immunology+infectious diseases

Question 1

Anaphylaxis

Adrenaline- Hydrocortisone- Chlorphenamine

< 6 months: – micrograms (0.–ml 1 in 1,000)

– mg – micrograms/kg

6 months - 6 years: – micrograms (0.-ml 1 in 1,000). – mg. – mg

6-12 years: – micrograms (0.-ml 1 in 1,000)

– mg. - mg

Adult and child > 12 years: – micrograms (0.-ml 1 in 1,000). – mg. – mg

Answer 1

Adrenaline- Hydrocortisone- Chlorphenamine

< 6 months: 150 micrograms (0.15ml 1 in 1,000)

25 mg 250micrograms/kg

6 months - 6 years: 0.15 micrograms (0.15ml 1 in 1,000). 50 mg. 2.5 mg

6-12 years: 300 micrograms (0.3ml 1 in 1,000)

100 mg. 5 mg

Adult and child > 12 years: 500 micrograms (0.5ml 1 in 1,000). 200mg. 10 mg

Question 2

Adrenaline

< 6 months- – micrograms (0.–ml 1 in 1,000)

6 months - 6 years- – micrograms (0.–ml 1 in 1,000)

6-12 years- – micrograms (0.-ml 1 in 1,000)

Adult and child > 12 years- – micrograms (0.-ml 1 in 1,000)

Adrenaline can be repeated every - minutes if necessary.

The best site for – injection is the anterolateral aspect of the middle third of the thigh.

Answer 2

Adrenaline

< 6 months-150 micrograms (0.15ml 1 in 1,000)

6 months - 6 years-150 micrograms (0.15ml 1 in 1,000)

6-12 years-300 micrograms (0.3ml 1 in 1,000)

Adult and child > 12 years-500 micrograms (0.5ml 1 in 1,000)

Adrenaline can be repeated every 5 minutes if necessary. The best site for IM injection is the anterolateral aspect of the middle third of the thigh.

Question 3

Radioallergosorbent test (RAST)

Determines the amount of – that reacts specifically with suspected or known allergens, for example – to – protein.

Results are given in grades from - (negative) to - (strongly positive)

Useful for food allergies, inhaled allergens (e.g. Pollen) and wasp/bee venom

Blood tests may be used when skin prick tests are not suitable, for example if there is extensive eczema or if the patient is taking antihistamines

Answer 3

Radioallergosorbent test (RAST)Determines the amount of IgE that reacts specifically with suspected or known allergens, for example IgE to egg protein. Results are given in grades from 0 (negative) to 6 (strongly positive)

Useful for food allergies, inhaled allergens (e.g. Pollen) and wasp/bee venom

Blood tests may be used when skin prick tests are not suitable, for example if there is extensive eczema or if the patient is taking antihistamines

Question 4

Skin patch testing-Useful for –

Around 30-40 allergens are placed on the back. Irritants may also be tested for.

The patches are removed 48 hours later with the results being read by a dermatologist after a further 48 hours

Answer 4

Skin patch testingUseful for contact dermatitis. Around 30-40 allergens are placed on the back. Irritants may also be tested for. The patches are removed 48 hours later with the results being read by a dermatologist after a further 48 hours

Question 5

Anaphylaxis: A child aged 6-11 years should be administered adrenaline at a dose of –micrograms (0.-ml), repeated every - minutes if necessary

Answer 5

Anaphylaxis: A child aged 6-11 years should be administered adrenaline at a dose of 300 micrograms (0.3ml), repeated every 5 minutes if necessary

Question 6

Skin prick test

Most commonly used test as easy to perform and inexpensive.

Drops of diluted allergen are placed on the skin after which the skin is pierced using a needle.

A large number of allergens can be tested in one session.

Normally includes a histamine (positive) and sterile water (negative) control.

A wheal will typically develop if a patient has an allergy. Can be interpreted after 15 minutes

Useful for – allergies and also -

Answer 6

Skin prick testMost commonly used test as easy to perform and inexpensive. Drops of diluted allergen are placed on the skin after which the skin is pierced using a needle. A large number of allergens can be tested in one session. Normally includes a histamine (positive) and sterile water (negative) control. A wheal will typically develop if a patient has an allergy. Can be interpreted after 15 minutes

Useful for food allergies and also pollen

Question 7

Anaphylaxis - adult adrenaline dose = – mcg (0.- ml of 1 in 1,000)

Answer 7

Anaphylaxis - adult adrenaline dose = – mcg (0.- ml of 1 in 1,000)

Question 8

Anaphylaxis - serum – levels rise following an acute episode

Answer 8

Anaphylaxis - serum tryptase levels rise following an acute episode

Question 9

Patients who have had emergency treatment for anaphylaxis should be observed for – hours from the onset of symptoms

Answer 9

Patients who have had emergency treatment for anaphylaxis should be observed for 6–12 hours from the onset of symptoms