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Flashcards in Allergy and Immunology Deck (22):

A pt presents hemodynamically unstable with hypotension, tachycardia and difficulty breathing after starting Bactrim most likely suffers from ....



What is the best initial treatment for anaphylaxis?

Intramuscular epinephrine (1:1000 concentration), corticosteroids (4-6 hours to work), antihistamine (diphenhydramine, hydroxyzine)


A pt presents with sudden swelling of the face, palate, tongue and airway after being hit in the face with a pillow/ wood chips hitting them in the arm and have other associated symptoms like stridor, abdominal pain and lack of response to steroids most likely suffers from ...

Hereditary Angioedema


What is the pathophysiologic cause of Hereditary Angioedema?

deficiency of C1 esterase inhibitor


What is the diagnostic test and findings associated with Hereditary Angioedema?

Low levels of C2 and C4 in the complement pathway


A pt presents with sudden swelling of the face, palate, tongue and airway and has history of hypertension being treated with lisinopril most likely suffers from....

Angioedema secondary to ACE inhibitor use


What is the best initial treatment for acute episodes of angioedema? (3)

1. infusion with fresh frozen plasma
2. stop ACE inhibitor (if using)
3. consider ICU admission (especially if airway compromised)


What is the best initial treatment for chronic episodes of angioedema associated with hereditary angioedema?

Ecallantide (blocks bradykinin production)
(can also use steroids such as danazol or stanazol)


What is the only effective treatment for neurosyphillis?



What is the next best step in the management of a pt with neurosyphillis with a history of life threatening anaphylaxis to penicillin?

stop all beta blockers and desensitize to penicillin (have epinephrine ready for reaction)


A pt presents with recurrent episodes of nasal itching, stuffiness, rhinorrhea, paroxysms of sneezing and itchy eyes most likely suffers from ..

Allergic Rhinitis


Other than avoidance of allergen, what is the most effective treatment for allergic rhinitis?

Intranasal corticosteroids
(can also use antihistamines, nasal saline spray and wash, leukotriene inhibitors)


What is the most important step in management of a patient being desensitized to an allergen?

Stop the use of beta blockers (will block effect of epinephrine if needed to treat anaphylactic reaction)


What is the mechanism of action of cromolyn?

stabilizes mast cells to prevent degranulation and release of histamine and leukotrienes


An adult pt presents with recurrent episodes of sinopulmonary infections (bronchitis, sinusitis, pneumonia, pharyngitis), episodes of malabsorption, steatorrhea and diarrhea, and splenomegaly most likely suffers from ....

Common Variable Immunodeficiency (B-cells are present but don't produce Ig)


What is the diagnostic test and findings associated with Common Variable Immunodeficiency?

total IgG


What is the treatment for Common Variable Immunodeficiency?

Infusions of IV immunoglobulins


A male child presents with recurrent sinopulmonary infections (bronchitis, sinusitis, pneumonia, pharyngitis) and is found have a small/absent spleen most likely suffers from..

X-linked Agammaglobulinemia (Bruton's; B cells are missing so no Ig)


What is the treatment for X-linked Agammaglobulinemia (Bruton's)?

infusion with IV immunoglobulins


A pt presents with anaphylaxis after blood donation and has a history of recurrent sinopulmonary infections and spruelike malabsorption syndrome most likely suffers from ....

IgA Deficiency


What is the best treatment for IgA deficiency?

1. treat infections as they occur
2. avoid blood transfusions with blood for non-IgA deficient donors


A pt presents with recurrent Staphylococcus skin infections most likely suffers from ....

Hyper IgE syndrome (treat infections as arise)