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AKT revision > Allergy/Immune/Oncology/ID > Flashcards

Allergy/Immune/Oncology/ID Flashcards

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1
Q

what are the four types of hypersensitivity reactions?

A

type I - anaphylactic
type II - cell bound
Type III - immune complex
Type IV - delayed hypersensitivity

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2
Q

what is the mechanism of type I hypersensitivity reactions?

A

IgE mediated reaction - IgE reacts with the antigen

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3
Q

what are examples of type I hypersensitivity reactions?

A

anaphylaxis
atopy - asthma, eczema, hayfever

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4
Q

what is the mechanism of action in type II hypersensitivity reactions?

A

IgG or IgM binds to antigens on the cell surface

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5
Q

what are examples of type II hypersensitive reactions?

A

goodpastures syndrome
pernicious anaemia
rheumatic fever
autoimmune haemolytic anaemia
ITP

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6
Q

what immunoglobulins are involved in type III hypersensitivity reactions?

A

sle
post strep glomerulonephritis
EAA

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7
Q

what mediates type IV reactions?

A

T cell mediated

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8
Q

what are examples of type IV reactions?

A

TB
graft versus host disease
Alergic contact dermatitis
scabies
EAA
MS
GBS

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9
Q

what is oral allergy syndrome?

A

IgE mediated hypersensitivity reaction to specific raw, plant based foods including fruits, vegetables, nuts and certain spices

the allergy is due to cross-sensitisation to a structurally similar allergen present in pollen - not o the actual protein in the food itself

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10
Q

what are the symptoms of oral allergy syndrome?

A

tingling or pruritis of the lips, tongue and mouth

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11
Q

what is the most common allergen involved in oral allergy syndrome?

A

birch pollen

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12
Q

are the symptoms of oral allergy syndrome the same throughout the year or do they vary?

A

they are worse during summer months - as they are so strongly linekd to birch pollen allergies

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13
Q

are the symptoms of oral allergy syndrome worse with raw or cooked foods?

A

worse with raw foods - cooking them denatures the proteins, preventing symptoms from occuring

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14
Q

what dose of adrenaline is given in 6 months to 6 years of age?

A

150 micrograms (0.15ml 1 in 1000)

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15
Q

what dose of adrenaline is given from 6-12 years?

A

300 micrograms (0.3ml, 1 in 1000)

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16
Q

what dose of adrenaline is given in adults and children > 12 years?

A

500 micrograms (0.5 mls of 1 in 1000)

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17
Q

when should IM adrenaline injection be repeated?

A

if symptoms not improved in 5 mins

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18
Q

where should the IM adrenaline injection be given?

A

anterolateral aspect of the middle third of the thigh

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19
Q

how many adrenaline auto-injectors should patients be prescribed?

A

2

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20
Q

what are the 3 most common cancers in men and the 3 most common in women?

A

Prostate / breast
lung
colorectal

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21
Q

which type of chemotherapy agent causes pulmonary fibrosis?

A

bleomycin

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22
Q

which type of chemotherapy agent causes haemorrhagic cystitis ?

A

cyclophosphamide

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23
Q

which antiemetic is the best for chemotherapy induced nausea and vomiting?

A

metoclopramide first line
ondansetron second line - 5HT 3 antagonist

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24
Q

which chemotherapy agent causes peripheral neuropathy?

A

vincristine

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25
what are the contraindications for the influenza vaccine?
food allergy to egg aged < 2 years current febrile illness or blocked nose (as intranasal vaccine) current wheeze hx of severe asthma pregnancy/breastfeeding if the child is taking aspirin (i.e. kawasaki) - due to rise of reyes syndrome
26
which are the different types of malaria species?
plasmodium sp - p falciparum - most severe, causes cerebral malaria p vivax + p ovale - can relaps3 p malariae - less severe, chronic infection p knowlesi - zoonotic
27
what are the symptoms of malaria/
fever- often cyclical or irregular rigors headache malaise myalgia nausea/vomiting/diarrhoea jaundice hepatosplenomegaly neuro signs - indicator of more severe cerebral disease
28
what are the red flag signs of more severe malarial disease?
altered consciousness severe anaemia hypoglycaemia acidosis resp failure shock + multi organ failure
29
what is the gold standard investigation for malaria?
blood films - thick and thin to detect the parasite + species
30
which strains of malaria can lead to relapse?
p vivax and p ovale
31
how do you prevent malarial relapse in certain strains?
primaquine - taken to prevent relapse
32
which malarial prophylacitic agent causes headache as a SE?
chloroquine
33
which malarial prophylactic most commonly causes GI upset?
atovaquone + proguanil - (malarone)
34
which antimalarial commonly causes photosensitivty and oesophagitis?
doxycycline
35
which antimalarial commonly causes dizziness + neurophsychiatric distubrance?
mefloquine (Lariam)
36
which antimalarials are contraindicated in epilepsy?
chloroquine mefloquine (lariam)
37
which antimalarial can be taken by a pregnant woman safely?
chloroquine
38
what is the first line treatment of gonorrhea?
IM ceftriaxone
39
what is the second line treatment of gonorrhoea or given as alternative if IM not tolerated?
oral cefixime 400mg single dose + axithromycin 2g single dose
40
what causes lyme disease?
borrelia burdorferi
41
what are the symptoms of lyme disease?
erythema migrans - "bulls eye" rash at the site of the tick bite typically develops 1-4 weeks after the initial bite usually painless then systemic features - headahe, lethargy, fever, arthalgia
42
what re some late features of lyme disease?
can cause CVS symptoms - heart block + peri/myocarditis neurological symptoms - facial nerve palsy, radicular pain, meningitis
43
management of suspected early lyme disease?
doxycycline - if early disease
44
what should be given for late disseminated lyme disease?
ceftriaxone
45
what is the first line test for lyme disease?
ELISA antibodies - first line test if negative and still suspected in 4-6 weeks - then repeat ELISA test if symptoms still present in 12 weeks but initial tests negative, then can do immunoblot test
46
what is the treatment for BV?
5-7 day course of metronidazole if symptomatic no treatment needed if incidental finding and asymptomatic single 2g dose of metronidazole can be used if adherence is an issue
47
what causes BV?
gardnerella vaginalis infection
48
what antibiotics are used to treat TB?
initial phase - RIPE - 2 months Rifampicin Isoniazid Pyrazinamide Ethambutol continuation phase - 4 months Rifampicin Isoniazid
49
what are SE of rifampicin?
hepatitis orange secretions flu like symptoms
50
what are the SE of isoniazid?
peripheral neuropathy hepatitis agranulocytosis
51
what are the SE of pyrazinamide?
hyperuricaemia - may cause gout arthalgia myalgia hepatitis
52
what is the SE of ethambutol?
optic neuritis - check visual actuity before starting treatment
53
what is the first line treatment for chlamydia?
doxycycline 7 days axithro if allergic
54
what causes trichomonas?
trichomonas vaginalis
55
what are the symptoms of trichomonas?
vaginal discharge - offensive, yellow/green and frothy vulvovaginitis strawberry cervix men usually asymptomatic
56
what is the invetigation for trichomonas?
wet mount - shows motile trophozites
57
name the inducers of the p450 system?
CArbamazepine, Rifampicin, Phenytoin/Phenobarbitone, Excess alcohol intake (chronic), Topiramate, Smoking/St. John's Wort CARPETS
58
what effect do p450 inducers have on the INR?
inDUCers reDUCE the INR
59
what effect do p450 inhibitors have on the INR?
INhibitors INCREASE the INR
60
why do betablockers cause a disruption in sleep?
This occurs due to their ability to block β-adrenergic receptors in the brain, which reduces melatonin secretion. Melatonin is a hormone that regulates sleep-wake cycles, so its suppression can disrupt sleep. Additionally, beta-blockers may increase vivid dreams or nightmares.
61
what are alpha blockers used for?
treat hypertension + BPH Alpha blockers are a group of drugs that block the effect of adrenaline on specific receptors (alpha receptors) found in the smooth muscle lining blood vessels and the urinary tract. The main indications for their use are hypertension, where they cause vasodilation and reduce systemic vascular resistance, and benign prostatic hyperplasia (BPH), where they relax smooth muscle in the prostate and bladder neck to improve urinary flow.
62
give two examples of alpha blockers?
tamsulosin doxasozin
63

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