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Allergy, immunology, infection > Allergy > Flashcards

Flashcards in Allergy Deck (37):
1

Anaphylaxis, type and etiology?

Type 1
IgE to mast cells
Degranulation
Vasodilation

2

Anaphylaxis, presentation

Low BP
Fast or slow HR
Hives, prurits
angiodema
headache, vomiting
diarrhea, SOB, cough

3

Autoimmune hemolytic anemia, type and etiology?

Type 2, cytotoxic
IgG bind to RBCs, leading to premature destruction,
-1/2 cases idiopathic

4

Autoimmune hemolyic anemia, presentation?

Symptoms - non specific, may have general symptoms of anemia -fatigue etc.
-jaundice or splenomegaly
-reticulocytes in peripheral blood smear

5

Poststreptococcal glomerulonephritis, type and etiology?

Type 3, Immune complex mediated
-prior infection of beta hemolytic strep
-immune complexes form and get stuck in glomeruli

6

Contact Dermatitis, type?

Type 4, Delayed Hype reaction

7

PSGN background info?

History of pharyngitis summer
-or impetigo in winter

8

Contact dermatitis, etiology?

Phase 1- sensitization
Phase 2- Allergic response after preexposure.
May take months or years to see response

9

Contact dermatitis, symtoms?

Primary= intense pruritis
Pain with excoriation, risk of secondary infection
-transient erythema, vesiculation, swelling with bullae

10

Serum sickness, type and etiology?

Type 3, ICF
admin of nonhuman protein leads to AB response
- ICF deposits in small vessels/tissues = vasculitis and tissue injury
Ex. antitoxins and antivenims

11

Vasculitis, type and etiology?

Type 3, ICF
Immune complexes get stuck in vessel walls.

12

Three types of vasculitis?

Small- Henochschonlein purpurn

Medium - Kawasaki disease

Large vessel - Giant cell(temporal) arteritis

13

Symptoms of vasculitis?

Regardless of size, systemic inflammation:
-fever, night sweats
-fatigue, anorexia, weight loss
-arthralgias, arthritis

SMall= thick palpable purpura

14

Transplant rejection, type and etiology?

Type 4, delayed
Graft destruction caused by T cell-mediated to allograft histocompatibility antignes

15

Transplant rejection, symptoms

Broad: fevers, chills, malaise, arthralgias

16

Anaphylaxis vs. anaphylactoid?

Anaphylaxis = IgE dependent

Anaphylactoid = IgE independent
-no sensitization required
-can occur on first exposure
-not predicted by skin test

17

Urticaria

Hives
Swelling of upper dermis
rasied blebs (wheals) with circuscribed edges (red halo)
Itching (pruritis)

18

Angioedema -acquired

swelling of the deep dermis
characterized by pain or burning not pruritus
-typically affects the face

19

Angioedema - hereditary

deficiency of complement inhibitors
leads to recurrent potentially life threatening attacks facial, laryngeal and GI swelling

20

Urticaria and angiodema pathphys, and Treatment?

-Type 1 hypersensitivity, degranulation of mast cells
Histamine binds to H1 and H2, causing aterial dilation, venous constriction, increased capillary permeability

Treatment: ovar H1 antihistamine

21

Atopic diseases

-allergic rhinitis
- atopic dermatitis
- allergic asthma
- allergic gastroenteropathy

22

Food allergy vs. food intolerance?

allergy = specific immune response
-potentially life threatening
intolerance = associated with digestion
- not life threatening

23

Most common food allergies?

IgE associated:
- milk, eggs, peanut, soy, wheat, tree nuts, fish, shellfish
-asthma and urticaria not likely to be caused by food allergies

24

exanthematous/
morbilliform

Etiology: commonly penicillin family

S&S: "rash all over," widespread symmetric, erythematous macules and papules on the trunk and extremities, pruritus, mild, fever
-First exposure rash after 7-10 days
Most common of all cutaneous drug eruptions (90%)

-Stop medication, resolves a few days to a week after the medication is stopped, can continue medication if not too severe and meds can't be substituted, resolves without sequelae

-Treat: topical steriods and oral antihistamines

25

Fixed Drug Eruption Etiology

commonly:
phenolphthalein
tetracyclines
metronidazole
sulfonamides
NSAIDS
salicylates

26

Fixed drug eruption S&S

erythematous patch with central bulla, same location with re-exposure
-often affects acral areas
-30 min to 8hrs from exposure
-healed lesions dark brown or purple

27

Fixed drug eruption Diag work up and management

stop meds, should resolve days to weeks
-non eroded lesions can use topical steriod
- eroded lesions can use antimicrobial ointment
- if widespread and generalized refer to derm

28

Drug related eosinophilia w/ systemic symptoms
DIHS or DRESS
Etiology

Etiology:
Sulfa drugs
penicilin
minocycline,
metronidzole
isoniazid
phenytoin
diclocfenac
meloxicam
abacavir

29

Drug related eosinophilia w/ systemic S&S and PE findings
DIHS or DRESS

Fever, malaise, start typically 3rd wk, (1-12wks)

Patient is sick looking with rash!

Facial edema, diffuse erythematous macules and plaques, Trunk and extremities.
Organ involvement

CBC, LFT, BUN, creatinine
Elevated WBC, AST, Atypical lymphocytes

consult derm and stop meds
if not severe can use topical steroids and systemic antihistamines

30

Steven-Johnson syndrome
Toxic Epidermal necrolysis etiology

Sulfa antibotics, sulfasalazine
Allopurinol
Tetracyclines, Thiacetrazone
Anticonvulsants (carbamezapine, phenbarbital, phentoin, lamotrigine
NSAIDS, Nevirapine

31

Steven-Johnson syndrome
Toxic Epidermal necrolysis S&S

Painful sloughing rash. Flaccid blisters that spread with pressure. 8 weeks after exposure.
- Fever, headaches, malaise before lesions 1-3 days preceding lesions

-Initial lesions irregular red to purpuric macules.
Could have mucous membrane involvement

-Erythematous erosions, open skin, begin as flaccid blisters
-if 30% BSA = toxic epidermal necrolysis

-punch tissue biopsy, if 25-30% BSA = burn unit

-discontinue all non life sustaining meds. If skin is dusky gray , necrosis is likely

32

Manifestations of IgE: eyes

Swelling of conjunctiva

33

Manifestations of IgE: skin

Uriticaria (hives)
Pruritis (itching)
flushing

34

Manifestations of IgE: Respiratory tract

SOB
wheezes/stridor
hoarseness
pain with swallowing
cough

35

Manifestations of IgE: Heart

fast or slow HR
Low BP

36

Manifestations of IgE: GI tract

crampy/ abdominal pain
diarrhea
vomiting
rhinorrhea
swelling of lips and tongue and throat
pelvic pain
loss of bladder control

37

Manifestations of IgE: Neuro

lightheadedness
loss of consciousness
confusion
headache
anxiety