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41 Cards in this Set
- Front
- Back
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Does treatment of allergic affect osa.
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Yes, even central osa
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Most common sx of asthma?
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Cough, usu nocturnal, waking up at night. listen to lungs.
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Kids with COME, what percent have allergies?
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40-50%
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What is the Odds ratio of developing asthma in pts with dm allergy?
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8
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What is the OR of developing asthma in pts with AR?
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3
Of pts with AR, 30-50% risk of asthma 80% of asthma pts have AR..... |
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Rhinitis leads to bronchialnreactivity and AR pts are more likely to respond to methacholine challenge. This is due to
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Systemic propagation of inlflamatory mediators
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What is nasal bronchial reflex?
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When you challenge the nose, the bronchi respond. If you block the nose, you see a 20% drop in FEV1
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What cell type is the most important in AR and asthma?
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Eosinophil
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If you treat pts with atopy with SCIT, what decrease in risk of asthma in kids
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So far for the duration of immunotherapy, then later study said for 7 years.
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What needs to be done prior to skin testing in pts with cough?
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Pre and post spirometry.
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What cells have MHC 1
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All nucleated cells, conveys 'self'
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What cells express MHC II
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All immune cells
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Clonal expansion
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Exponential numbers of cells that can respond to a particular antigen
....via amplification, then form memory cells |
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Artificial immunity
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Ig pass through placenta, ab in breast milk
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Innate immunity examples
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Cellular response present at birth, generic to common pathogens
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Barriers
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Skin , tears, mucus
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Adaptive immunity
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One cell recognizes one entity, DNA splicing allows for unlimited variations of Ig.
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Two lineages of cellular immunity
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Lymphoid and myeloid
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APC's
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Langherhans, etc
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Mast cells vs basophils
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Baso - circulation. Mast cells in skin, tissues. Both react with histamine
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Eosinophil proteins from granules
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MBP - mjr basic protein. Eosinophilic cation protein. Good for killing worms, parasites
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NK cells
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No ab or t cell receptors. Kill cells....
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T helper cells vs cytotoxic t cells
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Help with cellnsignaling vs scavenging for viral or cancer cells
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Th1
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Bacterial, viral, autoimmunity. Il 2 ifn gamma
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Th2
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Allergies and parasites, asthma and allergic rhinitis. IL-4,5,9,13.
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T-reg cells
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Down regulates th2 response. !very important for suppressing allergy
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B cells switch with immunotherapy
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F
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IgE
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Usually less than 1% of blood, most is bound to mast cells in blood
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What Ig crosses placenta
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IgG
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Ig has heavy and light chains. Which has binding site for allergen
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Light.
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IL- 4,5,13
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Allergic response, stim th2, eos.
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IL- 10
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Down regulates the inflammatory response
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Complement
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Two pathways, classicial via complement. Alternative....
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Gel and coombs
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1 - allergy, asthma, anaphylaxis*
2- igG attack of tissue 3- circulating complexes that deposite in kidney and jts 4- cell mediated, delayed, like poison ivy |
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What prostaglandin in involved with AR
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PGE2.
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Hygiene hyporthesis
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Th2 preponderance in youth. Usually kids are exposed to bugs causes a rise in the TH1 response. Without stimulus, the Th2 remains dominant. Start responding to allergy.
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Primary goal of immunomtherapy
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Shift from th2 to th1
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What are the most bothersome sx AR pts complain of?
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Sinus pressure and nasal congestion
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What are dennie's lines
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Lower eye lid lines from chronic rubbing. Eye version of a supra tip crease
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What makes some people allergic and others not?
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Genetics and environment
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Allergic march
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Atopic dermatitis like eczema, then food allergies, then asthma, which all peak and fall in younger years. then allergic rhinitis which stays high in prevalence.
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