MTB - Allergology/Immunology Flashcards
initial therapy - anaphylaxis
- subcutaneous Epi. 1:1000 conc
- corticosteroids
- H1-antagonist antihistamines (diphenhydramine or hydroxyzine)
sudden swelling of the face, palate, tongue and airway in assoc. w/ minor trauma to the face or hands OR ingestion of ACE inhibitors
angioedema
hereditary angioedema
C1 esterase inhibitor deficiency
assoc. symptoms with angioedema
stridor
abdominal pain
lack of response to steroids
diagnosis of angioedema
low levels of C2 and C4 complement
Tx. of acute episodes of angioedema
infusion of FFP
DOC for hereditary angioedema
ecallantide
Ecallantide
inhibitor of kallikrein; blocks bradykinin production
what drug class may be used for chronic therapy of angioedema
androgens - danazol, stanazol
- raise levels of C1 esterase inhibitor
CCS - patient comes in with signs of anaphylaxis after insect bite w/ no improvement after Epi injection, steroids or H1 blockers - > what do you do?
admit patient to ICU
when desensitizing a patient to a drug what other drugs should be stopped?
propranolol and all B-Blockers should be stopped prior to attempting desensitization (in case Epi needs to be used)
Symptoms of Allergic Rhinitis
recurrent episodes of nasal itching nasal stuffiness rhinorrhea paroxysms of sneezing eye itching dermatitis wheezing
DOC allergic rhinitis
intranasal steroids
- single most effective tx
Aside from intranasal steroids, what other therapies may be used for allergic rhinitis?
antihistamines (oral, intranasal) cromolyn ipratroprium bromide LT inhibitors nasal saline spray and wash
older man presents with recurrent episodes of sinopulmonary infections and a sprue-like abdominal disorder; he has enlarged LN and splenomegaly - dx?
Common variable immune deficiency
diagnostic testing - CVID
low levels of total IgG
B and T cells are present but do not make enough antibody
Tx. CVID
infusion of IV immunoglobulins
young male child presents with recurrent sinopulmonary infections - dx?
X-linked agammaglobulinemia
- no B cells = no Ig
- LN, adenoids and spleen are diminished or absent
MC primary immunodeficiency
IgA deficiency
CF: IgA deficiency
mostly asx recurrent sinopulmonary infections sprue-like malabsorption increased incidence of atopic conditions anaphylaxis w/ blood products
Tx. IgA deficiency
tx. infections as they arise
IVIG will not work as there is little IgA in it
patient comes in w/ recurrent skin infections caused by Staphylococcus
hyper IgE syndrome
Tx. hyper IgE syndrome
tx. infections as they arise
