Rheumatology and Immunology Flashcards
What is an example of a tumor necrosis factor alpha inhibitor medication?
Infliximab
What are two defining qualities of juvenile idiopathic arthritis?
Persistence of arthritis for greater than 6 weeks and being less than 16 years of age
Just read
Tea lymphocytes bind with antigen triggering response which causes release of humoral mediators including cytokines and b cell production. Antibodies block binding of antigens to cellular receptors and neutralize microbes and microbial toxins
What kinds of primary immunodeficiencies require PJP prophylaxis?
Combined and phagocytic
What are four immunosorologies that can be present in lupus?
Positive double-stranded DNA antibodies, positive anti-smith antibodies, positive antiphospholipid antibodies, positive ANA
How does a humoral primary immunodeficiency present?
Sino pulmonary or GI infections, otitis media, cellulitis, meningitis or osteomyelitis
How many characteristics need to be present for a 100% sensitivity and specificity of childhood lupus?
For criteria
What makes up our adoptive or humoral immunity?
Lymphocytes which are our t cells, b cells and our NK cells
What organisms are most often responsible for infections related to primary humoral immunodeficiencies?
Encapsulated bacteria such as hemophilus influenza b, pneumococci, streptococci or parasites
What symptoms are associated with neonatal SLE?
Heart block, rash, thrombocytopenia, abnormal LFTs, coomb’s positive hemolytic anemia
What are the diagnostic criteria of Kawasaki disease?
Fever for 5 days as well as 4 to 5 of the following criteria: conjunctivitis, red lips and tongue, rash, cervical lymphadenopathy, swelling redness on palms of hands and or souls of feet
What organisms are most often responsible for the infections related to combined primary immunodeficiencies?
Fungal, viral, myobacterium
Is Kawasaki more common in males or females?
Nails
What is the primary treatment for acute Kawasaki disease?
I v i g 2 g per kg
What symptoms are required to qualify as anaphylaxis after a known exposure?
Two of the following: skin or mucosal tissue involvement, respiratory compromise, reduced BP, persistent GI symptoms
X-linked a gamma globulinemia common variable immunodeficiency, transient hypogamaglobulinemia of infancy are all what types of primary immunodeficiency?
Humoral
What are the seven subtypes of JIA?
Oligoarticular, polyarticular RF negative, polyarticular RF positive, systemic, entesitis related, related arthritis, psoriatic arthritis, undifferentiated
What is the time frame for HIV presentation?
Within 10 weeks of infection
What are the three phases and length of phases of Kawasaki disease?
Cute 14 days, subcute 2 to 4 weeks, convalescence months to years
What kind of primary immunodeficiencies will likely need a bone marrow transplant?
Cellular and combined
What immune organs need to be evaluated when looking at primary immunodeficiencies?
Tonsils, spleen, lymph nodes
What are three localized growth abnormalities associated with JIA?
Accelerated growth at ossification center causing a longer affected limb. Premature epiphyseal fusion causing a short limb, temporomandibular joint causing micrognathia
What cells make up our innate immunity?
Neutrophils, monocytes, macrophages, natural killer cells
What test screens for HIV and what test is diagnostic for HIV?
The ELISA screens, and the western blot assay diagnosis
How do older children with HIV present?
Acute viral and syndrome, fever, fatigue, myalgias, arthrologist, lymphadenopathy, oral ulcers
How do combined primary immune deficiencies present?
Fair to thrive, respiratory or gastrointestinal infections, candidal skin infections
22Q 11.2 deletion is what type of primary immunodeficiency?
Cellular
What is the most common age range for Kawasaki disease?
Less than 5 years of age
What needs to be avoided in primary deficiencies?
Live virus vaccines
What is the principal treatment for HIV?
Highly active antiviral therapy
What lab findings are found in Kawasaki disease?
Elevated ESR, elevated CRP, elevated platelets, leukocytosis, hypoalbuminemia, anemia
Is lupus more common in males or females?
Females
What lab finding suggests an increased risk for uveitis?
Positive ANA
How do phagocytic primary immunodeficiencies present?
Severe skin and visceral infections caused by bacteria or funguses
What’s abnormality is found on an echo in a patient with Kawasaki disease?
Coronary artery dilation, stenosis, or aneurysms
How do infants with HIV present?
Viral infections, growth retardation, skin rash, lymphadenopathy
What is a chronic non-granulomatous inflammation of the anterior chamber of the eye?
Uveitis
What type of immunodeficiency results from a genetic disorder that affects components of the innate and adaptive immune systems?
Primary immunodeficiencies
What are some common presentations of lupus at diagnosis?
Fever lymphadenopathy weight loss ulcers arthritis
What defines AIDS?
CD4 t cell count of less than 200
How frequently do you monitor viral levels? When well
6 to 12 months
What is the aspirin dosing for Kawasaki disease?
80 to 100 mg per kilogram per day weaned once a fever to 3 to 5 mg per kg per day
What is a disease modifying anti-romatic drug?
Methotrexate
What characteristic is present in 95% of patients with lupus?
A malar rash
SCID, with Scott Eldridge syndrome are what kind of primary immunodeficiency?
Combined antibody and cellular
