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64 Cards in this Set
- Front
- Back
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Atopic ppl tend to develop what 3 diseases?
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-allergic rhinitis
-asthma -atopic dermatitis |
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Allergic inflammatory response persists from the influx of what?
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basophils, eosinophils, monocytes, lymphocytes, and neutrophils
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Breast feeding for how long may prevent or delay allergies?
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6 months
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How long should you avoid fish and peanuts in children?
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fish for 12 months and peanuts for 3-4 years
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What is the most common of allergic reactions and most common dz of resp tract?
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allergic rhinitis
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What are some symptoms of Perennial allergic rhinitis?
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chronic exposure, chronic nasal congestion, sniffing, and snoring but less sneezing than allergic rhinits
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What type of skin disorder is characterized by skin lesions that are dry, pruritic, scaly, erythematous?
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atopic dermatitis (eczema)
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What is the most useful clue in the dx of eczema?
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distribution of lesions with vary by age
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Tell me about the infentile form of eczema. (distribution that is)
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face, extensor of arms, chest, diaper is spared
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What is the lesion distribution of eczema in older kids?
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antecubital and popliteal fossa on wrists and dorsal surface of hands
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What are some associated finds in eczema?
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-pityriasis alba
-keratosis pilaris -increased IgE and food allergies |
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In eczema lesions that are crusted, weepy, or vesicular what should be suspected?
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that they are infected with S. aureus or herpes
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What is the tx for eczema infections?
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-d/c steroids and emollients
-cool wet compresses to skin -for staph give povadone or topic or systemic abx -for herpes give topical or systemic acyclovir |
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What are the most common foods causing IgE mediated rxns?
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-milk
-eggs -peanuts -shellfish -soy -wheat |
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What are some risk factors for anaphylaxis?
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-asthma
-food allergy -multiple antibiotic allergy -use of B-blockers |
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Most anaphylaxis reactions are IgE mediated and _____ cell initiated.
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mast cell initiated
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In an anaphylaxis reaction, what things cause production of nitric oxide resulting in vascular diation and leakage?
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-histamine
-TNF -PAF |
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What is a grade 1 anaphylaxis reaction?
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involves skin only
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What is a grade 2 anaphylaxis reaction?
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invovle skin w/ nausea and hypotension
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What is a grade 3 anaphylaxis reaction?
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involving shock
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What is a grade 4 anaphylaxis reaction?
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involving respiratory arrest
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What are 2 things that can predispose a more severe epidose of anaphylaxis?
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underlying asthma and use of BB (propranolol)
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What are some treatments for anaphlaxis?
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-epi
-IV fluid bolus (10-20 mg/kg) if low BP -diphenydramine -cimetidine -cortidosteroids -inhaled bronchodilator |
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What do phagocytic cells of the innate immune do?
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engulf and digest foreign atnigens and microorganisms
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What cells predominate phagocytic cells in the blood?
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PMNs
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Phagocytosis triggers what?
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NADPH oxidase system that generates superoxide and hydrogen perosice which aid in killing ingested organisms
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Macrophages are long lived phagocytic cells that develop from what?
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monocytes in the blood and kill facultative intracellular organisms
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What do natural killer cells do?
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mediate cytotoxic activity against virally infected cells and tumor cells
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The major soluble factors in the immune system are part of what system?
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complement system
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What is the complement system?
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system of 30 plasma and cell membrane proteins that act sequentially to amplify immunologic stimuli, and it is antibody independent
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The adaptive immune system is composed of what 2 types of cells?
What do they work against? |
B and T cells that work against pathogens and proteins
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Antibodies or Ig are serum proteins produced by B cels that bind to what?
What is result of this reaction? |
antigens, the reaction results in agglutination of antigen, in opsonization of antigen for phagocytosis, or in binding of complement leading to cytolysis of pathogen
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What is IgG?
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major Ig produced in 2nd immune response, diffuses into tissue and across placenta
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What is the 1st antibody produced in primary antigenic stimulation?
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IgM
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What is the primary Ig of mucosa?
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IgA
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What does IgD do?
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serves as antigen receptor on B cells
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What Ig is the principal mediator of immediate hypersensitivity rxns?
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IgE
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T cells are involved in what?
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cytolysis of virus-infected cells, stimulation of B-cell activation and differentiation, and recruitment of macrophages, neutrophils, eosinophils, basophils, and mast cells
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T cells are major cell type responsible for immunity to what?
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intracellular organisms
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CD4 T cells produce what?
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cytokines that play a role in helping regulate immune response
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CD8 T cells are involved in what?
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killing viruses
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Multiple infections with fungi suggest what?
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T-cell deficiency
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Invasive pulmonary infection w/Aspergillus fumigatus suggest what?
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chronic granulomatous dz
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Severe infection after live vaccine suggests what?
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x-linked agammaglobulinemia
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Oportunistic infections suggest impairment of what?
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immune system
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CHildren with recurrent mycobacterial infections should be evaluated for deficiences of what things?
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-INF-gamma production
-IL-12 production -reduced IL-12 receptor function |
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What are 4 primary immunodeficiencies?
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-B-cell defects
-T-cell defects -Phagocytic defects -complement defects |
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What are the MC primary immunodeficiency disorders?
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defects in antibody production
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What are the MC primary immunodifciency disorders?
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deficiencies of antibody production
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Deficiencies in antibody production result in recurrent what?
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sinopulmonary infections
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In B-cell or antibody defects, what type of infections don't cause problems?
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viral or fungal
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Def of IgG can be observed when?
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1st year of life
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Isolated deficiency of IgQA is associated with what?
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recurrent infections
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What are some lab findings in B cell defects?
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-decreased serum Ig Levels
-low albumin w/low Ig levels assoc w/ low synthetic rate due to poor nutrition or increase loss of proteins from protien-lsoing enteropathy or though skin dz |
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In T cell defects, what type of infections does a person get?
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fungi or intracellular pathogens (viruses, mycobacteria, T. gondii, Leishmania)
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In T cell defects, what else might pts also lack?
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CD4 helper cells and cytotoxic CD8 cells
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What is tx for T cell defects?
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bone marrow or stem cell transplant or IVIG
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What are some s/s of phagocytic defects?
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mucous membrane infections, lymphadenitis, poor wound healing, delayed umbilical separation, and absence of pus
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What organisms are often involved in Phagocytic defects?
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-s.aureus
-fungi -gram neg bacteria |
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What labs do you run for phagocytic defects?
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CBC and morphology, nitroblue tetraxolium test for CGD
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What is tx for phagocytic defects?
CGD? |
-frequent abx courses
-subq recominant interferon gamma |
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What are some things that characterize complement defects?
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recurrent pyogenic infections, deficiency of other compenents result in lupus like dz or vasculitis
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What it the TOC for complement defects?
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long courses of abx
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What labs can you run in complement defects?
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total hemolytic activity of serum (CH50)
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