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micro/immuno? wrap up > infections in immunocompromised > Flashcards

infections in immunocompromised Flashcards

1
Q

identify 3 immunocompromised infections?

A

Pneumocystis jirovecii
Cryptococcus neoformans
Fungal infections other than tinea and thrush

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2
Q

Absence of neutrophils (

A

Kostmann’s, congenital neutropenia)

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3
Q

immunocompromised often infected with?

A

Characterized by recurrent bacterial infections and Aspergillus infection

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4
Q

defects in phagocyte function:

often infected with 3 bugs here:

A

Characterized by recurrent bacterial infections (especially S. aureus and other catalase positives), Aspergillus, and Candida sp. Infections

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5
Q

missing C5-C9 what are you going to be infected with?

A

neisseria

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6
Q

x-linked agammaglobulinemia- due to defect in what?

A

X-linked agammaglobulinemia – due to defect in Bruton tyrosine kinase

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7
Q

when does CVID present?

A

Common variable immunodeficiency – presents age 2 to 20, typically early teens, due to various genetic defects; may have autoimmune disorders

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8
Q

what is the most common immunodeficiency?

A

IgA deficiency – most common immunodeficiency

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9
Q

all manifesations of:

Clinical manifestations
Recurrent bacterial (especially encapsulated organisms like S. pneumoniae, H. influenzae) and viral infections
Recurrent sinopulmonary infections or otitis
Giardiasis
Some may be associated with autoimmune disorders or increased risk of malignancy

A

immunoglobulin deficiencies

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10
Q

what is defect in SCID?

how do you tx?

A

absence of T cells; impacts B cell function and B cells may also have functional deficiencies
Treated with stem cell transplantation

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11
Q

what is DiGeorge?

A

Congenital thymic hypoplasia, heart disease, hypoparathyroidism, neonatal hypocalcemia
May develop autoimmune disorders in later life

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12
Q

what is the disorder in Wiscott-Aldridge syndrome?

TIE

A

X-linked: in WAS gene on X-chromosome–>T cells unable to reorganize actin cytoskeleton

Thrombocytopenia, severe eczema
Treated with stem cell transplantation
High risk to develop malignancies (especially lymphoma)

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13
Q

phagocyte deficiencies: which organisms

you need PLACESS for you cats.

A

Catalase positive bacteria and fungi

S. aureus, Nocardia species, P. aeruginosa, Serratia species, enteric gram-negative bacilli, Candida species, Aspergillus species

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14
Q

complement deficiencies:

which organsism?

A

Neisseria infections

S. pneumoniae, H. influenzae, Neisseria species

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15
Q 
Antibody deficiencies
 (B cell) which organsisms?

SHiN

SKiS

A

Organisms with polysaccharide capsules

Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, Mycoplasma species, Salmonella species, Shigella species, Campylobacter species, rotavirus, enteroviruses, Giardia species

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16
Q

which organisms commonly infect?

Cellular and combined immuno-deficiencies

A

Opportunistic infections, fungi, viruses

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17
Q

what are 3 aquired immunodeficiencies?

A

Chemotherapy
Bone marrow and solid organ transplant
Immunosuppressive therapies

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18
Q

Splenectomy and Sickle Cell Disease

increased risk for which two organsims?

A

Increased risk for sepsis with encapsulated bacteria, especially S. pneumoniae and H. influenzae type b

Antibiotic prophylaxis and empiric therapy indicated

19
Q

3 diseases of pregnancy?

A

UTIs
Hepatitis E: 15 -25% mortality
H1N1 influenza associated with increased morbidity and mortality

20
Q

chemotherapy-induced neutropenia/immunodeficiency

what are the clinical manifestations? (4 bugs here)

A

clinical manifesations

Bacterial and candidal sepsis
Aspergillosis
Pneumocystic pneumonia
Disseminated varicella

21
Q

3 ways to manage chemotherapy induced neutropenia/immunodeficiency?

A

Prophylaxis – bacterial and fungal, based on risk assessment for type of underlying malignancy

Aggressive use of empiric antimicrobial therapy at first sign of infection

G-CSF

22
Q

which procedure brings these about?

Risk of neutropenia plus profound lymphocytic dysfunction plus, in some patients, graft-versus-host
Pattern of infection varies with the length of time from transplant

A

Bone Marrow and Solid Organ Transplantation

23
Q

child w/albinism +

a phagocyte functional disorder characterized by large leukocyte granules

A

Chediak-Higashi syndrome

24
Q

what type of disorder is chronic mucocutaneous candidiasis?

A

T-cell disorder

25
Q

in myeloperoxidase deficiency, which bug commonly afflicts patient?

A

candida

26
Q

in complement deficiency, what do ppl with C1-C4 suffer from?

A

recurrent bacterial infections, autoimmune disorders

27
Q

how do you manage complement deficiency pts?

A

immunizations + prohylactic antibiotics if needed

28
Q

immunoglobulin deficiencies:

  1. which infections?
  2. are they at increased risk for cancer/ autoimmune disorder?
  3. how do you dx?

how do you manage?

A
  1. recurrent bacerial infection ( S. pneumo + H. influenza) + viral infections , recurrent sinopulmonary infections or otitis, giradiasis
  2. yes, at increased risk for autoimmune disorders or increased risk for malignancy
  3. dx: quantitaive immunoglobulin measurement
  4. IgG replacement if deficient (do NOT use in IgA defiinecy), give prophylacit Abx.
29
Q

what is SCID and how do you tx?

A

SCID = absece of T cells; impacts B cell function and B cells may also have functional deficiencies

tx: stem cell transplantation

30
Q

what is DiGeorge?

what may these kids develop later in life?

A

-congenital thymic hypoplasia, heart disease, hypoparathyroidism, neonatal hypocalcemia

may develop autoimmune disorders later in life

31
Q

what do kids with wiscott-aldridge syndrome present with?

how do you tx?

what are they at risk of developing?

A
  1. TIE: thrombocytopenia, eczema, infections
  2. tx w/stem cell transplantation
  3. high risk to develop malingancies (esp. lymphoma)
32
Q

what are kids with lymphocytic disorders at risk for? (3)

A
  1. opportunistic infections (pneumocystis pneumonia; fungal infections, protozoa; disseminated viral)
  2. recurrent bacterial infection:
  3. increased risk for malignancy
33
Q

KNOW: kid with phagocyte def at risk for??

A

catalase + and bacteria and fungi

34
Q

kids with complement deficiencies at risk for?

A

neiserria infections

35
Q

kids with antibody deficiencies (B cell)

A

organisms with polysaccharide capsule

36
Q

cellular and combined immuno deficiencies at risk for?

A

opportunistic infections, fungi, viral infections

37
Q

what are the five indications for immmune evaluation?

A
  1. opportunistic infection
  2. recurrent infection other than URIs in the young child at a day care center
  3. failure to thrive
  4. persistent infection despite therapy
  5. hx of recurrent infections w/a defined cause is more meaningful than a hx of frequent, self-limiting infections of presumed viral cause
38
Q

what are the three evaluations for possible immunodef:

1

A
  1. history
  2. CBC, differential and platelet count (neutropenia and thrombocytopenia)
  3. Hgb electrophoresis (sickle cell disease), HIV, serology/PCR, sweat test (cystic fibrosis)
  4. addl testing based on prelim ddx
39
Q

what is basic work up of possible immunodef

A

genomic analysis (for 120+ genes_

40
Q

2 bugs with big impact on ppl w/splenectomy and sickle cell disease

A

sespis w/encapuslaed bacteria esp: s. pneumo and H. influenza type B

antibiotic prophylaxis and empiric therapy indicated

41
Q

3 infections with pregnancys

A

UTIs

hepatitis E: 15-25% mortality

H1N1 influenza associated with increased morbidity and mortality

42
Q

what is the risk of infection proprotional to in ppl w/chemo induced neutropenia?

A

proportional to degree and duration of neutropenia

43
Q

t/f. in ppl wht chemo induced neutropenia, lymphocytic dysfunction is present and may also manifest as infection

A

true

44
Q

what are 4 bugs that affect ppl with chemo induced neutropenia/immunodef

A

bacteria and candidal sespis

aspergillosis

pneuomycsitc pneumonia

disseminated varicella

micro/immuno? wrap up (14 decks)

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