Immunodeficiencies & infections Flashcards

1
Q

Most Primary Immunodeficiencies are single gene defects, what are the 3 domains?

A

1) Ab deficiency due to defect in B cells

2) Cellular due to T cell defect

3) Innate due to PRRs, phagocytes or complement defect

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2
Q

What about a child’s illness would make you suspect an immunodeficiency?

A

SPURR:
- Severe
- Persistant
- Unusual
- Recurrent
- Runs in family

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3
Q

What infections arise from Ab deficiencies?

A

Recurrent resp bacterial infections incl Pneumococcus & H influenzae

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4
Q

What type of infections arise from T cell deficiencies?

A

Opportunistic infections incl Pneumocytic Jiroveccii pneumonia (PCP) & CMV pneumonia

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5
Q

What type of infections would you expect to see in a phagocyte defect?

A

Staph aureus –> Sepsis, skin inf & deep organ abscesses

Aspergillus –> Lung, bones & brain inf

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6
Q

What infections do you see in complement deficiency?

A

N. Meningitidis (So meningitis)

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7
Q

What could you do if you suspect Primary Immunodeficiencies?

A

Ab? –> Ab tests & measuring immune response to vaccination with common pathogens

T cell? –> Diff WCC & immunophenotyping

Complement? –> Measure complement activation & individual factors

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8
Q

What’s the main secondary immunodeficiency?

A

HIV/AIDS

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9
Q

How would you spot HIV/aIDS?

A

Recurrent/disseminated VZV/HSV
Opportunistic Inf e.g. CMV pneumonia or PCP
Recurrent RTIs & Persistant oral thrush
Erythematous popular rash, generalized lymphadenopathy & FTT/developmental delay

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10
Q

Invasive fungal infections e.g. Candida Albicans or Aspergillus Fumigatus are often a presenting symptoms of Primary immunodeficiency. What else would cause one?

A
  • Neutropenia e.g. leukaemia/chemo
  • Neonates (immature immunity)
  • Broadspec Abx and/or abdo surgery

And primary immunodeficiency

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11
Q

What are the differences between an invasive candida vs aspergillus infection?

A

Candida:
- Endogenous
- Get from birth canal/staff’s hands
- +ve blood cultures
- Metastatic Foci

Aspergillus:
- Exogenous
- Get form air/water/environment
- -ve cultures with pulm disease
- Angio-invasive

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12
Q

Who tends to get neonatal Candidaemia?

A

Low BW babies( mainly prems) in their 2nd/3rd wk

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13
Q

What do you suspect in a premature neonate with sepsis syndrome, thrombocytopenia & Hyperglycaemia?

A

Neonatal Candidemia

(Clue is the hyperglycaemia, in a bacterial infection that would be low)

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