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Year 5 - Paediatrics > Paeds IMMUNITY > Flashcards

Paeds IMMUNITY Flashcards

1
Q

What are the general signs and symptoms of T cell defects?

A

Severe viral + fungal infections

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2
Q

What are the general signs and symptoms of B cell defects?

A

Severe bacterial infections

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3
Q

What are the general signs and symptoms of neutrophil defects?

A

Recurrent bacterial infections + invasive fungal infections

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4
Q

What are the general signs and symptoms of NK cell defects?

A

Recurrent viral infections

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5
Q

Give six examples of T cell defects

A

SCID
HIV
Ataxia telangiectasia
DiGeorge syndrome
Wiskott-Aldrick syndrome
Duncan disease

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6
Q

Give four examples of B cell defects

A

Bruton’s agammaglobulinaemia
Common variable ID
Hyper IgM
IgA deficiency

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7
Q

Given an example of a neutrophil defect disease

A

Chronic granulomatous disease

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8
Q

Give two examples of NK defects

A

Classical + functional NK cell deficiency

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9
Q

What are the 2 main signs and symptoms of leukocyte adhesion deficiency?

A

Delayed separation of umbilical cord
Chronic skin ulcers

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10
Q

What are the 2 main signs and symptoms of complement defects?

A

Recurrent bacterial infections (esp. encapsulated bacteria) + SLE-like illness

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11
Q

What is hyper-IgE also known as?

A

Job/Buckley syndrome

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12
Q

What are the signs and symptoms of hyper-IgE?

A

Eczema
Coarse facial features
Recurrent RTIs
Cold abscesses
Candidiasis

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13
Q

What is the pathophysiology (briefly) of ataxia telangiectasia?

A

Defective DNA repair causing T cell defect

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14
Q

What are people with ataxia telangiectasia at increased risk of?

A

Lymphoma

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15
Q

What are the signs and symptoms of ataxia telangiectasia?

A

Cerebellar ataxia
Developmental delay
Telangiectasia in eyes

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16
Q

What is the inheritance pattern of Wiskott-Aldrich syndrome?

A

X-linked

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17
Q

At around what age does Wiskott-Aldrich syndrome present?

A

7 months

18
Q

What are the signs and symptoms of Wiskott-Aldrich syndrome?

A

WATER:
Wiskott-Aldrich
Thrombocytopaenia
Eczema
Recurrent infections

19
Q

How can Wiskott-Aldrich syndrome be differentiated from ITP?

A

WAS presents ~7 months but ITP is more like 4 years

20
Q

What is the cause of eczema in Wiskott-Aldrich syndrome?

A

Raised IgA + IgE

21
Q

What is the cause of recurrent infection in Wiskott-Aldrich syndrome?

A

Low IgG + IgM

22
Q

How is Wiskott-Aldrich syndrome managed?

A

IVIg –> HSCT

23
Q

What is the inheritance pattern of Duncan disease?

A

X-linked

24
Q

What is the pathophysiology of duncan disease?

A

Inability to generate a normal response to EBV

25
Q

What are the signs and symptoms of duncan disease?

A

Death in initial EBV or development of a secondary B cell lymphoma

26
Q

How does a non-IgE mediated allergy present?

A

Erythema
Atopic eczema
GORD
Change in frequency of stools
Blood/mucus in stools
Constipation
Food aversion

27
Q

What should an allergy-focused history contain?

A

Classification (speed, onset, severity, reproducability)

Atopic hx (personal or FH)

Food diary

Details of food avoidance + why

Details of any feeding hx (age of weaning etc)

Cultural/ religious factors

Any previous elimination trials

28
Q

What are the 2 tests that can be done for allergy?

A

Test 1 = skin prick test
Test 2 = measurement of specific IgE antibodies

29
Q

When would you refer to a specialist for allergy?

A

Faltering growth
Severe atopic eczema
Multiple allergies, persisting suspicion, hx of an acute systemic/ severe delayed reaction

30
Q

How should allergy be managed?

A

Specialist care if indicated
Avoid relevant foods
MDT: advice from paediatric dietician to avoid nutritional deficiencies
Teach family + child how to manage allergic attack
Written info + adequate training

31
Q

What are the classifications of allergic rhinitis?

A

Intermittent vs persistent
Mild vs severe
Seasonal vs perennial

32
Q

What other differentials need to be ruled out in suspected allergic rhinitis?

A

Nasal polyps
Deviated nasal septum
Mucosal swelling/ depressed + widened nasal bridge

33
Q

How is occasional symptomatic relief achieved in allergic rhinitis?

A

Any age: intranasal azelastine (antihistamine)
2-5 y/o: oral certirizine

34
Q

How is frequent symptomatic relief achieved in allergic rhinitis?

A

If main issue nasal blockage/ polyps: intranasal beclomethasone

If main issue sneezing/ discharge: intranasal CS or oral antihistamine

35
Q

What is SCIT?

A

Subcutaneous Immunotherapy
Used to administer specific allergen immunotherapy
SC injection on a regular basis for 3-5 years
Can provide protection for any years but has risk of inducing anaphylaxis

36
Q

Who is most likely to develop a cow’s milk protein allergy?

A

Formula-fed children

37
Q

How should cow’s milk protein allergy be investigated?

A

Same as ‘food allergy’

38
Q

How should cow’s milk protein allergy be managed?

A

Trial cow’s milk elimination diet for 2-6 weeks:
In breast-fed babies, mother should exclude cow’s milk protein from her diet
Consider prescribing daily 1g calcium + 10mcg vit D

In formula-fed babies, replace cows milk based formula with hypoallergenic formula

39
Q

What is the most common complication of measles?

A

Acute otitis media

40
Q

Describe the presentation of meconium ileus

A

Large volumes of billious vomiting

Year 5 - Paediatrics (15 decks)

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