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Laughing Pedi > Allergy / Imm > Flashcards

Allergy / Imm Flashcards

(73 cards)

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0
Q

anaphylactoid reactions
what are they
likely culprits

A

direct degranulation of mast cells, not IgE - can pretreat

  • vanco red man (pretreat)
  • opiod
  • radiocontrast media
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1
Q

nasal polyps… do what?

A

screen for CF!

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2
Q

epi dose for anaphylaxis

A

1:1000

IM 0.01 mg/kg up to 0.3ML q15 min

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3
Q

abdominal pain, painful swelling at sites of trauma?
Dx
Test
Tx

A

hereditary angioedema
autosomal dominant, C1 inhibitor defect.
Complement C4 is best screening test
Tx w/ anabolic steroid (danazol) or newer C1INH prep for attack

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4
Q

serum triptase used to confirm what?

A

anaphylaxis to insect

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5
Q

what is urticaria pigmentosa

tx?

A

cutaneous mastocytosis
tx w/ H1/H2 blockade
red/brown macules that urticate when stroked, need bx? vasculitis

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6
Q

chronic urticaria def

cause?

A

lasts > 6 wks

90% idiopathic

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7
Q

joint and kidney involved, with one giant urticaria and target lesions 1 week after exposure?

A

serum sickness

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8
Q

hives with exercise?

A

cholinergic urticaria

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9
Q

Dx w/ recurrent bacterial infx at 4-6 mos, paucity of lymphoid tissue
Tx?
Risk of what major bug/dz

A

X linked agammaglobulinemia
Risk of meningoenceph w/ enteroviral
Tx w/ IVIG

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10
Q

most common immunoglobulin deficiency?

A

IgA def

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11
Q

inheritance of hyper IgM?

Sx

A

x-linked

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12
Q

recurrent abscesses, high IgE levels, dental anomalies

A

Hyper IgE syndrome

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13
Q

hallmark of phagocyte def?
Test?
Tx?

A

abnormal neutrophils very high levels, adenopathy, staph infx (catalase producers), lots of ulcers and recurrent infx of many types.
Abnormal NBT test
Tx w/ interferon gamma

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14
Q

syndrome with recurrent staph infx, large granules in WBC, may have partial albinism and periph neuropathy

A

Chediak-Higashi syndrome

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15
Q

recurrent infx w/o pus, delayed umbilical cord separation?

A

leukocyte adhesion def

No abscess formation b/c no pus

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16
Q

recurrent staph, abscesses, fungal infx, osteomyelitis with aspergillus, Serratia

A

CGD def! phagocyte def

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17
Q

% of asthma with resolution by adulthood

A

60%

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18
Q

TReatment of serum sickness?

A

oral steroids

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19
Q

interstitial nephritis and antibiotics is caused by what?

A

methicillin

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20
Q

recurrent neisseria meningitis

Dx and test?

A

Complement def C6-C9: check CH50

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21
Q

pollen food oral allergy syndrome, what foods?

Ragweed vs Tree polon

A

Ragweed: watermelon, melons, banana
Tree pollen: apple, pear, cherry, plum
FRESH ONLY

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22
Q

tx of chronic allergic rhinitis w/ lots of congestion?

A

intranasal steroids for congestion

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23
Q

pyoderma gangrenosum in what disease

A

IBD

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24
defect in X-linked agammaglobulinemia | Tx
Bruton's tyrosine kinase gene (no B cells / Immunoglobulin) | Tx: IVIG, broad spectrum Abx
25
TReatment for T cell deficiencies?
Stem cell or bone marrow trp to reconstitute
26
Treatment of SCID
ADA def, so replace with bovine ADA
27
Tx of Digeorge immunodef?
Thymic transplant
28
patient with recurrent bronchospasm and bronchiectasis with transient wandering pulm infiltrates Dx? Lab test?
allergic bronchopulmonary aspergillosis (NEED dx of chronic asthma for this) Has high Total serum IgE or IgG
29
latex food allergy cross reaction, which foods?
ABCs: avocado, banana, chestnut, Kiwi (cross of banana / papaya)
30
recurr infx, eczema, bleeding?
Wiskott Aldrich Sydrome, X linked
31
Top 5 food allergies?
milk, eggs, soy, wheat, peanuts
32
most important predictor of asthma, eczema, allergic rhinitis? Breast feeding does what?
parental hx: 50% if 1, 75% if two. | bf delays onset, but risk is same at age 2y
33
diagnosis of allergic rhinitis? | What is the major DDX?
snot eos | Also found in NARES: non-allergic rhinitis with eosinophilia syndrome: but Skin test and serum IgE levels neg/normal
34
Treatment and Medication for allergic rhinitis?
Treatment: Immunotherapy Medication: nasal steroids
35
what to do during immunotherapy if local skin reaction occurs?
wait 15-30, continue if no systemic rxn
36
def: rhinitis medicamentosa and vasomotor rhinitis
medicamentosa: rebound to adrenergic nasal drops vasomotor: drainage but no trigger / infx agent
37
recurrent rhinorrhea in child less than 3y?
URI! Pollen needs lots of exposure over years, not seen before 3y
38
treatment of chronic urticaria?
fexofenadine
39
type of reaction of contrast media? | Tx?
osmolality, hypertonicity rxn triggering mast cell degranulation/basophils. NOT IgE! Prevent w/ pretreatment (benadryl/steroids)
40
Treatment of child with life threatening rxn to bee sting?
allergist! Venom immunotherapy (98% effective for future rxns)
41
IgE mediated reaction is what type?
Anaphylactic, A Type 1
42
Ab mediated type of allergic rxn?
Type 2: Ab = B reaction
43
Type three allergic reaction is what?
Immune Complex / Arthus rxn
44
Type 4 allergic rxn is what?
Delayed hypersens: skin test PPD / Poison ivy
45
sneezing, wheezing, squeezing (tight chest), teary eyes. | Dx?
Ragweed Respiratory rxn
46
Drugs that may interfere with skin testing for allergies?
Antihistamine / drugs with these effects like TCAs / imipramine
47
RAST vs skin testing
skin testing in vivo, risk of anaphylaxis, but more sensitive and cheaper. RAST in vitro, not impacted by antihistamine tx and no anaphylaxis risk
48
Rule that reassurance is okay with frequent infx?
about 1/month, self limited GI and resp WITHOUT growth/FTT and without RECURRENT infx of one type.
49
recurrent pyogenic infx. Think what immunodef?
B cell Ab dysfunction
50
Chronic recurrent candida infx? Type of immunodef?
T cell dysfunction
51
No lymphoid tissue and recurrent infx/
SCID
52
key component in adaptive immunity?
Antigen presenting cells
53
ataxia, discolored conjunctivae, frequent sinus infx? | Dx and lab test / prognosis?
Ataxia telangiectasia | Incr AFP/risk for ca
54
Elevated T cell count, decreased lymphoid tissue, recurrent encapsulated pyogenic bacteria: strep pneumo, pseudomonas, H flu
Bruton's x-linked aggamaglobulinemia: Bcells affected so no plasma cells
55
Recurrent ear infx, pna then sinusitis in older kid? | Dx, dx test / confirmation, Tx, Prognosis?
Bruton's X linked agammaglobulinemia XLA Check immunoglobulin levels, then if low check B and T cell subsets. Tx w/ IVIG Risk for bronchiectasis and CLD
56
most common primary immunodef? Associated with what? Prognosis / Risk Tx?
CVID assoc w/ autoimmune dz too. Hi risk of lymphoma/EBV related Tx w/ IVIG
57
transmission of most complement def? exception?
autosomal recessive except X-linked properdin def
58
Best treatment for DiGeorge?
thymic transplantation for prevention of infx
59
Absence of CD40 ligand causes what? Risk for what dz? Tx?
X-linked hyper IgM syndrome: disrupts B cell differentiation (Can't change IgM --> IgG High risk of PCP w/o HIV Tx w/ Ig replacement (IVIG) and bactrim for PCP prophylaxis
60
``` HyperE syndrome? Also called Sx? Infx Assoc features Tx ```
Job Syndrome: Three Es: Eos, eczema, elevated IgE Infx w/ S aureus, chronic thrush Assoc w/ fractures, abnormal faces Tx w/ Abx and steroids
61
Lab Diagnosis of SCID
complete absence of T cell function, B cells may be normal | Flurometric analysis of T, B, and NK cell subsets
62
Severe infx, dermatitis, diarrhea, FTT in first few months of life, DX? A specific type? Tx
SCID, may be ADA deficiency | BMT
63
situation in which 6 mo has lots of infections and lab has severely low IgG, slightly low IgA, and normal IgM.
Transient hypogammaglobulinemia of infancy due to decreased helper T cell function
64
S. aureus abscesses and serratia marcescens UTIs, think of what immuno def? Tx?
Phagocyte issue: CGT | Tx: Abx, interferon gamma
65
Dx w/ high WBC > 20,000and infx w/ perirectal abscess, indolent skin infx, omphalitis but NO PUS, delayed wound healing
LAD: leukocyte adhesion def
66
Tx for LAD?
BMT can be curative
67
Zidovudine type of drug
nucleoside analog
68
nevirapine type of drug
reverse transcriptase inhib
69
indinavir type of drug
protease inhib
70
normal NBT test?
turns blue: good neutrophil ACTIVITY
71
what test for ability of cells to migrate in LAD?
Rebuck Skin Window
72
consider this dx if Ab levels are high in the first year but dysfunctional, and then later on are low?
HIV in infant

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