Allergy and Immune Flashcards
(452 cards)
1
Q
Up to which number of URIs/year in child consider common, normal healthy and not need for advanced investigation?
A
5-6
Unlucky»_space; 11-12 URIs/year
After 1 year the number decrease as Eustachian tube become tilting instead of it’s streaten.
2
Q
Otitis media complicates URIs IN —- % of cases.
A
30-50%
3
Q
When to suscpect immunedificiency baby for further investigation?
Red flags for immunodeficiency.
A
- Positive family history.
- Failure to thrive.
- Increasing frequency and severity of infections as children become older.
- Recurrent serious infections.
- Otitis media (>8episodes/year)
or complecated by mastoiditis. - Pneumonia (>1 episode/year).
- Enteric infections.
- Unusual sites of infection.
- opportunistic infections.
- Persistent Thrush in a child >1 year of age.
4
Q
Common types of primary immunodeficiency include _____ and _____ disorders.
A
T-cell, B-cell.
5
Q
T-cell generate in ____ and activate in ____ and differentiate into : ___,___
A
Bone marrow, Thymus and differentiate into T helper, T cytotoxic.
6
Q
Maturation of B-cell done by ____ and give ____.
A
CD4+T cell ( T-Helper), plasma cell.
Done in lymphatic tissue espicially ( Tonsils ).
7
Q
Function of T-cytotoxic cell in immunity is:
A
- Destroy virus-infected cells and tumor cells.
- Transplant rejection.
8
Q
Function of T-helper cell is :
A
Maturation of B-cell into plasma cell (giving immunoglubulins) which responsible of opsonization or coating.
Immunoglubuline is Antigen presenting cell.
9
Q
Which type of T-cell is responsible for maturation of B-cell.
A
CD4 T-helper cell.
10
Q
Enumerate possible types of immunoglubulins.
A
IgM, IgA, IgG, IgE, IgD.
MAGED (ماجد)
11
Q
Defect in which type of immunity presented at birth ?
A
cell-mediated immunity.
T-cell defects.
As it is not transmitted from mother to baby.
12
Q
At which time defects in humeral immunity become noticed?
A
present at 6 m of age or older.
Before that :Mother dependent immunity
13
Q
Defects in T-cells may include:
A
- Viral infections.
- Fungal infections.
- Mycobacteria PCP (PJP).
14
Q
Bacterial infections and protozoal infections is commonly affect ____ immunity.
A
Humeral
B-cell immunity.
15
Q
Which type of immunity cells is the 1st line defense against Enterovirus?
A
B-cells.
Humeral immunity.
Like bacterial and protozoal infections.
16
Q
True or False: Primary immunodeficiency is present at birth.
A
True
17
Q
Severe combined immunodeficiency (SCID) defined as:
A
Absence of all immune function, cell-mediated and humoral.
18
Q
Possible genetic mutations in Severe combined immunodeficiency (SCID).
A
- X-linked.
- AR.
- Sporadic.
19
Q
Autosomal recessive SCID is defeciency in which enzyme?
A
Adenosine Deaminase
Defeciency» build toxic metabolites.
20
Q
Enumerate possible keys to diagnose Severe combined immunodeficiency (SCID).
A
- +ve family history.
- Present before 3 months of age.
- Recuurent infection (Pneumonia).
- Failure to thrive.
- Chronic diarrhea.
- Dermatitis.
- No tonsils, lymph nodes, or adenids.
- Very small thymus.
21
Q
Which is the most diagnostic features of SCID that diffrentiate it from other immune defeciency babies?
A
- Usually presents before 3 months of age and die by 2 years.
- Small thymus with abcent tonsils.
- Abcent antibodies so there is no antibody response to vaccination.
- Sever lymphopenia from birth.
- Sever decrease or abcent immunoglubulins.
22
Q
Which is the recommended treatment for SCID ?
A
Stem cell (BM) transplant.
23
Q
Discribe etiology of X-linked Agammaglobulinemia.
X-linked» Boys
A» no (Abcence)
gammaglobulinemia» Ig (B-cell)
A
Defect in B lymphocyte development due to Bruton tyrosine kinase mutation
Almost No circulating B cell.
24
Q
When Agammaglobulinemia start to noticed?
A
at 6-9 months old
when maternal circulating antibodies disappear.
25
Which types of infection mainly affect XLA ?
1. Bacteria.
2. Protozoa (Giardia).
3. Enrterovirus.
## Footnote
(B-cell defect )
26
Give one precaution in XLA baby.
AVOID LIVE VACCINES.
27
Work up for XLA, and it’s finding?
Blood tests, mainly Flow cytometry>> No antibodies.
28
Best treatment for XLA
IVIG or SQIG.
29
Which type of immune defeciency disorders in chilren could come with RA, vitiligo and AIHA ?
## Footnote
Old child (rare before age of 6).
Common variable immunoglubulin defeciency (CVID).
30
Dose CVID disease have risk of malignency?
yes, **Lymphoma**
31
Differentiate between CVID and XLA in etiology.
XLA almost no circulating B cell due to Bruton tyrosine kinase mutation, but CVID has low antibodies and low level of most or all Ig classs due to lack of b lymphocytes or plasma cells.
32
Clinically, how to differentiate between XLA and CVID?
* XLA present after 6 m of life while CVID in adolescence.
* Work-up of XLA shows abcent antibodies, while CVID shows low antibodies (variable levels).
* Patent with XLA has no tonsils, but CVID has normal to large tonsils.
33
Best treatment for XLA and CVID is:---- ,while SCID is ----
IVIG or SQIG, BMT.
34
The most common immunodefeciency in pediatric is:
Selective IgA defeciency
| Undetectable serum IgA
35
Enumerate possible clinical presentation for IgAD.
90% of cases are a symptomatic.
Various GI infections with viruses and bacteria.
Recurrent sinopulmonary infection.
36
Most common presentation of IgAD is:
Recurrent sinopulmonary infection.
37
How to diagnose and treat IgAD?
Flow cytometry showes very low or abcent IgA.
Treatment is **supportivre by antibiotics*
38
Which type of immunodefeciency patient should avoid Ig as a treatment and why?
in IgAD should avoid IVIG and IgA containing materials (blood, plasma), as they have high risk of anaphylaxis.
39
Enumerate most common clinical features of Job Syndrome.
| Job Syndrome = Hyper-IgE Syndrome.
1. Recurrent skin infection ( abscesses).
2. Coarse facial features.
3. Eczematous dermatitis.
4. Recurrent pneumonia with pneumatocele.
40
Most common organism could cause HIES is:
Staphylococcus aureus.
41
How to diagnose and treat HIES?
Elevated serum IgE levels.
Treatment:
1. Prophylactic antimicrobial againist s. aureus and candida.
2. Eczematous dermatitis requires rigorous topical therapy with steroids and a moisturizing cream.
42
Which is the mechanism of HIES?
Damage to netrophil chemotaxis
43
Expect the disease:
Immune defect, X-linked, +ve EBV IgM antibodies serology with genetic background.
Duncan’s Disease.
| = X-linked lymphoproliferative syndrome.
44
Clinical features of Duncan’s disease?
1. Fulminant infectious mononucleosis.
2. Hemophagocytic lymphohistiocytosis.
3. Lymphoma.
4. Hypogammaglobulinemia.
| HLH
45
Associated complication with XLP:
1. Massive hepatic necrosis.
2. Hepatic encephalopathy.
3. coma and death.
46
Best treatment for XLP is:
Allogenic stem cell transplant.
47
What is the genetic background of Wiskott-Aldrich Syndrome.
X-linked Recessive (Xp11.22-23).
48
Enumerate common presentation of Wiskott-Aldrich Syndrome.
1. Bloody diarrhea.
2. Prolonged bleeding after circumcision.
3. Atopic dermatitis.
4. Infection with encapsulated organisms.
5. Death usually by 6-11 years.
49
Triad of Wiskott-Aldrich Syndrome is:
WATER
* W: Wiskott.
* A: Aldrich.
* T: Thrombocytopenia.
* E: Eczema.
* R: Recurrent infection.
50
Both Wiskott-Aldrich syndrome and ITP have thrombocytopenia, how to differentiate?
In ITP, platelet is large.
51
How to diagnose Wiskott-Aldrich syndrome?
1. Decrease T cell number and function.
2. Low IgM.
3. prenatal CVS, Amniocentesis
52
Wiskott-Aldrich syndrome increase risk of malignency, which kind of malignency?
Lymphoma and leukemia.
53
How to treat Wiskott-Aldrich syndrome?
1. Skin care.
2. IVIG and/or corticosteriods (thrombocytopenia).
3. Platelet transfusion (bleeding).
4. Spleenectomy.
5. Stem cell or bone marrow transplants.
## Footnote
Definit treatment is : Stem cell or bone marrow transplants.
54
Why DiGeorge Syndrome considered as immunodefecient disease?
It is a failure of the 3rd and 4th pharyngeal pouch that cause T cell defeciency ( lack of thymus).
## Footnote
due to 22q11 microdeletion
55
Other abnormalities assoscited with DiGeorge syndrom rather immunodefetiency?
Hypocalcemia ( lack of parathyroid).
Heart and great vessels abnormalities (VSD,TOF).
Abnormal facial features.
56
Multiple Choice: Which of the following is NOT a symptom of immunodeficiency? A) Frequent infections B) Slow growth C) High energy levels D) Autoimmune disorders
C) High energy levels
57
True or False: Children with immunodeficiency can receive live vaccines.
False
58
What is the role of immunoglobulins in the immune system?
Immunoglobulins are antibodies that help identify and neutralize pathogens.
59
What is the importance of early diagnosis of immunodeficiency in children?
Early diagnosis is crucial for timely treatment and prevention of serious infections.
60
Multiple Choice: Which of the following is a common sign of immunodeficiency? A) Chronic fatigue B) Sudden weight gain C) Skin rash D) Increased appetite
A) Chronic fatigue
61
What is the difference between primary and secondary immunodeficiency?
Primary immunodeficiency is genetic and present at birth, while secondary immunodeficiency is acquired due to external factors.
62
True or False: Immunodeficiency disorders can only affect children.
False
63
What is a bone marrow transplant used for in immunodeficiency treatment?
To replace damaged or non-functioning bone marrow that produces immune cells.
64
Fill in the blank: Regular __________ can help monitor children with immunodeficiency.
health check-ups
65
What is the significance of family history in assessing immunodeficiency?
Family history can indicate a genetic predisposition to primary immunodeficiency disorders.
66
Multiple Choice: Which condition is associated with an increased risk of infections in children? A) Asthma B) Immunodeficiency C) Diabetes D) Healthy diet
B) Immunodeficiency
67
What lifestyle adjustments can support a child with immunodeficiency?
Good nutrition, regular exercise, and avoiding exposure to infections.
68
What is Ataxia telangiectasia?
Ataxia telangiectasia is a rare genetic disorder that affects the nervous system and immune system.
69
True or False: Ataxia telangiectasia is an autosomal dominant disorder.
False. It is an autosomal recessive disorder.
## Footnote
ATM mutation at 11q22-23
70
What are the main symptoms of Ataxia telangiectasia in children?
The main symptoms include progressive ataxia, telangiectasia, and immunodeficiency.
71
Fill in the blank: Ataxia telangiectasia is caused by mutations in the ______ gene.
ATM
## Footnote
Ataxia-telangiectasia mutated
72
Multiple Choice: Which of the following is a common complication of Ataxia telangiectasia? A) Diabetes B) Cancer C) Hypertension
B) Cancer
## Footnote
Lymphoreticular malignency (non-hodgkin Lymphoma)
Leukemia
73
What is the typical age of onset for Ataxia telangiectasia?
Symptoms usually begin between the ages of 1 and 4 years.
## Footnote
2Y>> Ataxia.
3-7>> Telangiectesia.
Older>> Infections.
74
What type of cancer risk is increased in patients with Ataxia telangiectasia?
Lymphoma (Non-Hodgkin)
Leukemia
Lymphoreticular
75
Fill in the blank: Ataxia telangiectasia is characterized by ______ and ______.
ataxia (2nd year); telangiectasia (3-7 years)
76
Multiple Choice: Which diagnostic test is often used to confirm Ataxia telangiectasia? A) MRI B) Genetic testing C) Blood culture
B) Genetic testing
77
What is the role of the ATM protein in the body?
ATM protein is involved in the repair of DNA double-strand breaks.
78
True or False: There is a cure for Ataxia telangiectasia.
False. There is currently no cure.
## Footnote
Supportive mainly.
79
Fill in the blank: Children with Ataxia telangiectasia may require ______ to manage their symptoms.
physical therapy
80
What is a common neurological symptom of Ataxia telangiectasia?
Progressive loss of coordination and balance.
81
Multiple Choice: Ataxia telangiectasia is primarily associated with which system? A) Respiratory B) Nervous C) Digestive
B) Nervous
82
True or False: Telangiectasia refers to small dilated blood vessels on the skin.
True.
83
What is the significance of early diagnosis in Ataxia telangiectasia?
Early diagnosis allows for better management of symptoms and complications.
84
Fill in the blank: The prognosis for children with Ataxia telangiectasia is generally ______.
poor
85
What is one of the main challenges in managing Ataxia telangiectasia?
Managing the immune deficiency and preventing infections.
86
How Ataxia-Telangiectasia clinically presented?
1. Gait: Ataxic.
2. ocular manifestations.
3. cutaneous manifestations.
4. Inability to ambulate independently by 10 y.
5. Recurrent sinopulmonary infections.
87
Enumerate criteria for diagnosing Ataxia telangiectasia.
Elevated AFP.
Decreased IgA and IgE.
MRI: cerebral atrophy and ventricular enlargment.
88
True or False: BMT is a line of treatment in Ataxia telangiectasia.
False, due to cellular radio sesitivity ( X-ray hypersensitivity)
## Footnote
Even the cariers.
89
What is Leukocyte Adhesion Defect (LAD)?
A rare immunodeficiency disorder characterized by the inability of leukocytes to adhere to blood vessel walls and migrate to sites of infection.
90
True or False: LAD is primarily caused by a defect in the integrin family of proteins.
True
91
What are the main clinical features of LAD in pediatric patients?
* Recurrent bacterial infections (specially staph).
* delayed wound healing.
* skin ulcerations with abcent of pus and neutrophils at wound size.
* recurrent fungal infection.
92
True or False: Patients with LAD are at increased risk for viral infections.
False
93
What is the inheritance pattern of LAD?
Autosomal recessive
94
What laboratory test can help diagnose LAD?
Flow cytometry to assess the expression of integrins on leukocytes.
95
What is the treatment for LAD?
Prophylactic TMP/SMX
Bone marrow transplantation
Gene therapy
## Footnote
TMP: trimmethoprim
SMX: sulfamethoxazol
96
What is the primary role of leukocytes in the immune system?
To fight infections and respond to inflammation.
97
True or False: Patients with LAD typically have persistent leukocytosis.
True
## Footnote
WBCs COUNT 45 K
98
What is the primary mechanism affected in LAD?
Leukocyte migration to sites of infection due to impaired adhesion.
99
What type of infections are patients with LAD most susceptible to?
Bacterial infections, especially from encapsulated organisms (Staphylococcal).
100
True or False: LAD can be diagnosed based on clinical symptoms alone.
False
101
What is a common complication of LAD in pediatric patients?
Severe periodontal disease.
102
What role does CD11/CD18 integrin play in the immune response?
Facilitates the adhesion of leukocytes to endothelial cells.
103
What are some common diagnostic imaging findings in patients with LAD?
Abscesses, cellulitis, and osteomyelitis.
104
Fill in the blank: The diagnosis of LAD is confirmed by identifying defects in __________.
leukocyte adhesion molecules
105
Which age group is most commonly affected by LAD?
Infants and young children.
106
True or False: LAD can be treated with antibiotics alone.
False
107
What is the impact of LAD on quality of life in pediatric patients?
Significant due to recurrent infections and the need for medical interventions.
108
Which sign is most susceptible for LAD early after birth?
Delayed umbilical cord seperation>2m.
109
What is Myeloperoxidase (MPO)?
Myeloperoxidase is an enzyme found in neutrophils that produces hypochlorous acid from hydrogen peroxide and chloride ions.
110
What is Myeloperoxidase deficiency?
Myeloperoxidase deficiency is a rare genetic disorder characterized by the absence or reduced activity of the myeloperoxidase enzyme.
111
True or False: Myeloperoxidase deficiency is an autosomal recessive condition.
True
112
List one common clinical manifestation of Myeloperoxidase deficiency in children.
Usually a symptomatic
May present with disseminated candidiasis.
113
What type of infections are children with MPO deficiency particularly susceptible to?
Children with MPO deficiency are particularly susceptible to disseminated candidiasis.
114
Fill in the blank: Myeloperoxidase deficiency can lead to impaired ________ function.
neutrophil
115
Which laboratory test is commonly used to diagnose Myeloperoxidase deficiency?
Flow cytometry or enzyme assays.
116
True or False: Myeloperoxidase deficiency typically leads to severe immunodeficiency.
False
117
What is the primary role of myeloperoxidase in the immune system?
To generate reactive oxygen species that help kill bacteria.
118
Name one treatment option for managing infections in patients with MPO deficiency.
Prophylactic antibiotics.
119
What genetic mutation is associated with Myeloperoxidase deficiency?
Mutations in the MPO gene.
120
True or False: Myeloperoxidase deficiency can be completely cured.
False
121
What is the main risk factor for developing Myeloperoxidase deficiency?
Genetic inheritance.
122
Fill in the blank: Patients with MPO deficiency may have an increased risk of ________ due to impaired neutrophil function.
infections
123
True or False: All patients with Myeloperoxidase deficiency will experience symptoms.
False
124
What is one important consideration in the management of Myeloperoxidase deficiency?
Regular monitoring for infections.
125
True or False: Patients with MPO deficiency typically have normal levels of other immune cells.
True
126
What is the role of neutrophils in the immune response?
To engulf and kill pathogens.
127
What is chronic granulomatous disease (CGD)?
A genetic disorder that affects the immune system, impairing the body's ability to fight off certain infections.
128
True or False: CGD is primarily caused by a deficiency in the enzyme myeloperoxidase.
False
129
What type of infections are children with CGD particularly susceptible to?
Bacterial and fungal infections, especially from catalase-positive organisms.
130
Fill in the blank: CGD is caused by defects in the ________ complex.
NADPH oxidase
131
What is the inheritance pattern of autosomal recessive CGD?
It requires two copies of the mutated gene, one from each parent.
132
What is the typical age of onset for symptoms of CGD?
Symptoms usually appear in early childhood.
133
What is a common clinical manifestation of CGD?
Recurrent pneumonia or skin abscesses.
134
Which diagnostic test is used to confirm CGD?
Flow cytometric assessment of the respiratory burst: Neutrophil Oxidative Burst using Rhodamine dye.
135
What role do neutrophils play in CGD?
Neutrophils are unable to produce reactive oxygen species necessary for killing certain pathogens.
136
Fill in the blank: Treatment for CGD may include ________ prophylaxis.
antifungal
137
True or False: Bone marrow transplantation can be a curative treatment for CGD.
True
138
What type of specialist is often involved in the care of children with CGD?
Immunologist
139
What is the significance of catalase-positive organisms in CGD?
They can neutralize hydrogen peroxide, making them resistant to the immune response in CGD.
140
Multiple choice: Which of the following is a common treatment option for managing infections in CGD? A) Antibiotics, B) Steroids, C) Chemotherapy, D) All of the above
A) Antibiotics
141
What is the role of granulocyte transfusions in CGD management?
They can provide temporary immune support.
142
True or False: CGD can lead to granuloma formation in various organs.
True
143
What is the long-term prognosis for children with CGD with appropriate management?
Many children can lead relatively normal lives with proper treatment.
144
Fill in the blank: CGD is more common in ________ populations.
males
145
What is the importance of genetic counseling for families with CGD?
It helps families understand the inheritance pattern and risks for future children.
146
What lifestyle changes might be recommended for children with CGD?
Avoiding certain high-risk activities and maintaining good hygiene.
147
Multiple choice: Which of the following is a potential complication of CGD? A) Diabetes, B) Osteoporosis, C) Chronic lung disease, D) None of the above
C) Chronic lung disease
148
True or False: Vaccinations are not recommended for children with CGD.
False
149
150
What is the complement system?
A part of the immune system that enhances the phagocytic cells to clear microbes and damaged cells from an organism .
151
True or False: Complement system defects can lead to increased susceptibility to infections.
True
152
Fill in the blank: The complement system consists of ____ proteins that work together to fight infections.
plasma
153
What are the two main pathways of complement activation?
Classical, lectin, and alternative pathways.
154
Mechanism of classical pathway for complement:
C1 binds to IgG or IgM.
155
Mechanism of Alternative pathway in complement?
Microbial products directly activate C.
156
Initial complement defect associated with____ , while terminal complement defect associated with
Autoimmune diseases, increasing risk of infection(espicially meningiococcal).
157
Which complement component is known as the 'anaphylatoxin'?
C3a
158
Multiple Choice: Which of the following is NOT a function of the complement system?
A) Opsonization
B) Chemotaxis
C) DNA replication
C) DNA replication
159
What is the role of C5a in the complement system?
It acts as a potent chemotactic factor that attracts immune cells to sites of infection.
160
True or False: Children with complement deficiencies may present with recurrent bacterial infections.
True
161
Defect in ----- susceptible to recurrent Neisserial infections.
C5-6-7-8
## Footnote
So need third generation cephalosporin.
162
What is a common laboratory test to assess complement function?
Total complement activity (CH50) test.
C3 and C4
## Footnote
(CH50) Screening test.
C3,C4: helpful in determining the diagnosis of autoimmune conditions.
163
Fill in the blank: The complement component that forms the membrane attack complex is ____.
C5b
164
Multiple Choice: Which complement deficiency is associated with increased infections by encapsulated bacteria?
A) C1q deficiency
B) C3 deficiency
C) C4 deficiency
B) C3 deficiency
165
True or False: Complement deficiencies are more common in adults than in children.
False
166
What clinical condition is often seen in patients with complement component deficiencies?
Autoimmune diseases.
167
Fill in the blank: The complement system is activated in response to ____.
pathogens
168
What is the function of the membrane attack complex?
To create pores in the membranes of pathogens, leading to cell lysis.
169
Multiple Choice: Which of the following is a sign of complement deficiency?
A) Frequent skin infections
B) Chronic fatigue
C) Increased appetite
A) Frequent skin infections
170
True or False: Complement deficiencies can be hereditary or acquired.
True
171
What is the significance of measuring complement levels in pediatric patients?
To diagnose potential complement deficiencies and associated immune disorders.
172
Fill in the blank: The complement system interacts with other components of the immune system, such as ____ and ____.
antibodies; phagocytes
173
What is the role of C3b in the complement system?
It acts as an opsonin, marking pathogens for destruction by phagocytes.
| Opsonization.
174
True or False: The alternative pathway of complement activation does not require antibodies.
True
175
What are some common symptoms of complement system defects in children?
Recurrent infections, autoimmune disorders, and unexplained inflammation.
176
Fill in the blank: Complement deficiencies can lead to ____ due to inadequate immune response.
sepsis
177
What is the treatment approach for complement deficiencies?
Immunoglobulin replacement therapy and prophylactic antibiotics.
178
Which type of antibiotic could cover most strains of N meningitidis?
Third-generation cephlosporin
179
Multiple Choice: Which condition is NOT linked to complement deficiencies?
A) Systemic lupus erythematosus
B) Cystic fibrosis
C) Recurrent bacterial infections
B) Cystic fibrosis
180
If you suscpect a child as immunodefecient what is the initial tests?
1. CBC
2. ESR
3. Ig levels
4. Antibody function (antibody titers to vaccinations)
181
Normal ESR could exclude:
Chronic bacterial and fungal infections.
182
One thing in CBC could exclude Wiskott-Aldrich Syndrome?
Normal platelet count.
183
Normal absolute Lymphocyte count exclude:
T-cell defect
184
Normal absolute neutrophil count exclude:
congenital or acquired neutropenia.
185
presence of ____ dignose asplenia
| In RBCs formation and maturation
Howell-jolly bodies.
186
187
Boy and recurrent abscesses is likely to be:
Chronic granulomatus disease.
188
Delayed separation of umbilical cord, leukocytosis and no pus at the site of infection is likely to be:
Leukocyte Adhesion Defect.
189
Baby <6m with Recurrent infection + FTT + chronic diarrhea with absent tonsils and thymus
Sever combind immunodefeciency
190
Baby **Boy** >6m comes with recurrent infections , abcent tonsils and LNs is likely to be:
X-linked agammaglobulinemia
191
Adolescent comes with recurrent infections with low Igs and normal tonsils is likely to be:
Common variable immunodefecieny
192
Child comes with staph aureus infections with pneumatocele, course facial features and eczema.
Hyper IgE Syndrome
193
Child comes with PCP infections, mouth ulcers and sever neutropenia is mostly diagnosed:
Hyper IgM Syndrome
194
Child comes with recurrent GI infections and sinusitis with low IgA is diagnosed as:
IgA deficiency
195
Differentiate between Allergy and Atopy.
**Allergy** is abnormal response leading to allergic symptoms and signs while **Atopy** is hereditary susceptibility to allergy.
196
Mention the 2 phases of allergic reaction.
Early phase and late phase.
## Footnote
Early: Immediately after allergen exposure
Late: Reoccur after 6-8 hrs (up to 36h)
197
Most allergies are type ____, some are type ____.
1 (IgE-mediated)
4 (T-cell mediated)
## Footnote
IgE = hypersensitivity reactions.
198
Which cell and mediators esponsible for acute response allergic reaction?
Mast cell release:
* Histamin
* Prostaglandin
* Leukotrienes
199
In short, what is the mechanism of acute response of allergy?
200
Clinically after history of exposure to pathogen how the patient could come?
201
What could find in investigations for allergic patient?
1. Eosinophilia
2. High serum IgE level
## Footnote
Eosinophilia > 700mm3 and/or >5-10% in nasal secretions.
202
Low levels of IgE exclude :
Atopy.
203
What make allergy is most suscpected diagnosis?
| clinical evaluation
1. Relation to antigen exposure.
2. F.H of allergy.
3. Seasonal variation.
4. Response to antiallergic ttt.
204
What is the possible allergy tests could use in diagnosis?
* skin prick test (Intradermal)
* Radio allegro sorbent test (RAST)
* Provocation test (Challenge)
205
What is the most common allergic disorder in children?
Allergic rhinitis
206
What is the most common cause of anaphylaxis in children
Food allergy
207
True or False: Food allergies can cause anaphylaxis.
True
208
Fill in the blank: The immunoglobulin primarily involved in allergic reactions is _____.
IgE
209
What are the common symptoms of asthma in children?
Wheezing, coughing, shortness of breath, and chest tightness
210
Multiple Choice: Which of the following is NOT a common food allergen for children?
A) Milk
B) Eggs
C) Apples
D) Peanuts
C) Apples
211
What is the primary treatment for allergic rhinitis?
Intranasal corticosteroids
212
True or False: Allergic reactions can only occur after the first exposure to an allergen.
False
213
Fill in the blank: _____ is a common skin condition characterized by itchy, inflamed skin.
Eczema
214
What role does skin prick testing play in allergies?
It helps identify specific allergens that trigger allergic reactions.
215
Multiple Choice: Which of the following is a common symptom of eczema?
A) Rash
B) Fever
C) Nausea
D) Cough
A) Rash
216
What is the main goal of allergen avoidance strategies?
To prevent allergic reactions by avoiding exposure to known allergens.
217
True or False: Allergic conjunctivitis can cause red, itchy eyes.
True
218
Fill in the blank: The condition known as _____ is characterized by a severe allergic reaction that can be life-threatening .
Anaphylaxis
219
In short what is the mechanism of anaphylaxis?
Exposure to allergen >> rapid and massive release of meditors from mast cells and basophils following interaction of allergens with specific cell bound IgE.
220
Enumerate predisposing factors to allergy and anaphylaxis.
Every thing under the sun including sun itself could cause allergy.
221
What systems could affect with anaphylaxis?
1. Skin
2. GIT
3. Respiratory
4. CVS
5. CNS
222
What is possible GIT symptoms could find in anaphylactic patient.
Difficulty of swallowing and abdominal cramps.
223
What is the possible skin reactions associated with anaphylaxis?
* Tingling sensation arround mouth or face.
* feeling of warmth& flushing.
* urtecaria and angioedema.
224
Mention respirstory symptoms result fromananphylaxis.
* Nasal congestion
* chest tighhtness
* wheezes & inspiratory stridor.
225
How anaphylaxis could damage cardiac support?
Hypotention, bradycardia & arrhythmia as CVS manifestations with loss of consciousness may lead to arrest and death.
226
What is the first-line treatment for anaphylaxis?
IM Epinephrine injection
## Footnote
IM ( upper lateral aspect of thigh)
0.01ml/kg of 1/1000 conc (1mg/ml), repeated 5-15 min, up to .3ml.
227
At which muscle best to inject epinephrine in anaphlactic child?
vustus lateralis ms.
228
Process of treatment in anaphylactic shock.
1. IM epinephrine injection
2. Hospitalization
* Air way (ET tube may insert)
* Breathing (O2)
* Circulation ( Normal saline infusion for hypotension (20ml/kg upto 3 times), cardiac monitoring).
3. symptomatic
* IV antihistamine >> itching.
* IV corticosteroids >> prophylactic aganist late phase reaction
* Nebulized B2 stimulant >> bronchospasm.
229
Multiple Choice: Which of the following is a common environmental allergen?
A) Dust mites
B) Chicken
C) Apples
D) Milk
A) Dust mites
230
What is the purpose of allergy immunotherapy?
To desensitize the immune system to specific allergens.
231
True or False: Allergies can develop at any age.
True
232
What is the role of antihistamines in treating allergies?
To relieve symptoms by blocking the action of histamine.
233
Multiple Choice: Which of the following is a common symptom of allergic rhinitis?
A) Sneezing
B) Diarrhea
C) Headache
D) Fever
A) Sneezing
234
Enumerate types of allergic rhinitis.
1. Seasonal
2. perennial
235
Hay fever is called to which type of allergic rhinitis?
Seasonal
236
Allergens of Hay fever are:
wind-born pollens of trees, grasses and weeds.
237
True/false: Hay fever is rare before 4-5 years of age.
True.
238
What is the common age range for the onset of food allergies in children?
Infancy to early childhood
239
True or False: Asthma and allergies are often related.
True
240
Fill in the blank: The condition _____ is often triggered by allergens like pollen, dust mites, and animal dander.
Allergic rhinitis
241
What is the significance of family history in pediatric allergic disorders?
A family history of allergies increases the likelihood of a child developing allergies.
242
Multiple Choice: Which of the following is **NOT** a typical symptom of asthma?
A) Wheezing
B) Chest pain
C) Rash
D) Coughing
C) Rash
243
What is rhinitis?
An inflammation of the nasal mucous membrane.
244
True or False: All children with eczema will develop food allergies.
False
245
Fill in the blank: The _____ test is used to measure the level of IgE antibodies in the blood.
RAST (Radioallergosorbent test)
246
What is a common misconception about allergies?
That they can be outgrown in all cases.
247
Multiple Choice: Which food is least likely to cause an allergic reaction?
A) Peanuts
B) Shellfish
C) Wheat
D) Rice
D) Rice
248
True or False: Allergic reactions can occur immediately or hours after exposure to an allergen.
True
249
Fill in the blank: _____ is a chronic condition often associated with allergic rhinitis and asthma.
Sinusitis
250
What is the purpose of using a peak flow meter in asthma management?
To measure how well air moves out of the lungs.
251
Multiple Choice: Which of the following is a common treatment for eczema?
A) Antihistamines
B) Moisturizers
C) Antibiotics
D) Antipyretics
B) Moisturizers
252
What is the role of corticosteroids in treating allergic disorders?
To reduce inflammation and control symptoms.
253
True or False: Allergens can only be found in food.
False
254
Fill in the blank: A _____ is a severe allergic reaction that requires immediate medical attention.
Anaphylactic shock
255
Multiple Choice: What is one of the first signs of an allergic reaction?
A) Fever
B) Rash
C) Itching
D) Cough
C) Itching
256
What is the best way to manage a known food allergy?
Strict avoidance of the allergenic food.
257
True or False: Skin allergies can manifest as contact dermatitis.
True
258
Fill in the blank: The _____ is a device used to deliver medication directly to the lungs for asthma treatment.
Inhaler
259
What is the most effective way to prevent allergic reactions in children?
Identifying and avoiding allergens.
260
Multiple Choice: Which of the following can trigger asthma symptoms?
A) Cold air
B) Exercise
C) Allergens
D) All of the above
D) All of the above
261
True or False: Allergic reactions can be treated with home remedies alone.
False
262
What is the significance of a food challenge test?
It helps confirm or rule out food allergies under medical supervision.
263
What is allergic rhinitis?
Allergic rhinitis is an inflammatory condition of the nasal mucosa caused by an allergic reaction to airborne allergens.
264
Name two common allergens that can trigger allergic rhinitis in children.
Pollen and dust mites.
265
What are the primary symptoms of allergic rhinitis?
Sneezing, nasal congestion, runny nose, and itchy eyes.
266
Fill in the blank: Allergic rhinitis is often associated with __________.
Asthma.
267
What is the role of IgE in allergic rhinitis?
IgE antibodies bind to allergens and trigger the release of histamines from mast cells.
268
Multiple Choice: Which of the following is **NOT** a common symptom of allergic rhinitis?
A) Sneezing
B) Fever
C) Itchy eyes
D) Nasal congestion
B) Fever
269
What age group is most commonly affected by allergic rhinitis?
Children aged 2 to 18 years.
270
True or False: Allergic rhinitis can lead to complications like sinusitis and otitis media.
True
271
What is the first-line treatment option for allergic rhinitis in children?
Antihistaminics.
272
Fill in the blank: Avoiding __________ is crucial in managing allergic rhinitis.
Allergens.
273
What is the difference between seasonal and perennial allergic rhinitis?
Seasonal allergic rhinitis occurs at specific times of the year, while perennial allergic rhinitis occurs year-round.
274
Multiple Choice: Which of the following medications is a common antihistamine used for allergic rhinitis?
A) Ibuprofen
B) Cetirizine
C) Amoxicillin
D) Prednisone
B) Cetirizine
275
What type of test is commonly used to diagnose allergic rhinitis?
Skin prick test or specific IgE blood test.
276
True or False: Allergic rhinitis has a genetic component.
True
277
Name a non-pharmacological treatment for allergic rhinitis.
Nasal saline irrigation.
278
Fill in the blank: __________ can help reduce exposure to indoor allergens.
Air purifiers.
279
What is the long-term management strategy for children with persistent allergic rhinitis?
Allergen immunotherapy.
280
Multiple Choice: Which of the following is a symptom of moderate to severe allergic rhinitis?
A) Mild sneezing
B) Interference with sleep
C) No impact on daily activities
D) Occasional nasal congestion
B) Interference with sleep
281
What is the mechanism of action of intranasal corticosteroids?
They reduce inflammation in the nasal passages.
282
Dark circles under eye, rabbit nose and allergic salute are signs of:
Allergic rhinitis.
283
Best options of treatment in allergic rhinitis are:
1. Antihistaminics
2. Steroidal nasal sprays
3. Cromolyn nasal solutions
4. Saline nasal wash
## Footnote
1st line is antihistamine ( Desloratadine (Aerius))
284
What is atopic dermatitis?
Atopic dermatitis is a chronic inflammatory skin disorder characterized by dry, itchy, and inflamed skin.
285
True or False: Atopic dermatitis only affects children.
False: Atopic dermatitis can affect individuals of all ages, although it is more common in children.
286
Fill in the blank: Atopic dermatitis is often associated with other allergic conditions, such as ____ and ____.
asthma and allergic rhinitis
287
What are common symptoms of atopic dermatitis in pediatric patients?
Erythema, dryness, edema, intense pruritus, exudation, crusting & scaling
288
Which areas of the body are most commonly affected by atopic dermatitis in infants?
## Footnote
more acute and express with introduction of certain foods.
The face, scalp, and extensor surfaces of the limbs.
289
In older children which sites is mor susceptible for atopic dermatitis?
## Footnote
3-5y and more sub acute or chronic.
Flexural folds of extremities.
290
What is the most common age of onset for atopic dermatitis?
Birth to 6 months
291
What is the role of genetics in atopic dermatitis?
Genetics play a significant role, as a family history of atopy increases the risk of developing the condition.
292
True or False: Atopic dermatitis can be triggered by environmental factors.
True: Environmental factors such as allergens, irritants, and changes in weather can trigger flare-ups.
293
What is the primary goal of treating atopic dermatitis?
The primary goal is to manage symptoms and prevent flare-ups.
294
Fill in the blank: ____ creams are often prescribed to manage inflammation in atopic dermatitis.
Topical corticosteroid & Emollients
295
What are some common moisturizers recommended for children with atopic dermatitis?
Emollients like petroleum jelly, creams, and lotions.
296
True or False: Bathing can worsen atopic dermatitis.
False: Proper bathing techniques can help hydrate the skin and remove irritants.
297
What is the significance of the skin barrier in atopic dermatitis?
A compromised skin barrier can lead to increased water loss and susceptibility to allergens and irritants.
298
Fill in the blank: ____ therapy may be used for severe atopic dermatitis that does not respond to topical treatments.
Systemic
299
What is the impact of atopic dermatitis on a child's quality of life?
It can significantly affect sleep, social interactions, and emotional well-being.
300
Which is a common complication of atopic dermatitis?
Secondary bacterial infections with bacteria, herpes simplex or wart.
301
True or False: Atopic dermatitis is contagious.
| contagious = transmitted from person to person.
False: Atopic dermatitis is not contagious.
302
What role does education play in managing atopic dermatitis?
Education helps families understand the condition, identify triggers, and adhere to treatment plans.
303
What is the long-term outlook for children with atopic dermatitis?
Many children outgrow the condition, but some may continue to experience symptoms into adulthood.
304
What is possible treaetment for atopic dermatitis?
1. Topical steriod.
2. Emollients.
3. sedative antihistamines.
4. cotton clothes are preferred.
5. Avoidance of perfumed soaps and irretants.
6. If food allergy, avoidance of the offending food.
305
Atopic dermatitis baby could suffer from Psychological disturbances. Explane.
Atopic dermatitis cause lack of sleep due to pruritis and the disfigurement caused by lichenification and hyperpigmentation, all these caused psychological disturbances.
306
What is allergic march?
A progression of allergic conditions that typically starts in infancy or early childhood.
## Footnote
Help in knowing the prognosis of allergic conditions.
307
List four common conditions associated with allergic march.
Atopic dermatitis, food allergy, allergic rhinitis, and asthma.
308
Fill in the blank: Allergic march often begins with ____ in infancy.
Atopic dermatitis
309
What age range is typically affected by allergic march?
Infancy to early adulthood.
310
What is the relationship between atopic dermatitis and asthma in allergic march?
Atopic dermatitis can precede and increase the risk of developing asthma.
311
Multiple Choice: Which of the following is NOT part of allergic march?
a) Food allergies
b) Allergic rhinitis
c) Diabetes
c) Diabetes
312
What environmental factors can contribute to allergic march?
Exposure to allergens, pollution, and tobacco smoke.
313
What is the typical progression of allergic march?
Atopic dermatitis → Food allergy → Allergic rhinitis → Asthma.
314
Multiple Choice: Which age group is most commonly diagnosed with allergic rhinitis?
a) Infants
b) Toddlers
c) School-age children
c) School-age children
315
What is urticaria commonly known as?
Hives
316
True or False: Urticaria can occur in children of all ages.
True
317
What is angioneurotic edema?
Acute onset of bitting edema that involves the eyelids, lips, genitalia and extremities with deeper layers of skin and SC tissues are involved.
318
____ and ____ conceder as common target organs of angioedema.
URT, GIT.
319
Urticaria defined as :
well circumscribed raised skin lesions (wheals) of various sizes which may be intensely pruritic.
320
What are common triggers for urticaria in pediatric patients?
Infections, food allergies, medications, and insect stings.
321
Multiple Choice: Which of the following is NOT a type of urticaria?
A) Acute
B) Chronic
C) Seasonal
D) Physical
C) Seasonal
322
What is the first-line treatment for urticaria in children?
Antihistamines
323
Multiple Choice: Which of the following is a common food allergen that may trigger urticaria?
A) Milk
B) Rice
C) Potatoes
D) Bread
A) Milk
324
True or False: Urticaria can occur without any identifiable cause.
True
325
What is the role of corticosteroids in treating severe cases of urticaria?
To reduce inflammation and control severe symptoms.
326
Fill in the blank: In angioedema, swelling may also occur in the ________ and ________.
throat, gastrointestinal tract
327
What diagnostic tool is often used to identify triggers of urticaria?
Skin prick tests
328
Multiple Choice: Which age group is most commonly affected by urticaria?
A) Infants
B) Toddlers
C) Adolescents
D) All ages
D) All ages
329
True or False: Urticaria and angioedema can occur together.
True
330
What should be done if a child experiences difficulty breathing due to angioedema?
Seek emergency medical attention immediately.
331
Enumerate types of angioedema.
Heredetary, acquired
332
What is hereditary angioedema (HAE)?
Hereditary angioedema is a genetic disorder characterized by recurrent episodes of severe swelling in various parts of the body.
333
True or False: Hereditary angioedema is caused by a deficiency of C1 esterase inhibitor.
True
334
What are the common triggers for angioedema attacks in pediatric patients?
Common triggers include stress, trauma, infections, and certain medications.
335
Fill in the blank: HAE is classified into two main types: Type I is due to ____ of C1 esterase inhibitor, and Type II is due to ____ of C1 esterase inhibitor.
deficiency, dysfunction
336
What is the main symptom of hereditary angioedema?
The main symptom is sudden and severe swelling, typically affecting the face, extremities, gastrointestinal tract, and airway.
337
What age group is most commonly affected by hereditary angioedema?
Pediatric patients, particularly those under the age of 18.
338
True or False: HAE can be diagnosed with a simple blood test.
True
339
What is the standard treatment for acute attacks of hereditary angioedema?
The standard treatment includes the administration of C1 inhibitor concentrates or other specific medications.
340
Which medication is commonly used for long-term prophylaxis in patients with hereditary angioedema?
Long-term prophylaxis may include the use of attenuated androgens or C1 inhibitor replacement therapy.
341
What is the inheritance pattern of hereditary angioedema?
Hereditary angioedema is inherited in an autosomal dominant pattern.
## Footnote
AD
342
What is a potential complication of untreated angioedema in children?
A potential complication is airway obstruction, which can be life-threatening.
343
True or False: Patients with HAE may require emergency intervention during an attack.
True
344
What lifestyle modifications can help manage hereditary angioedema?
Avoiding known triggers, managing stress, and maintaining a healthy lifestyle can help manage the condition.
345
What is the significance of early diagnosis in hereditary angioedema?
Early diagnosis is crucial for timely intervention and to prevent complications.
346
Fill in the blank: The most common site of swelling in pediatric patients with HAE is _________.
the face
347
How can parents help manage their child's hereditary angioedema?
Parents can help by educating themselves about the condition, recognizing symptoms, and ensuring prompt treatment during attacks.
348
What is a food allergy?
An immune system reaction that occurs soon after eating a certain food.
349
Name the most common food allergens in children.
Milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish.
350
Enumerate classes of food allergens and which one is more sever?
Class1 >> more sever contain: milk, egg, seafood, peanut, tree nuts, wheat and soy
Class2 >> contain: Fruits and vegetables.
351
Other substences cause food allergy rather than class1,2 food allergens?
Hidden allergens ( not written in marketed food ingredients).
Reactions of food additives.
## Footnote
So it is advice to parents not to let their babies eat non-known,non-homemade food.
352
True or False: Food allergies in chidren is more common than adults.
True.
353
Food could cause ____ manifestation due to ____, and also could cause ____ like _____
systemic due to allergy
local reaction like contact dermatitis
354
Treatment of allergy from food is ____, while treatment of local reaction from food is _____.
Avoidence
local anti-histamin or vasline.
355
True or False: Always immune is responsible for food allergic reaction.
False.
## Footnote
Non-immune mediated ( intolerance) is adverse reaction to foods.
356
How could intolerence cause food allergy?
Enzymatic
Pharmacological
Undefined
357
What is the difference between a food allergy and a food intolerance?
Food allergies involve the immune system, while food intolerances do not.
358
Fill in the blank: The most common food allergy in children is ______.
milk.
359
What is anaphylaxis?
A severe, potentially life-threatening allergic reaction.
360
Multiple choice: Which of the following is NOT a symptom of food allergy? A) Hives B) Nausea C) Coughing D) Headache
D) Headache.
361
What is the role of epinephrine in food allergies?
Epinephrine is used to treat severe allergic reactions (anaphylaxis).
362
True or False: Most children outgrow food allergies.
True.
363
What is the first step in managing a suspected food allergy?
Consulting a healthcare professional for evaluation and testing.
364
Fill in the blank: The skin prick test is commonly used to diagnose ______.
food allergies.
365
Multiple choice: Which food is least likely to cause an allergy? A) Peanuts B) Cow's milk C) Rice D) Eggs
C) Rice.
366
What is the recommended action if a child experiences an allergic reaction?
Administer epinephrine and seek emergency medical help.
367
True or False: Food allergies are more common in boys than girls.
True.
368
What is cross-reactivity in food allergies?
When a person allergic to one food is also allergic to another due to similar proteins.
369
Fill in the blank: The elimination diet is a method used to identify __.
food allergies.
370
Multiple choice: Which of the following is a common method for food allergy testing?
A) Blood test
B) MRI
C) X-ray
D) Ultrasound
A) Blood test.
371
What is the role of a food allergy action plan?
To provide a clear set of instructions for managing allergic reactions.
372
True or False: Food allergies can cause gastrointestinal symptoms.
True.
373
What is the most effective way to prevent food allergy reactions?
Avoiding the allergenic food.
374
What is a challenge test in pediatric food allergy?
A challenge test is a controlled procedure where a child is given a suspected allergenic food to determine if an allergy is present.
375
True or False: A challenge test can only be performed in a hospital setting.
False
376
Fill in the blank: A positive result in a challenge test indicates that the child has a ______ to the tested food.
sensitivity or allergy
377
What is the primary purpose of conducting a challenge test?
To confirm or rule out a food allergy diagnosis.
378
What is cow milk protein allergy?
An immune response to proteins found in cow's milk.
379
True or False: Cow milk protein allergy is the same as lactose intolerance.
False
380
What are the common symptoms of cow milk protein allergy?
Symptoms include hives, gastrointestinal issues, respiratory problems, and anaphylaxis.
381
Fill in the blank: Cow milk protein allergy primarily affects ____ in infants and young children.
infants
382
Which two proteins in cow's milk are most commonly associated with allergies?
Casein and whey
383
Multiple Choice: Which of the following is a potential treatment for cow milk protein allergy?
A) Cow's milk elimination diet
B) Increased dairy intake
C) Antihistamines
D) None of the above
A) Cow's milk elimination diet
384
What is the main symptoms of cow milk protein allergy?
GI symptoms ( diarrhea, vomiting)
FTT
385
Cow milk protein allergy as immune respone is mostly
Non-IgE mediated.
386
What dietary modifications are necessary for someone with cow milk protein allergy?
Avoidance of all cow's milk and dairy products.
387
Best treatment of cow milk protein allergy is:
1. Discontinuing the milk formula
2. Changing to hypoallergenic-hydrolyate formula such as Nutramigen
388
At what age coud re-introduce cow milk for patients with cow milk protein allergy?
9-12m
## Footnote
As the condition usually resolves by itself by then.
389
What is the definition of asthma in pediatric patients?
Asthma is a chronic inflammatory disease of the airways that causes wheezing, breathlessness, chest tightness, and coughing in children.
390
Which of the following is NOT a common symptom of asthma in children?
A) Wheezing
B) Persistent cough
C) Fever
D) Shortness of breath
C) Fever
391
Which environmental triggers considered as risk for asthmsa?
Respiratory viruses
Allergens
Tobacco smoke
392
At which age is mostly reported asthma in?
prior 6y.
393
Fill in the blank: The diagnosis of asthma in pediatric patients typically involves a combination of __________, physical examination, and lung function tests.
medical history
394
What is a common method used to diagnose asthma in children?
A common method is spirometry, which measures the amount and speed of air a child can exhale.
395
What are the most common chronic symptoms od asthma?
Intermittent dry cough.
Expiratory wheezes.
396
Enumerate ways to diagnose asthma.
1. spirometry
2. Response to broncho dilators
3. Exercise challenge
397
True or False: Chest radiograph is super useful in diagnosis Asthma.
False, as often it appear normal, aside from subtle and non-specific findings of peribronchial thickening.
398
True or False: A positive response to bronchodilator therapy is a key indicator for asthma diagnosis in children.
## Footnote
+ve response mean improvement of FEV1> 12%
True
399
Fill in the blank: Asthma diagnosis in children may done by exercise challenge as it worsening in ____ in asthmatic patient.
FEV1>15%
400
What is most common spirometry result in Asthmetic patient?
Low FEV1
FEV1/FVC is <0.8
401
Multiple Choice: Which test is not typically used in the diagnosis of asthma in children?
a) Spirometry
b) Peak flow measurement
c) Blood test
d) Skin prick test
c) Blood test
402
What is the classification of asthma based on severity?
Asthma is classified into:
intermittent,
mild persistent,
moderate persistent,
and severe persistent.
403
True or False: Intermittent asthma symptoms occur more than twice a week.
False
404
Fill in the blank: Mild persistent asthma is characterized by symptoms occurring more than ___ times a week but not daily.
twice
405
What defines moderate persistent asthma?
Symptoms occur daily and may affect daily activities with FEV1<60%.
406
Which type of asthma is the most severe?
Severe persistent asthma
407
True or False: Patients with severe persistent asthma can experience symptoms that are continuous.
True
408
What is a key characteristic of intermittent asthma?
Symptoms occur less than twice a week.
409
Multiple Choice: Which type of asthma has symptoms that are controlled with low-dose inhaled corticosteroids?
A) Intermittent
B) Mild Persistent
C) Moderate Persistent
D) Severe Persistent
B) Mild Persistent
410
How often do symptoms occur in moderate persistent asthma?
Daily
411
Fill in the blank: Severe persistent asthma can lead to ___ limitations in daily activities.
significant
412
What is the treatment approach for severe persistent asthma?
High-dose inhaled corticosteroids.
SABA.
High dose inhaled corticosteroids.
Long-acting B2 agonist.
Oral steroids.
413
True or False: All types of asthma can be managed with the same treatment plan.
False
414
What is the significance of asthma severity classification?
It helps in determining the appropriate management and treatment strategies.
415
Multiple Choice: Which type of asthma requires a step-up in treatment due to daily symptoms?
A) Intermittent
B) Mild Persistent
C) Moderate Persistent
D) None of the above
C) Moderate Persistent
416
What is the maximum frequency of nighttime symptoms in intermittent asthma?
No more than twice a month.
417
True or False: Patients with intermittent asthma may not require daily medication.
True, just SABA when need
418
What is the primary goal in managing asthma severity?
To achieve and maintain control of the asthma symptoms.
419
Fill in the blank: Patients with ___ asthma experience symptoms throughout the day and night.
severe persistent
420
What distinguishes mild persistent asthma from moderate persistent asthma?
Mild persistent asthma has symptoms less than daily, while moderate persistent asthma has daily symptoms.
Mild persistent asthma need just low dose inhaled corticosteroid with SABA as atreatment, while moderate need low to medium dose inhaled corticosteroids with long acting B2 agonist.
421
What is the definition of persistent asthma?
Persistent asthma is a chronic condition characterized by ongoing symptoms and frequent exacerbations requiring ongoing treatment.
422
True or False: Early exposure to tobacco smoke is a risk factor for persistent asthma.
True
423
Fill in the blank: Children with ___________ are at higher risk for developing persistent asthma.
atopy
424
Which environmental factor is associated with increased risk of persistent asthma in early childhood?
Exposure to indoor allergens such as dust mites and pet dander.
425
What role does maternal asthma play in a child's risk for persistent asthma?
Maternal asthma increases the likelihood that the child will develop persistent asthma.
426
True or False: Air pollution has no impact on the development of asthma in early childhood.
False
427
What is one common respiratory infection in early childhood that can increase asthma risk?
Respiratory syncytial virus (RSV) infection.
428
Multiple choice: Which of the following is NOT a risk factor for persistent asthma?
A) Family history of asthma
B) Exposure to secondhand smoke
C) Regular physical activity
D) Allergic rhinitis
C) Regular physical activity
429
What is the impact of socioeconomic status on asthma risk in young children?
Lower socioeconomic status is associated with higher risk for persistent asthma.
430
True or False: Breastfeeding has been shown to reduce the risk of persistent asthma.
True
431
Fill in the blank: Exposure to __________ can exacerbate asthma symptoms in children.
pollutants
432
What type of allergy is most commonly linked to persistent asthma in children?
Allergic rhinitis.
433
Multiple choice: Which of the following is a significant risk factor for asthma in children?
A) Low birth weight
B) High birth weight
C) Exclusively formula-fed
D) None of the above
A) Low birth weight
434
What is the relationship between obesity and persistent asthma in children?
Obesity increases the risk of developing persistent asthma.
435
What is the significance of early childhood wheezing in relation to asthma?
Early childhood wheezing can be an indicator of future persistent asthma.
436
Fill in the blank: Genetic predisposition plays a __________ role in the development of persistent asthma.
significant
437
What is one preventive measure that can be taken to reduce asthma risk in children?
Reducing exposure to allergens and irritants.
438
True or False: Asthma can be completely cured in children.
False
439
Triggers to diagnose severity of asthma is ____________
1. Daytime and nighttime symptoms frequency
2. SABA use for quick relief
3. Ability to engage in normal or desired activities
4. spirometry
440
A child has 7y with 2 exacerbations requiring oral corticosteroid in the same year considered as:
persistent asthma
441
When to concider an infant has persistent asthma?
Has risk factor for asthma + one of:
* **4 or more** of **wheezing** over the past year that lasted >1day and affect sleep.
* **2 or more** exacerbations in 6m requiring **systemic corticosteroids**
442
In sever allergic asthma ____ is best for patients over 6y of age, and ____ is best for sever eosinophilic asthma over 12y of age
Omalizumab
Mepolizumab
443
What is the primary goal of asthma management?
To achieve and maintain well-controlled asthma.
444
Fill in the blank: Patients with well-controlled asthma should not experience __________ during the day.
asthma symptoms
445
Which of the following is a key indicator of well-controlled asthma?
A) Frequent nighttime awakenings
B) No limitations on activities
C) Daily use of rescue inhaler
B) No limitations on activities
446
What is the recommended frequency of short-acting beta-agonist use for well-controlled asthma?
Less than twice a week.
447
Short answer: Name a common medication class used in the long-term management of asthma.
Inhaled corticosteroids.
448
True or False: Asthma control can vary over time and requires regular assessment.
True
449
What is a common tool used to assess asthma control?
Asthma Control Test (ACT).
449
450
Multiple choice: Which factor can affect asthma control?
A) Environmental triggers
B) Medication adherence
C) Both A and B
C) Both A and B
451
How doctor determine that patient is well controlled asthmtic patient.
1. Symptoms: <2days/wk
2. Rescue bronchodilator: <2 days/wk
3. FEV1: >80% of predicted
4. Exacerbations: <2 in past year
5. Activity: no interference
