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106 Cards in this Set
- Front
- Back
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where is complement made
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in the liver
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what fixes complement
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igg and igm*
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what rises in response to allergic reaction
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ige
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what rises in response to parasitic infections
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ige
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physical and lab findings of bruton's agammaglobulinemia
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x linked
no b cells, tonsils, or germinal centers <10% immunoglobulins present |
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presentation of a pt with bruton's agammaglobulinemia
tx |
recurrent bacterial infection after mom's ig's are depleted
give immunoglobulin |
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what is the defect in common variable hypogammaglobulinemia
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nml #s of b cells, but they don't work well --> low levels of immunoglobulins
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presentation of common variable hypopgammaglobulinemia
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increased susceptability to infections and AUTOIMMUNE DZ
low levels of immunoglobulins |
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immune defect in digeorge syndrome
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absent 3rd and 4th pharyngeal pouches
no t cells, hypocalcemia nml b cells and immunoglobulins |
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what is particularly deadly to pts with digeorge
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live vaccines
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presentation of wiskott-aldrich syndrome
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thrombocytopenia
eczema recurrent infections |
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immune defects in wiskott-aldrich
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defective cmi
low igm, high iga, nml igg and ige |
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immune defect in scid
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no t or b cells, no thymus, no adenosine deaminase which --> no dna synthesis
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clinical presentation of ataxia-telangiectasia
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cerebellar ataxia
cutaneous teleangiectasia SKIN CANCER |
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immune defect in ataxia-telangiectasia
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igA deficiency
Thymus - hypoactive (A-T) |
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immune defect in chronic granulomatous disease
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decreased respiratory burst due to deficient nadph oxidase fxn
increased susceptability to catalase + organisms |
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clinical presentation of chronic granulomatous disease
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hepatosplenomegaly
aphthous ulcers seborrhea |
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infections that pts with chronic granulomatous diseaes are susceptible to
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staph and proteus (catalase + organisms)
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immune defect in chediak-higashi
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defective chemotaxis
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presentation of chediak-higashi
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recurrent staph and strep infection
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pathophys of selective iga deficiency
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anti-iga ige
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iga tx for selective iga deficiency
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--> anaphylaxis
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immune defect in job's syndrome
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decreased chemotaxis
high ige |
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clinical presentation of job's syndrome
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frequent sinus and pulmonary infecions
cold skin staph abscesses |
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clinical presentation of x linked lymphoproliferative dz
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decreased ab to ebv
ebv infection is FATAL |
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how to dx chronic granulomatous dz
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nitroblue tetrazolium tests (nbt) is deficient
dhr conversion test is + |
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tx fo chronic granulomatous dz
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proph bactrim and interferon gamma therapy
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d/o of terminal complement have ferquent infections with
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n. meningitis
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mechanism of type i hypersensitivity reaction
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antigens react with ige bound to surface of basophils or tissue mast cells --> degranulation wiht release of histamine
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examples of type i hypersensitivity
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urticaria
anaphylaxis angioedema |
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tx of anaphylaxis
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secure airway (intubation, or if not possible, cricothyrotomy)
subq epi |
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mechanism of type ii hypersensitivity
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preformed igm and igg ab tha treact with antigen --> secondary inflammation
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examples of type ii hypersensitivity
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erythroblastosis fetalis
transfusion reactions autoimmune hemolytic anemia grave's disease hyperacute transplant rejection pernicious anemia |
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mechanism of type iii hypersensitivity
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immune complexes deposit in bv --> inflammatory response
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examples of type iii hypersensitivity
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serum sickness
rheumatoid arthritis pan sle |
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mechanism of type iv hypersensitivity
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t cell release of inflammatory mediators
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examples fo type iv hypersensitivity
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tuberculin reaction
contact dermatitis sarcoidosis |
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most common primary immunodeficiency
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iga deficiency
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classic presentation of iga deficiency
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anaphylaxis after ivig infusion
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physical appearance of a pt with job syndrome
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fair skin
red hair eczema |
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in HIV: when should PCP prophylaxis be given
drug of choice |
CD4 <200
Bactrim |
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treatment for PCP
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Bactrim
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in HIV, when should prophylaxis be given for toxo
drug of choice |
CD4 <100
bactrim |
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treatment for toxo
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sulfadiazene + pyromethoxazole
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in HIV, when should prophylaxis be given for MAC
drug of choice |
CD4 <50
Azithromycin |
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treatment for MAC
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CAR
Clarithromycin Azithromycin Rifabutin |
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CD 4 count associated with cryptococcus
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<100
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TX FOR cryptococcus
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amphotericin B + flucytosine
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CD4 count associated with cryptosporidium
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<150
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tx for cryptosporidium
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paromocin + azithromycin
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CD4 count associated with isospora
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<100
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CD4 count associated with cyclospora
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<100
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treatment for isospora
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bactrim
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tx for cyclospora
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bactrim
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cd4 count associated with microsporidia
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<100
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tx for microsporidia
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albendazole
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cd 4 count associated with e. hystolytica
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any
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tx for e. hystolytica
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metronidazole
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cd4 count associated with giardia
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any
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tx of giardia
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metronidazole
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cd4 count associated with c diff
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any
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tx of c diff
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metronidazole
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appearance of a chancre
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1 cm papule or painless ulcer
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organism that causes chancre
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t. pallidum
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diagnostic test for syphilis
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darkfield microscopy (in primary syphilis)
fta-abs, vdrl/rpr (false neg in primary syphilis, but can be used later) |
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chancre:
pain? adenopathy? |
painless
firm, b/l adenopathy |
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tx of syphilis
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pcn
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appearance of herpes ulcer
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grouped papules, vesicles, pustules
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diagnostic test of hsv
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tzanck smear is quickest
cx is gold standard |
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hsv ulcer:
pain? adenopathy? |
yes
firm, b/l adenopathy |
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tx fo hsv ulcers
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acyclovir, famcyclovir, or valacyclovir for outbreaks;
if >5/yr tx iwth acyclovir |
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appearance of chancroid
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purulent ulcer with shaggy borders
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organism causing chancroid
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h. ducreyi
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chancroid:
pain? adenopathy? |
yes
tender u/l adenoapathy |
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tx of chancroid
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ACCE
azithromycin, ceftriaxone, cipro, or erythromycin |
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appearance of lymphogranuloma vereum
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papule, vesicle, ulcer
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organism causing lymphogranuloma venereum
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chlamydia trachomatis
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lymphogranuloma venereum:
pain? adenopathy? |
no
tender, u/l |
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tx of lymphogranuloma venereum
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doxycycline or eyrthromycin
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appearance of granuloma inguinale
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nodules, coalescing granulomatous ulcers
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diagnostic test of chancroid
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cx
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diagnostic test of lymphogranuloma venereum
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complement fixation or immunofluorescence
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granuloma inguinale:
pain? adenopathy? |
no
rarely |
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tx of granuloma inguinale
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BCDE
bactrim cipro doxy or erythromycin |
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organism that causes granuloma inguinale
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c (donavania) granulomatis
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organism most commonly causing yeast infection
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candida
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discharge seen with yeast infection
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thick and curd-like
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ph of vaginal d/c in yeast infx
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4-5
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tx of yeast infx
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fluconazole
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complications of yeast infx
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none
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organisms that cause bv
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gardnerella, m. hominis, other anaerobes
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d/c seen in bv
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white-gray non-inflammatory (no WBCs)
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pH of d/c in bv
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5-6
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diagnostic test of yeast infx
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koh shows branching hyphae and spores; gram stain
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diagnostic test of bv
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clue cells, whiff test
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tx of bv
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metronidazole
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complications of bv
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if a pregnant woman is infected, then there can be premature labor, prom, etc
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should partner be treated in bv
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no
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oranism causing trichomoniasis
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trichomonas vaginalis
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d/c in trich
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yellow-green
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other sx seen in trich
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dyspareunia
dysuria strawberry cervix |
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ph of d/c in trich
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6-7
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diagnostic test for trich
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wet prep showing flagellated organisms
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tx of trich
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metronidazole
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complications of trich
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adverse pregnancy outcomes
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should partner be treated in trich or bv?
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only in trich
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