allergy/immuno Flashcards Preview

PEDIATRIC BRS > allergy/immuno > Flashcards

Flashcards in allergy/immuno Deck (84):
1

anaphylaxis

acute systemic IgE mediated reaction

2

what does anaphylaxis effect?

vascular tone and bronchial reactivity

3

mechanism of of anaphylaxis

antigen binding to IgE on the surface of mast cells and basophils results int eh release of potent mediators that affect vascular tone and bronchial activity

4

what are the cardiovascular symptoms relating to anaphylaxis?

ranges from mild hypotension to shock

5

what is the treatment for acture respiratory and cardiovascular complications of anaphylaxis?

epinephrine

6

this is an IgE mediated inflammatory response int he nasal mucosa to inhaled antigens

allergic rhinitis

7

pathophysiology behind allergic rhinitis

mast cells degranulate and release histamine, leukotrienes, kinins, and prostaglandins

8

these are dark circles under the eyes caused by VENOUS CONGESTION

allergic shinders

9

these are creases under the eyes as a result of CHRONIC EDEMA

Dennie's lines

10

what is the lab eval of allergic rhinitis?

total IgE concentration may be elevated, allergen skin testing

11

what is critical to do before an allergy skin test?

discontinue antihistamines 4-7 days before skin testing

12

how can you differentiate allergic rhinitis from other disorders

more than 10% eosinophils suggests allergic rhinitis

more POLYMORPHIC LEUKOCYTES SUGGESTS AN INFECTION CAUSE

13

what is the most effective class of drugs for controlling rhinitis symptoms?

intranasal steroids

14

what are the 2 benefits of intranassal steroids

minimal systemic absorption, and the hypothalamic pituitary adrenal axis is not affected at recommended doses

15

diphenhydramine is a ____ generation antihistamine that may cause _____ and can impair academic performance

first generation antihistamine
sedation

16

cetirizine, fexofenadine, loratidine are all what class of drugs

second generation antihistamines that are safer and better tolerated

17

how does cromolyn sodium work?

prevents max cell degranulation

18

these relieve vasoconstriction and relieve nasal congestion but can cause insomnia, nervousness and rebound rhinitis?

decongestants (pseudoephedrine)

19

repeated injections of allergens with time lead to ?

better tolerance of the allergen by the patient

20

chronic inflamm dermatitis

atopic dermatitis (eczema)

21

characteristics of eczema

dry skin and lichenification

22

when is atopic dermatitis worse?

in extremes of temperature

23

is atopic dermatitis familial?

yes

24

acute or chronic? erythema, weeping and crusting and secondary staph aureus, hsv infection?

ACUTE

25

acute or chronic? lichenification, dry scaly skin and pigmentary changes?

chronic

26

truncal and facial area, scalp and EXTENSOR SURFACES are affected

infantile form of atopic dermatitis

27

FLexural serfeces, lichenifcation ?

early childhood form of atopic dermatitis

28

what are the 4 major criteria of eczema?

pruritus
personal/familial history of atopy
typical morphologic distribution
relapsing or chronic dermatitis

29

management of eczema

avoid known triggers
low to medium potency corticosteroid cream except on face
antihisamines
baths

30

this is an igE mediated response to food antigens?

food allergy

31

what are most allergic reactions caused by?

egg, milk, peanut, soy wheat and fish

32

true or false, exclusive breastfeeding for 6 months may decrease food allergies and atopic dermatitis in the infant?

true

33

what are the 2 tests for food allergies?

skin tests and radioallergosorbent tests

34

what its he definitive test for food allergy?

double blind placebo controlled food challenge test

35

what can local skin reactions be treated with for insect bites?

cold compresses, analgesics and antihistamines

36

diffuse urticartia tx

antihistamines and systemic steroids

37

this is a circumscribes, raised vanishing areas of edema that are always pruritic? they are are also symmetric and migratory

urticaria

38

these 2 groups of ppl are at higher risk for acute urticaria due to latex allergy

MYELOMENINGOCELE
health care workers

39

this is urticaria that last >6 months

chronic urticaria

40

what is chronic urticaria usually associated with?

malignancy and rheumatologic disease

41

those with chronic urticaria generally have an Ig___ antibody to the Ig____ receptor

IgG antibody to the IgE receptor

42

these are common drugs that cause drug allergies

penicillin, sulfonamides, cephalosporins, aspirin and other non steroidal antiinflam drugs and narcotics

43

phagocytic cells, nK cells, toll-like receptors, mannose binding protein and alternative complement pathway are all what type of response?

innate response ( first defense)

44

T cells, B cells and immunoglobulin molecules are all what type of response?

adaptive responses

45

serum igA concentrations

IgA deficiency ( most common deficiency)

46

a patient comes in with recurrent sinusitis, pneumonia, otitis media and bronchitis along w/ chronic diarrhea and foul smelling fatty droplet diarrhea w/ SLE and JVA will most likely have what?

igA deficiency

47

how is igA deficiency diagnosed?

quantitative measurement of serum immunoglobulin

48

true or false IVIG is indicated in IgA deficiency?

false, IVIG is not indicated b/c IgA cannot be replaces, IVIG is not indicated because it contains almost all IgG

49

normal numbers of B and T cells but variable degrees of T - cell dysfunction?

common variable immunodeficiency w/ HYPOGAMMAGLOBULINEMIA

50

a fully immunized boy comes in but his titers still show low antibodies? what does he most probably have?

diminished antibody function due to common variable immunodeficiency

51

3 treatments for common variable immunodeficiency?

monthly IVIG replacement
aggressive management of infections w/ antibiotics
chronic diarrhea management w/ nutritional support

52

deficiency of the common gamma chain of receptor for cytokines IL 2,4,7,9 and 15?

x linked SCID

53

caused by T- cell ontogeny defect and adenosine deaminiase def?

Autosomal recessive SCID

54

what 2 opportunistic organisms will cause infection within the first few months of life in a baby w/ SCIDS?

candida and pneumocystis carinii

55

how will a patient w/ acids present in CBC? flow cytometry? ogg? t cell response?

1. perisient lymphopenia

56

treatments for SCIDS

1. supportive care
2. blood prudcts be irradiated to prevent draft vs. host disease
3. monthly IVIG replacement
4. TMPSMX prophylaxis for P. Carinii

57

combined immunodeficiency, cerebellar ataxia, oculocutaneous telangiectasias, and predisposition to malignancy?

mutation of a gene on the long arm of CHROMOSOME 11

ataxia telangiectasia

58

true or false? most patients diagnosed w/ ataxia telangiectasia will need wheel chair assistance by early adolescence?

true

59

what are most patients w/ ataxia telengectasia deficient in?

IgE and IgA

60

what should those w/ ataxia telangiectasia avoid?

avoid ionizing radiation which exacerbates DNA breakage and repair thus increasing risk for malignancy

61

cardiac defects, abnormal facies, thymic hypoplasia, cleft palate and hypocalcemia?

digeorges syndrome

62

what chromosome is involved w/ digeorges syndrome?

22q11

63

x linked disoder characterized by combined immunodeficiency, eczema, congenital thrombocytopenia w/ small platelets?

wiskott aldrich syndrome

64

what gene product is lost in wiskott aldrich syndrome?

t - cell receptor signaling and cyto skeletal organization

65

what will those w/ wiskott aldrich syndrome generally present w/

- infection w/ encapsulated organism such as h. influenza and s. pneumo
- thromboycytopenia w/ small defective platelets ( frequent bleeding episodes)
- eczema

66

those with wiskott aldrich syndrome will have decreased Ig_____

IgM

67

what is the therapy of choice for wiskott aldriche syndrome?

HLA matched bone transplantation

68

what will cure the thromboycytopenia in wiskott aldrich?

splenectomy

69

severe hypogammaglobulinemia w/ a paucity of mature B cels in peripheral blood w/ normal t- cell number and function?

Brutons Agammaglobulinemia

70

this gene is critical to normal B-cell ontogeny and mutations lead to a block in the development from Pre-b Cellt o B cell?

BTK

71

what is preserved in britons a gammaglobulinemia?

t - cells are present and cell mediated functions are preserved, IVIG replacement to prevent infection

72

defective NADPH results in what?

chronic granulomatous disease

73

does chronic grandulomatous disease affect catalase positive or negative bacteria?

catalase positive

74

what are 3 disorders of granulocytes?

CGD, schwachman diamond syndrome, chediak higashi sydrome

75

what is characteristic of CGD?

abscess formation

76

what is the diagnostic test for CGD?

nitroblue tetrazolium test

77

what 3 things are given prophylactically to CGD patients?

TMP SMX, itraconazole for aspergillus, interferon gamma

78

patients with disease present with recurrent soft tissue infection, chronic diarrhea and failure to thrive

schachman diamond syndrome

79

patients with those infections generally have s. aureus infections, neutropenia, thrombocytopenia, and partial albinism

chediak higashi syndrome

80

composed of plasma proteins and cellular receptors functioning in an integrated series to prevent infection

complement systom

81

how can you differentiate between early component deficiency vs. late component?

early - autoimmune
late - increased meningococcal and gonococcal infections

82

this type of complement deficiency will cause heretarary angioedema and episodic swelling ov arious body parts including hands and feet and bowel

C1 esterase deficiency

83

how can you diagnose complementt system disorders

CH50

84

management of complement deficiency

1. tx bacterial infect
2. manage autoimmune disease
3. fibrinolysis inhibitiors and attenuated androgens (DANAZOL) for hereditary angioedema