Infections in Immunocompromised

Question 1

Opportunistic infections

Answer 1

An infection caused by a microorganism that generally does not cause disease, but does so when lowered resistance is caused by impairment of the body’s immune system.

Pneumocystis
Cryptococcus
Fungal infections

KNOW THESE THREE Pneumoc, cryptoc, fungo

Question 2

Characteristics of primary immunodeficiencies *

Answer 2

• Often begin in the first days to weeks of life
• Therapeutic response often slow
• Therapy often leads to suppression and not eradication
• Common organisms cause severe manifestation or recurrent infection
• Unusual opportunistic organisms cause infection
• Growth delayed
• multiple infections simultaneously

Question 3

Within the phagocyte abnormalities category, what is the syndrome which is defined by an absence of neutrophils

Answer 3

Kostmann’s syndrome

Question 4

What is cyclic neutropenia

Answer 4

phagocyte populations wax and wane

Question 5

Phagocyte abnormalities such as Kostmann’s syndrome and/or cyclic neutropenia are characterized by what

Answer 5

Recurrent bacterial infections and aspergillus infections.

Makes sense

Question 6

Defects in phagocyte function

Answer 6

• Defective intracellular bacterial killing

- Defective trafficking and adhesion

Question 7

Complement deficiency C1-C4 leads to

Answer 7

recurrent bacterial infections and autoimmune

Question 8

Terminal complement deficiency leads to

Answer 8

Neisseria Sp infection

Question 9

Management of complement deficiencies

Answer 9

immunizations and prophylactic antibiotics

Question 10

x linked agammaglobulinemia due to deficiency in

Answer 10

bruton tyrosine kinase

Question 11

common variable immunodeficiency presents when

Answer 11

age 2-20, typically in early teens, due to variable genetic defects

Question 12

Most common imunodeficiency

Answer 12

IgA

Question 13

clinical manifestations of immunoglobulin deficiencies

Answer 13

• recurrent bacterial and viral infections (especially encapsulated organisms like strep pneumo and H flu)
• recurrent sinopulmonary infections or otitis
• Giardiasis
• Some may be associated with autoimmune disorders or increased risk of malignancy

Question 14

Management of IgG deficiency

Answer 14

replace it

Question 15

Lymphocytic disorders can represent

Answer 15

Abnormal antigen processing or presentation to T cells
Defects in T cells
Defects in cytokine production or responsiveness

Question 16

Lymphocytic disorders are generally inherited as autosomal recessive or x-linked

Answer 16

ok…know

Question 17

Severe combined immunodeficiency

Answer 17

No T cells and Poor B cell function

Question 18

Di George syndrome

Answer 18

Thymic hypoplasia, hypoparathyroidism, hypocalcemia, heart disease

May develop autoimmune later in life

Question 19

Wiscott- Aldrich

Answer 19

thrombocytopenia, severe eczema, treateed with stem cell

High risk of malignancy

Question 20

Categories of Primary Immunodeficiencies

Answer 20

• Innate immunity
  includes phagocyte number and function as well as complement
• B cell leading to dysfunction in Ig production
• T cell

Question 21

Phagocyte deficiencies leave pts susceptible to

Answer 21

Catalase positive bacteria/fungi

Question 22

Complement deficiencies leave pts susceptible to

Answer 22

Neisseria

Question 23

Antibody deficiency leaves pts susceptoble to

Answer 23

organisms with polysaccharide capsules

Question 24

Cellular and combined immunodefiiency leaves ppl at risk for

Answer 24

opportunistics, fungi, viruses

Question 25

splenectomy and sickle cell watch out for

Answer 25

Sepsis with encapsulated bacteria like strep pneumo and H flu

Question 26

Pregnancy

Answer 26

UTI, Hep E, H1N1 assoc with increased morbidity and mortality

Question 27

Chemo

Answer 27

• Risk of infection proportional to degree and duration of chemo
• Watch for bacterial and candidal sepsis
• Aspergillosis
• pneumocystis pneumonia
• Disseminated Varicella