosteroids - Rituximab, belimumab - Mycophenolate - Azathioprine - Cyclophosphamide - Gold salts - TKIs: imatinib, dasatanib - Anticonvulsants: CARBAMAZEPINE, valproate, phenytoin, lamotrigine - ACEIs, salicylic acid (sporadically described) Nephrotic syndrome, peritoneal dialysis Intestinal diseases (IBD, coeliac disease, intestinal lymphangectasia): test stool A1AT. Severe burns EBV, CMV, rubella Multiple myeloma, CLL Lymphomas: Hodgkin and non-Hodgkin B cell, DLBCL, follicular, mantle cell lymphoma, marginal zone, Burkitt's Good's syndrome (hypogamma + thymoma) Radiotherapy
2
Q
What is the DDx for secondary hypocomplementaemia?
A
Classical pathway: - SLE - Antiphospholipid syndrome - Cryoglobulinaemia - Vasculitis - AIHA Alternative pathway: - Membranoproliferative GN - C3GN, DDD
3
Q
What is required for Dx of AIDS?
A
CD4<200cells/uL OR AIDS-defining illness
4
Q
What are the most common regimes for HIV treatment?
A
2 NRTIs + NNRTI / protease inhibitor / integrase inhibitor
5
Q
Which infections are associated with AIDS?
A
PJP MAC Recurrent bacterial pneumonias Candidiasis of the oesophagus, trachea, bronchi, or lungs Coccidiomycosis Cryptococcus Histoplasmosis CMV HSV - ulcer, oesophagus, bronchi, lungs Cryptosporidium Toxoplasmosis Salmonella septicaemia PML HIV dementia Cerebral lymphoma Kaposi's sarcoma Burkitt's lymphoma NHL
6
Q
What should be covered in a HIV long case?
A
Viral acquisition - MSM/IVDU/transfusion Seroconversion illness symptoms Sexual contacts - male/female/both Sexual activity (receptive vs insertive) Family and work - aware of disease? Constitutional symptoms
7
Q
What are the side effects of NRTIs?
A
Peripheral neuropathy
Pancreatitis
Lipoatrophy
Hepatic steatosis
Tenofovir - renal impairment, OP
Abacavir - SJS/TEN (HLA-B*5701), hyperlipidaemia, CV events
Lamivudine - pancreatitis
Emtricitabine - skin discolouration
8
Q
What are the side effects of INSTIs?
A
Insomnia and dizziness
9
Q
What are the side effects of protease inhibitors?
A
Insulin resistance, hyperglycaemia, DM Lipodystrophy Hepatotoxicity Bleeding in pts with haemophilia PR prolongation
