Unit 11: Allergy and Immune

Question 1

Type 1 hypersensitivity rxn

Answer 1

Interaction between antigen and IgE antibody; cells release histamine, leukotrienes, and prostaglandins
–produces vasodilation and increased capillary permeability
Typically anaphylactic

Question 2

Type 2 hypersensitivity rxn

Answer 2

Cytotoxic reactions; antibody reacts with antigenic component of a cell; activates killer T cells to aid in destruction of antigenic cell
Transfusion reactions

Question 3

Type 3 hypersensitivity rxn

Answer 3

Immune complexes activate complement system–promotes release of polymorphonuclear cells that promote tissue permeability
SLE is example

Question 4

Type 4 hypersensitivity rxn

Answer 4

Delayed hypersensitivity

Allergic dermatitis

Question 5

Cutaneous reaction

Answer 5

Urticuria, pruritus, hives

Secondary to release of histamine–antihistamines are mainstay of treatment

Question 6

First generation antihistamine

Answer 6

Sedating
Diphenhydramine, hydroxyzine, chlorpheniramine
Cross the bbb
Cause anticholinergic effects

Question 7

2nd generation antihistamine

Answer 7

nonsedating

Loratadine + Fexofenadine

Question 8

Anaphylaxis reaction

Answer 8

Angioedema, pruritus, urticaria, N/V, wheezing, smooth muscle contraction, vasodilation
Immediate treatment with epinephrine to increase BP and acts as an antagonist to histamine

Question 9

Allergic rhinitis

Answer 9

Airway allergy due to antigens: pollen, dust mites, mold spores, enzymes, insects, etc.
Mediators released into nasal mucosa causing vasodilation, increased capillary permeability, increased mucous production, and stimulation of nerve endings

Question 10

Intranasal antihistamines

Answer 10

Olopatadine + Azelastine

Question 11

Nasal decongestants

Answer 11

Sympathomimetic amines chemically related to NE

Cause vasoconstriction–relief from nasal congestion

Question 12

Topical intranasal decongestants

Answer 12

Phenylephrine, naphazoline, oxymetazoline, tetrahydrozoline

Rebound phenomenon can occur

Question 13

Intranasal corticosteroids

Answer 13

Beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone
Most effective form of therapy for allergic rhinitis

Question 14

intranasal cromolyn

Answer 14

Mast cell stabilizer preventing antigen induced degranulation, inhibiting release of histamine and other cytokines
Helpful only in preventing nasal symptoms

Question 15

First line therapy for allergic rhinitis

Answer 15

Intranasal corticosteroids

Question 16

Second line therapy for allergic rhinitis

Answer 16

Antihistamines/nasal decongestants

Question 17

AIDS CD4 count

Answer 17

<200

Question 18

Initial symptoms of HIV

Answer 18

Fever, swollen lymph nodes, sore throat, skin rash, muscle soreness, HA, N/V, diarrhea

Question 19

Dx criteria for HIV

Answer 19

Presence of HIV RNA or p24 antigen in plasma or serum

Question 20

Normal CD4 count

Answer 20

500-1600

Question 21

Nucleoside reverse transcriptase inhibitors

Answer 21

Abacavir, didanosine, emtricitabine, lamivudine, stavudine, zidovudine
May cause lactic acidosis

Question 22

Non nucleoside reverse transcriptase inhibitors

Answer 22

Delavirdine, efavirenz, etravirine, nevirapine, rilpivirine

May cause GI distress

Question 23

Protease inhibitors

Answer 23

-avir

Potent virologic efficacy, durable effects, high barriers to resistance

Question 24

Fusion inhibitors

Answer 24

Enfuvirtide only available agent

Question 25

Integrase inhibitors

Answer 25

Dolutegravir, elvitegravir, rategravir

Recommended in combo with dual NRTI

Question 26

Recommended treatment in previously untreated patients

Answer 26

2 NRTI’s + 3rd drug (either protease inhibitor or integrase inhibitor)