Infection, Immunology and Allergy Flashcards
Who should receive prophylaxis for meningococcal disease?
Other household contacts only
Which condition is characterised by a triad of hepatosplenomegaly, lymphadenopathy and erythroderma in the presence of raised IgE or peripheral eosinophil count?
Omenn Syndrome (an autosomal recessive form of severe combined immunodeficiency)
What is the treatment for Chediak-Higashi syndrome?
Ascorbic Acid
Chediak-Higashi syndrome is characterised by …
Increased susceptibility to infection
A mild bleeding diathesis
Partial oculocutaneous albinism
Progressive peripheral neuropathy
A tendency to develop a life-threatening lymphoma syndrome
Four days of prodromal illness with conjunctivitis and Koplik spots is pathognomonic of what?
Measles
Toxic shock syndrome is caused by which organisms?
Staph Aureus
Strep. pyogenes
Describe the features of possible underlying HIV infection in children?
Failure to thrive
Generalised lymphadenopathy
Hepatosplenomegaly
Parotid gland enlargement
Persistent oral candidiasis
Chronic candida nappy rash
Recurrent otitis media
Chronic dermatitis
Chronic diarrhoea
Treatment of Pneumocystis Carinii Pneumonia?
Cotrimoxazole (21 days high dose)
Broad Spectrum Antibiotics (Cefuroxime)
Anti-TB medications
Rash spreading from the face down to the rest of the body?
Measles
Recurrent infections, consanguineous marriage and albinism
Chediak-Higashi Syndrome
Name two live vaccinations?
BCG
MMR
Which groups of individuals are live vaccines contraindicated in?
Immunocompromised patients
Those on immunosuppressants
Those using corticosteroids
Which vaccination is contraindicated in a patient with previous anaphylaxis to eggs?
Tick-borne encephalitis
Yellow Fever
Investigation for C.difficile?
Toxin detection in stool sample
Mild intestinal symptoms and microcytic anaemia?
D. Latum
Hepatomegaly and microcytic anaemia with bloody diarrhoea?
Ameobic Abscess
Water foul smelling diarrhoea?
Giardia
Slapped cheek disease is caused by ??
Parvovirus B19
Which antibiotics treat mycoplasma pneumonia?
Erythromycin
Clarithromycin
Opportunistic infections in patients with HIV?
Cytomegalovirus Retinitis
Pneumocystis Pneumonia
Disseminated Mycobacterium Avium Complex
Oesophageal Candidiasis
Cryptococcal Meningitis
Chronic Cryptosporidium Enteritis
Causes of an absent thymus on CXR?
DiGeorge Syndrome (low calcium)
Severe Combined Immunodeficiency (normal calcium)
Ataxia Telangiectasia (normal calcium)
Treatment of severe campylobacter jejuni?
Normally conservative management however if severe it should be treated with AZITHROMYCIN
What is the treatment of Shigella?
Ciprofloxacin
What is the antibiotic treatment of Giardia?
Metronidazole
Greyish deposit on oropharynx/ pseudomembrane?
Diptheria
Management of Diptheria?
Antitoxin
Penicillin
Preparation for Intubation
Aplastic crisis in sickle cell disease is caused by?
Parvovirus B19
Treatment of Anaphylaxis is with?
1:1000 Adrenaline IM
What is the gold standard for diagnosis of malaria?
Thick and thin blood film
What do phagocyte function disorders typically present with?
Recurrent oral and cutaneous infection
Lymphadenitis
Chronic cough
Poor wound healing
Prolonged infections with poor response to abc
Presents with recurrent deep seated infections such as lymphadenitis or abscesses?
Chronic granulomatous disease
Which condition causes delayed separation of the umbilical cord?
Leucocyte Adhesion Deficiency (LAD-1)
Pharmacological management of PCP?
Co-Trimoxazole
Causative organism of Croup?
Parainfluenza
Causative organism of Slapped cheek/ erythema infectiosum?
Parvovirus B19
Causative organism of Scarlet Fever?
Group A strep
Lyme disease rash?
Erythema Migrans (bulls eye lesion)
Very high temperature, diarrhoea and macular rash?
Salmonella
Delayed separation of the umbilical cord after birth/
Leucocyte-Adhesion Defect
Coxsackie virus is an example of what type of virus?
Enterovirus
Outline the Gell and Coombs classification of hypersensitivity?
Type 1 - anaphylaxis
Type 2 - Cell mediated
Type 3 - Immune mediated
Type 4 - Delayed hypersensitivity
Type 5 - Autoantibodies that bind to the cell surface receptors (MG and Graves disease)
Outline the primary immunodeficiencies with eczema?
Wiskott Aldrich syndrome - immunodeficiency, thrombocytopenia and eczema
Hyper IgE syndrome - skeletal abnormalities
Chronic granulomatous disease - multiple, multisystemic granulomatous lesions
Omenn syndrome - diarrhoea, hepatosplenomegaly, hypereosinophilia, erythroderma > eczema
What is Bartonella Henselae a cause of?
Cat scratch disease
What is Borrelia burgdorferi the causative organism of?
Lyme disease
What is a Ghon complex indicative of?
TB
What are the cells of adaptive immunity?
Helper T cells
B cells
Plasma cells
Cytotoxic T cells
Which cells are responsible for antibody production?
B cells
What is the shape of e.coli?
Gram negative rods (catalase positive, oxidase negative)
What are the contraindications to MMR vaccination?
Severe immunosuppression
Allergy to neomycin
Children who have received another live vaccine by injection within 4 weeks
Pregnancy should be avoided for at least 1 month following vaccination
Immunoglobulin therapy within the past 3 months (there may be no immune response to the measles vaccine if antibodies are present)
What is the Hutchinson triad - diagnostic criteria of syphilis?
Interstitial keratitis
Hutchinson incisors
8th cranial nerve deafness
What is the structure of streptococcus pneumonia?
Gram positive cocci in chains
What are neutrophil polymorphs an indication of?
Acute inflammation
What are granulomas an indication of?
Chronic inflammation
Vaccination schedule in premature children?
Should be done according to their chronological age
What are the characteristic features of congenital rubella?
Sensorineural deafness
Congenital cataracts
Describe the steps of acute inflammation?
Vasoconstriction
Vasodilation
Increased permeability of vessels
Stasis of red blood cells
Neutrophil margination
RNA is transcribed from DNA by which enzyme?
RNA polymerases
What is the exclusion period for hand, foot and mouth disease?
NO exclusion is needed
Describe a WCC?
Lymphocytes - viral in nature
Neutrophils - bacterial in nature
Eosinophils - fungal in nature
Monocytes - protozoan in nature
Blood film post-splenectomy?
Howell-jolly bodies
Heinz bodies
Poikilocytes (target cells)
Pappenheimer bodies
Erythrocyte containing siderotic granules
Erythema ….?
Erythema migrans- Lyme disease
Erythema multiforme- Herpes simplex, mycoplasma
Erythema marginatum- Rheumatic fever
Erythema nodosum- Crohns disease, streptococcal
Can cause hydros fetalis if contracted during pregnancy?
Parvovirus B19
What are the risk factors for developing active TB?
silicosis
chronic renal failure
HIV positive
solid organ transplantation with immunosuppression
intravenous drug use
haematological malignancy
anti-TNF treatment
previous gastrectomy
Which infection can cause spontaneous splenic rupture?
EBV
What are the most common complications of mumps?
Orchitis (1 in 5)
Pancreatitis (1 in 10)
Which cell types make up the innate immune system?
Neutrophils
Basophils
Mast cells
Eosinophils
Monocytes
Macrophages
Natural killer cells
Dendritic cells
At what level does the spina cord end?
L1/L2
What are the contraindication to the rotavirus vaccination?
Hypersensitivity
Severe combined immunodeficiency disease
Intusseception
What is the risk period for chickenpox at delivery?
The risk period for neonates is those whose mother developed chickenpox within 5 days before or 2 days after delivery
Where are histamine receptors found?
CNS tissue, smooth muscle and endothelium
Parietal cells in the stomach
Central and peripheral nervous tissue
Basophils
Drug causes of hepatic granulomas?
Allopurinol
Sulphonamides
