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106 Cards in this Set

  • Front
  • Back
where is complement made
in the liver
what fixes complement
igg and igm*
what rises in response to allergic reaction
ige
what rises in response to parasitic infections
ige
physical and lab findings of bruton's agammaglobulinemia
x linked
no b cells, tonsils, or germinal centers
<10% immunoglobulins present
presentation of a pt with bruton's agammaglobulinemia
tx
recurrent bacterial infection after mom's ig's are depleted
give immunoglobulin
what is the defect in common variable hypogammaglobulinemia
nml #s of b cells, but they don't work well --> low levels of immunoglobulins
presentation of common variable hypopgammaglobulinemia
increased susceptability to infections and AUTOIMMUNE DZ
low levels of immunoglobulins
immune defect in digeorge syndrome
absent 3rd and 4th pharyngeal pouches
no t cells, hypocalcemia
nml b cells and immunoglobulins
what is particularly deadly to pts with digeorge
live vaccines
presentation of wiskott-aldrich syndrome
thrombocytopenia
eczema
recurrent infections
immune defects in wiskott-aldrich
defective cmi
low igm, high iga, nml igg and ige
immune defect in scid
no t or b cells, no thymus, no adenosine deaminase which --> no dna synthesis
clinical presentation of ataxia-telangiectasia
cerebellar ataxia
cutaneous teleangiectasia
SKIN CANCER
immune defect in ataxia-telangiectasia
igA deficiency
Thymus - hypoactive
(A-T)
immune defect in chronic granulomatous disease
decreased respiratory burst due to deficient nadph oxidase fxn

increased susceptability to catalase + organisms
clinical presentation of chronic granulomatous disease
hepatosplenomegaly
aphthous ulcers
seborrhea
infections that pts with chronic granulomatous diseaes are susceptible to
staph and proteus (catalase + organisms)
immune defect in chediak-higashi
defective chemotaxis
presentation of chediak-higashi
recurrent staph and strep infection
pathophys of selective iga deficiency
anti-iga ige
iga tx for selective iga deficiency
--> anaphylaxis
immune defect in job's syndrome
decreased chemotaxis
high ige
clinical presentation of job's syndrome
frequent sinus and pulmonary infecions
cold skin staph abscesses
clinical presentation of x linked lymphoproliferative dz
decreased ab to ebv
ebv infection is FATAL
how to dx chronic granulomatous dz
nitroblue tetrazolium tests (nbt) is deficient
dhr conversion test is +
tx fo chronic granulomatous dz
proph bactrim and interferon gamma therapy
d/o of terminal complement have ferquent infections with
n. meningitis
mechanism of type i hypersensitivity reaction
antigens react with ige bound to surface of basophils or tissue mast cells --> degranulation wiht release of histamine
examples of type i hypersensitivity
urticaria
anaphylaxis
angioedema
tx of anaphylaxis
secure airway (intubation, or if not possible, cricothyrotomy)
subq epi
mechanism of type ii hypersensitivity
preformed igm and igg ab tha treact with antigen --> secondary inflammation
examples of type ii hypersensitivity
erythroblastosis fetalis
transfusion reactions
autoimmune hemolytic anemia
grave's disease
hyperacute transplant rejection
pernicious anemia
mechanism of type iii hypersensitivity
immune complexes deposit in bv --> inflammatory response
examples of type iii hypersensitivity
serum sickness
rheumatoid arthritis
pan
sle
mechanism of type iv hypersensitivity
t cell release of inflammatory mediators
examples fo type iv hypersensitivity
tuberculin reaction
contact dermatitis
sarcoidosis
most common primary immunodeficiency
iga deficiency
classic presentation of iga deficiency
anaphylaxis after ivig infusion
physical appearance of a pt with job syndrome
fair skin
red hair
eczema
in HIV: when should PCP prophylaxis be given
drug of choice
CD4 <200
Bactrim
treatment for PCP
Bactrim
in HIV, when should prophylaxis be given for toxo
drug of choice
CD4 <100
bactrim
treatment for toxo
sulfadiazene + pyromethoxazole
in HIV, when should prophylaxis be given for MAC
drug of choice
CD4 <50
Azithromycin
treatment for MAC
CAR
Clarithromycin
Azithromycin
Rifabutin
CD 4 count associated with cryptococcus
<100
TX FOR cryptococcus
amphotericin B + flucytosine
CD4 count associated with cryptosporidium
<150
tx for cryptosporidium
paromocin + azithromycin
CD4 count associated with isospora
<100
CD4 count associated with cyclospora
<100
treatment for isospora
bactrim
tx for cyclospora
bactrim
cd4 count associated with microsporidia
<100
tx for microsporidia
albendazole
cd 4 count associated with e. hystolytica
any
tx for e. hystolytica
metronidazole
cd4 count associated with giardia
any
tx of giardia
metronidazole
cd4 count associated with c diff
any
tx of c diff
metronidazole
appearance of a chancre
1 cm papule or painless ulcer
organism that causes chancre
t. pallidum
diagnostic test for syphilis
darkfield microscopy (in primary syphilis)
fta-abs, vdrl/rpr (false neg in primary syphilis, but can be used later)
chancre:
pain?
adenopathy?
painless
firm, b/l adenopathy
tx of syphilis
pcn
appearance of herpes ulcer
grouped papules, vesicles, pustules
diagnostic test of hsv
tzanck smear is quickest
cx is gold standard
hsv ulcer:
pain?
adenopathy?
yes
firm, b/l adenopathy
tx fo hsv ulcers
acyclovir, famcyclovir, or valacyclovir for outbreaks;
if >5/yr tx iwth acyclovir
appearance of chancroid
purulent ulcer with shaggy borders
organism causing chancroid
h. ducreyi
chancroid:
pain?
adenopathy?
yes
tender u/l adenoapathy
tx of chancroid
ACCE
azithromycin, ceftriaxone, cipro, or erythromycin
appearance of lymphogranuloma vereum
papule, vesicle, ulcer
organism causing lymphogranuloma venereum
chlamydia trachomatis
lymphogranuloma venereum:
pain?
adenopathy?
no
tender, u/l
tx of lymphogranuloma venereum
doxycycline or eyrthromycin
appearance of granuloma inguinale
nodules, coalescing granulomatous ulcers
diagnostic test of chancroid
cx
diagnostic test of lymphogranuloma venereum
complement fixation or immunofluorescence
granuloma inguinale:
pain?
adenopathy?
no
rarely
tx of granuloma inguinale
BCDE
bactrim
cipro
doxy
or erythromycin
organism that causes granuloma inguinale
c (donavania) granulomatis
organism most commonly causing yeast infection
candida
discharge seen with yeast infection
thick and curd-like
ph of vaginal d/c in yeast infx
4-5
tx of yeast infx
fluconazole
complications of yeast infx
none
organisms that cause bv
gardnerella, m. hominis, other anaerobes
d/c seen in bv
white-gray non-inflammatory (no WBCs)
pH of d/c in bv
5-6
diagnostic test of yeast infx
koh shows branching hyphae and spores; gram stain
diagnostic test of bv
clue cells, whiff test
tx of bv
metronidazole
complications of bv
if a pregnant woman is infected, then there can be premature labor, prom, etc
should partner be treated in bv
no
oranism causing trichomoniasis
trichomonas vaginalis
d/c in trich
yellow-green
other sx seen in trich
dyspareunia
dysuria
strawberry cervix
ph of d/c in trich
6-7
diagnostic test for trich
wet prep showing flagellated organisms
tx of trich
metronidazole
complications of trich
adverse pregnancy outcomes
should partner be treated in trich or bv?
only in trich