Aaaaazzzzz 2 C02 Immu

Front 1

What is Immediate Hypersensitivity?

Back 1

Immediate Hypersensitivity is Anaphylaxis.

Front 2

What is Anaphylaxis pathophio? What similar condition?

Back 2

Anaphylaxis is an acute worst allergic condition. Synomymous with Immediate Hypersensitivity. Pt already Sensitized to Antigen. IgE binds to Mast Cells, leading to release of Granules (eg Histamine, Prostaglandins, and Leukotrienes), results in Abnormalities that define Anaphylaxis. Anaphylactoid Reactions are Non-IgE related, are clinically Identical and Tx the same, and Do Not Need Preceding Sensitization to Antigen. Anaphylaxis has Respiratory and Hemodynamic effects. Anaphylaxis is defined by Severity, Not the Cause, or Reaction.

Front 3

What is etiology of Anaphylaxis?

Back 3

Anaphylaxis and Allergic event has Same causes - 1 Insect Bites and Stings, 2 Medications (Penicillin, Phenytoin, Lamotrigine, Quinidine, Rifampin, Sulfa), 3 Foods, 4 Latex (in Healthcare Workers)

Front 4

What is an Important cause of Anaphylaxis in Healthcare workers?

Back 4

Important cause of Anaphylaxis in Healthcare workers - Latex.

Front 5

Anaphylaxis Px?

Back 5

Anaphylaxis Px - 1 Rash, 2 Hypotension (Tachycardia), 3 Respiratory (Shortness of Breath, Wheezing, Swelling of Lips, Tongue, or Face, Stridor). Urticaria is considered part of Anaphylaxis, Not just an Allergy.

Front 6

Anaphylaxis Tx?

Back 6

Anaphylaxis Tx Best Initial - 1 Epinephrine, 2 Antihistamines (Diphenhydramine H1 blocker, Ranitidine H2 blocker), 3 Glucocorticoids (Methylprednisolone or Hydrocortisone, 4 Emergent Airway Protection if Needed (Intubation or Cricothyroidotomy)

Front 7

Anaphylaxis Lx?

Back 7

Anaphylaxis Lx - None

Front 8

Anaphylaxis Etiology? Px? Lx? Tx?

Back 8

Anaphylaxis and Allergic event has Same causes - 1 Insect Bites and Stings, 2 Medications (Penicillin, Phenytoin, Lamotrigine, Quinidine, Rifampin, Sulfa), 3 Foods, 4 Latex (in Healthcare Workers). Anaphylaxis Px - 1 Rash, 2 Hypotension (Tachycardia), 3 Respiratory (Shortness of Breath, Wheezing, Swelling of Lips, Tongue, or Face, Stridor). Urticaria is considered part of Anaphylaxis, Not just an Allergy. Anaphylaxis Lx - None. Anaphylaxis Tx Best Initial - 1 Epinephrine, 2 Antihistamines (Diphenhydramine H1 blocker, Ranitidine H2 blocker), 3 Glucocorticoids (Methylprednisolone or Hydrocortisone, 4 Emergent Airway Protection if Needed (Intubation or Cricothyroidotomy)

Front 9

What is Angioedema?

Back 9

Angioedema is Swelling of 1 Face, 2 Tongue, 3 Eyes, 4 Airway. Swelling due to 1 C1 Esterase Inhibitor. Association of Onset with Minor Physical Trauma, usually Idiopathic. Recent Start of ACEI before symptoms.

Front 10

Angioedema Px?

Back 10

Angioedema Px - Hereditary Angioedema is Characterized by 1 Sudden Facial Swelling and 2 Stridor with 3 No Pruritus and 4 No Urticaria.

Front 11

Angioedema Lx?

Back 11

Angioedema Lx Best Initial - 1 Decreased levels of C2 and C4 in Complement pathway, 2 Deficiency of C1 Esterase Inhibitor.

Front 12

Angioedema Tx?

Back 12

Angioedema Tx - 1 Acute Tx with Fresh Frozen Plasma, 2 Long-term mgt with Androgens (Danazol and Stanazol), 3 Ensure Airway Protection First - rapidly evolving process (Hereditary Angioedema Does Not Respond to Glucocorticoids.)

Front 13

What is Not Angioedema Tx?

Back 13

Angioedema Hereditary Angioedema Does Not Respond to Glucocorticoids.

Front 14

What is Urticaria? Lx? Tx?

Back 14

Urticaria is a form of Allergic Reaction that causes Sudden Swelling of Superficial layers of Skin. Urticaria is a Localized Anaphylaxis with a Wheal and Flare. Causes 1 Insects, 2 Medications, 3 Foods, 4 Physical agents (Pressure - Dermatographism, Cold, Vibration). Lx - None. Tx - 1 Antihistamines (Hydroxyzine, Diphenhydramine, Fexofenadine, Loratidine, or Cetirizine, Ranitidine), 2 Leukotriene Receptor Antagonists (Monteleukast or Zafirlukast)

Front 15

What is Dermatographism?

Back 15

Dermatographism is Pressure causing Urticaria

Front 16

What Urticaria Tx?

Back 16

Urticaria Tx - 1 Antihistamines (Hydroxyzine, Diphenhydramine, Fexofenadine, Loratidine, or Cetirizine, Ranitidine), 2 Leukotriene Receptor Antagonists (Monteleukast or Zafirlukast)

Front 17

What are Antihistamine meds?

Back 17

Antihistamine meds are 1Hydroxyzine, 2 Diphenhydramine, 3 Fexofenadine, 4 Loratidine, 5 Cetirizine, 6 Ranitidine

Front 18

What are Leukotriene Receptor Antagonists meds?

Back 18

Leukotriene Receptor Antagonists (like Antihistamine, without dizziness) - 1 Monteleukast or 2 Zafirlukast

Front 19

What class is Hydroxyzine?

Back 19

Hydroxyzine is Antihistamine

Front 20

What class is Diphenhydramine?

Back 20

Diphenhydramine is Antihistamine.

Front 21

What class is Fexofenadine?

Back 21

Fexofenadine is Antihistamine

Front 22

What class is Loratidine?

Back 22

Loratidine is Antihistamine

Front 23

What class is Cetirizine?

Back 23

Cetirizine is Antihistamine

Front 24

What class is Ranitidine

Back 24

Ranitidine is Antihistamine

Front 25

What class is Monteleukast?

Back 25

Leukotriene Receptor Antagonists (like Antihistamine, without dizziness) - 1 Monteleukast or 2 Zafirlukast

Front 26

What class is Zafirlukast?

Back 26

Leukotriene Receptor Antagonists (like Antihistamine, without dizziness) - 1 Monteleukast or 2 Zafirlukast

Front 27

Allergic Rhinitis. Etiology? Px? Lx? Tx?

Back 27

Allergic Rhinitis. Etiology - Seasonal Allergies (eg Hay Fever) - IgE dependent triggering of Mast cells. Px - Recurrent Episodes of 1 Watery Eyes, Sneezing, Itching Nose, and Itchy Eyes, 2 Inflamed, Boggy Nasal Mucosa, 3 Pale or Violaceous Turbinates, 4 Nasal Polyps. Lx - Clinical Dx. Skin Testing and Blood Testing for Reactions to Antigens maybe useful in Identify a Specific Etiology. Allergen-Specific IgE levels may be Elevated. Nasal Smear may show Large Numbers of Eosinophils. Tx - 1 Prevention with Avoidance of Precipitating Allergen (aaaa Close windows and use air conditioning to avoid Pollen, bbbb Get Rid of Animals to which pt is Allergic, cccc Cover Mattresses and Pillows, dddd Use Air Purifiers and Dust Filters), 2 Intranasal Corticosteroids Sprays, 3 Antihistamines (Loratidine, Clemastine, Fexofenadine, Brompheniramine), 4 Intrasasal Anticholinergic med (Ipratropium), 5 Desensitization to Allergens that Cannot be Avoided

Front 28

Allergic Rhinitis. Etiology?

Back 28

Allergic Rhinitis. Etiology - Seasonal Allergies (eg Hay Fever) - IgE dependent triggering of Mast cells.

Front 29

Allergic Rhinitis. Px?

Back 29

Allergic Rhinitis. Px - Recurrent Episodes of 1 Watery Eyes, Sneezing, Itching Nose, and Itchy Eyes, 2 Inflamed, Boggy Nasal Mucosa, 3 Pale or Violaceous Turbinates, 4 Nasal Polyps.

Front 30

Allergic Rhinitis. Lx?

Back 30

Allergic Rhinitis. Lx - Clinical Dx. Skin Testing and Blood Testing for Reactions to Antigens maybe useful in Identify a Specific Etiology. Allergen-Specific IgE levels may be Elevated. Nasal Smear may show Large Numbers of Eosinophils.

Front 31

Allergic Rhinitis. Tx?

Back 31

Allergic Rhinitis. Tx - 1 Prevention with Avoidance of Precipitating Allergen (aaaa Close windows and use air conditioning to avoid Pollen, bbbb Get Rid of Animals to which pt is Allergic, cccc Cover Mattresses and Pillows, dddd Use Air Purifiers and Dust Filters), 2 Intranasal Corticosteroids Sprays, 3 Antihistamines (Loratidine, Clemastine, Fexofenadine, Brompheniramine), 4 Intrasasal Anticholinergic med (Ipratropium), 5 Desensitization to Allergens that Cannot be Avoided

Front 32

Allergic Rhinitis. Prevention?

Back 32

Allergic Rhinitis. 1 Prevention with Avoidance of Precipitating Allergen (aaaa Close windows and use air conditioning to avoid Pollen, bbbb Get Rid of Animals to which pt is Allergic, cccc Cover Mattresses and Pillows, dddd Use Air Purifiers and Dust Filters)

Front 33

What types of Primary Immunodeficiency Disorders exist?

Back 33

Primary Immunodeficiency Disorders exist - 1 Common Variable Immunodeficiency (B cell not making Immunoglobulin), 2 X-Linked (Bruton) Agammaglobulinemia (male child absence of Tonsils and Lymph nodes - absence B cells), 3 Severe Combined Immunodeficiency (deficiency Both B and T cells), 4 IgA Deficiency, 5 Hyper IgE Syndrome, 6 Wiskott-Aldrich Syndrome (Immunodeficiency and Thrombocytopenia and Eczema - T cells Reduced), 7 Chronic Granulomatous Disease (Extensive Inflammatory reactions - alot of pus in Lymph Nodes)

Front 34

Common Variable Immunodeficiency. Etiology? Px? Lx? Tx? Increased Risk of developing what disease?

Back 34

Common Variable Immunodeficiency. Etiology - Normal numbers of B cells, but Not Making effective Amounts of Immunoglobulins. Decrease in all subtypes - IgG, IgM, and IgA. Px - Recurrent Sinopulmonary infections in Adults. Frequent episodes of Bronchitis, Pneumonia, sinusitis, and Otitis Media, and other manifestations (Giardiasis, Spruelike Intestinal Malabsorption, and Increase in Autoimmune diseases such as Pernicious Anemia and Seronegative Rheumatic disease). Lx - Immunoglobulin levels are Decreased and Decreased response to Antigen Stimulation of B cells. Tx - Antibiotics are used for each infection as it develops. Chronic Maintenance is with regular Infusions of Intravenous Immunoglobulins. Increased Risk of developing Lymphoma.

Front 35

What is another name for X-linked Agammaglobulinemia?

Back 35

Another name for X-linked Agammaglobulinemia is Bruton Agammaglobulinemia.

Front 36

What is another name for Bruton Agammaglobulinemia?

Back 36

Another name for Bruton Agammaglobulinemia is X-linked Agammaglobulinemia.

Front 37

X-linked Agammaglobulinemia Px? Lx? Tx?

Back 37

X-linked Agammaglobulinemia Px - Male children with Increased Sinopulmonary infections. Lx - B Cells and Lymphoid tissues are diminished. Decreased or Absence of Tonsils, Adenoids, Lymph Nodes, and Spleen. T Cells are Normal. Tx Infections as they Arise. Long-term regular administration of Intravenous Immunoglobulin (IVIG) keeps these children healthier.

Front 38

What does B cells problem cause?

Back 38

B cells Decreased immunoglobulin production leads to Recurrent Sinopulmonary infection beginning as early as 6 months of age.

Front 39

What does T cells problem cause?

Back 39

T cells Decreased in Numbers gives many infections seen in pt with AIDS (PCP, Varicella, and Candida).

Front 40

Severe Combined Immunodeficiency. Px? Lx? Tx?

Back 40

Severe Combined Immunodeficiency. Px - Combined means Deficiency in Both B and T Cells. B cell problem - Recurrent Sinopulmonary infection beginning as early as 6 month of age. T cell number decreased similar to pt with AIDS (PCP, Varicella, and Candida). Lx - Decreased Immunoglopulins (B cell), and Decreased T cell count. Tx - Tx infection as they arise, and Undergo Bone Marrow transplant (curative)

Front 41

IgA Deficiency Px? Tx?

Back 41

IgA Deficiency Px - 1 Recurrent Sinopulmonary infections, 2 Atopic disease, 3 Anaphylaxis to blood transfusion when blood is given from a pt who has Normal levels of IgA, 4 Spruelike condition with fat malabsorption, 5 Increase in Risk of Vitiligo, Thyroiditis, and Rheumatoid Arthritis. Tx Infections as they Arise, and ONly use Blood that is from IgA-Deficient donors or Washed. IVIG injection will Not work because too few IgA and it make Provoke Anaphylaxis.

Front 42

Hyper IgE Syndrome Px? Tx?

Back 42

Hyper IgE Syndrome Px - Recurrent Skin Infections with Staph. Tx - Prophylactic Antibiotics (Dicloxacillin or Cephalexin)

Front 43

Wiskott-Aldrich Syndrome Px? Tx?

Back 43

Wiskott-Aldrich Syndrome Px - 1 Immunodeficiency, 2 Thrombocytopenia, and 3 Eczema. T lymphocytes are Markedly Deficient in Blood and Lymph Nodes. Tx - Bone Marrow Transplantation is Definitive.

Front 44

Chronic Granulomatous Disease. Px? Lx?

Back 44

Chronic Granulomatous Disease. Px - Genetic disease resulting in Extensive Inflammatory reactions. Lymph Nodes with Purulent Material Leaking out. Aphthous Ulcers and Inflammation of Nares is Common. Granulomas may become Obstructive in GI or Urinary Tract. Odd Combination of infections - 1 Staph, 2 Burkholderia, 3 Nocardia, and 4 Aspergillus. Lx - Abnormal Nitroblue tetrazolium Testing - detects Decreasei in Respiratory Burst that produces Hydrogen Peroxide. Decrease in NADPH Oxidase, which generates Superoxide.

Front 45

Abnormal Nitroblue Tetrazolium Testing. How does it work? Dx?

Back 45

Abnormal Nitroblue Tetrazolium Testing - NBT detects Decrease in respiratory Burst that produces Hydrogen Peroxide. Decrease in NADPH Oxidase, which generates Superoxide. Dx - Chronic Granulomatous Disease