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37 Cards in this Set
- Front
- Back
1. Describe the role of IgE antibody in atopic disease. |
1. Atopic individuals produce large amounts of IgE antibody in response to antigens that do not elicit IgE responses in other people
2. In an atopic individual, mast cells are coated with IgE antibody specific for the antigen(s) to which the individual is allergic. 3. This process of coating mast cells with IgE is called sensitization, because coating with IgE specific for an antigen makes the mast cells sensitive to activation by subsequent encounter with that antigen. |
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1. Briefly outline the steps involved in IgE production (include the role of T cells and cytokines).
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1. In individuals who are prone to allergies, exposure to some antigens results in the activation of Th2 cells and the production of IgE antibody
2. Two of the cytokines secreted by Th2 cells, interleukin-4, and IL-13, stimulate B lymphocytes specific for the foreign antigens to switch to IgE-producing plasma cells. |
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1. List the most important mast cell mediators of allergic reactions and their actions.
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1. The most important mediators produced by mast cells are vasoactive amines and proteases
2. They are responsible for acute vascular and smooth muscle reactions and inflammation, the hallmarks of immediate hypersensitivity |
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1. Distinguish the “early phase” and “late phase” allergic reactions and the mediators involved.
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1. Early phase – Histamines produced by the activation of mast cells by the IgE
2. Late phase – cytokines produced by mast cells stimulate the recruitment of leukocytes, which cause the late-phase reaction. |
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Explain the pathogenesis of allergic rhinitis. |
1. It affects 10-30 percent of children and adults in the U.S. while creating a significant economic impact in terms of clinician visits, lost school and work days, and medications
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Briefly summarize the epidemiology and impact of allergic rhinitis in the United States. |
1. It affects 10-30 percent of children and adults in the U.S. while creating a significant economic impact in terms of clinician visits, lost school and work days, and medications
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Describe the primary symptoms associated with allergic rhinitis. |
1. Sneezing, rhinorrhea, nasal obstruction and nasal itching
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List the major additional conditions associated with allergic rhinitis |
1. Postnasal drip, cough, and irritability
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Explain the mechanisms of skin tests and in vitro tests used for atopic diseases and describe the positive results |
1. A needle is used to inject an allergen and watch for a wheal and flare reaction
2. Blood draw to check for IgE |
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What is an allergy |
1. IgE-mediated immediate hypersensitivity reaction
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A substance that causes a hypersensitivity reaction |
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What is atopy |
Genetically predisposed for an allergy |
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What is hypersensitiviity |
An excessive immune response |
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Describe Reoviridae |
1. Non-enveloped, icosahedral capsid |
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Describe Picornaviridae (Polio) |
non-enveloped, icosahedral capsid |
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What are the Entero viruses |
1. Echovirus |
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Describe Coronaviridae |
1. Enveloped, helical capsid |
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Describe SARS |
1. Rapid onset |
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Describe MERS-CoV |
1. Most infections result in severe respiratory illness |
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Describe Bunyaviridae |
1. Enveloped, helical capsid |
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Describe Parvoviridae |
1. Non-enveloped, icosahedral capsid |
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Describe Adenoviridae |
1. non-enveloped, icosahedral capsid |
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Identify the most common etiologies of viral URTI’s |
Picornaviruses ~ 50% of cases Coronaviruses 10-20% of cases Adenoviruses 5% or cases Paramyxoviruses 10-15% of cases Orthomyxoviruses 10-15% of cases Parvoviruses, Reoviruses, and Bunyaviruses are rare |
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1. Discern fact from fiction in regard to myths about the common cold |
1. Usually 5-14 days 2. Nasal congestion, sore throat, malaise, fever 3. Encompasses diseases of larynx, pharynx, sinuses 4. Most caused by viruses, fall and winter prevalence 5. Treatment aimed at managing symptoms |
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1. Recognize the diagnostic tests available for virus identification |
ID by PCR, serology, sequencing, virus isolation, microscopy |
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1. Recognize the importance of global travel and epidemiology in tracking new emerging viral causes of URTI’s |
1. Understanding where the individuals have traveled and how the virus spreads will help to determine the initial location of the virus |
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1. Explain the use of first and second generation antihistamines in allergic rhinitis. |
1. Antihistamines compete with histamine for the H1 receptor sites that contribute to sneezing, itching, rhinorrhea, and conjunctivitis. |
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1. Compare the first generation antihistamine diphenhydramine, the second generation agents loratadine and fexofenadine and the intranasal antihistamine azelastine in terms of sedative effects and ability to cross the blood-brain barrier |
1. First generation cross the blood-brain barrier and have significant sedative and anticholinergic effects |
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1. Compare the first generation antihistamine diphenhydramine, the second generation agents loratadine and fexofenadine and the intranasal antihistamine azelastine in terms of anticholinergic effects |
1. first generation demonstrate decreased motor skills, diminished driving ability, and reduced cognition |
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1. Compare the first generation antihistamine diphenhydramine, the second generation agents loratadine and fexofenadine and the intranasal antihistamine azelastine in terms of duration of action |
1. second generation have a longer duration |
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1. Discuss the use of intranasal corticosteroids (a.k.a. topical intranasal glucocorticoids) versus systemic oral corticosteroids for the treatment of allergic rhinitis. |
1. Intranasal corticosteroids provide a 50 to 90% reduction in symptoms. In contrast to antihistamines, topical corticosteroids reduce nasal congestion in addition to relieving itching, rhinorrhea, sneezing, and allergic conjunctivitis. |
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Explain the mechanism of action and role of fluticasone, triamcinolone, beclomethasone, and mometasone (corticosteroids) in treating allergic rhinitis |
1. Corticosteroids inhibit T-lymphocyte mucous secretion, vascular permeability, and mast cell proliferation. |
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Explain the mechanism of action and role of cromolyn ( a mast cell stabilizer) in treating allergic rhinitis |
1. cromolyn stabilizes mast cells and mediates additional anti-inflammatory activities toward macrophages and T lymphocytes. |
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Explain the mechanism of action and role of montelukast (a leukotriene modifier) in treating allergic rhinitis |
1. a pro-inflammatory vasoactive mediator |
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Explain the mechanism of action and role of ipratropium (an anticholinergic) in treating allergic rhinitis |
Block M receptors allowing the sympathetic nervous system to take over |
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Explain the mechanism of action and role of phenylephrine and pseudoephedrine (decongestants) in treating allergic rhinitis |
1. treat nasal stuffiness but are mild stimulants |
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1. Indicate the most common side effect(s) associated with antihistamines, decongestants, corticosteroids, mast cell stabilizers and leukotriene modifiers used in the treatment of allergic rhinitis. |
1. Antihistamines – decreased motor skills, diminished driving ability, and reduced cognition |