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24 Cards in this Set
- Front
- Back
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Anaphylaxis mechanism
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1. Sensitization
2. Re-exposure: IgE binds mast cells --> release granules = prostaglandins, leukotrienes, histamine |
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Anaphylactoid reaction
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- no presensitization
- no IgE - AG --> mast cell --> granules (histamine) |
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Hereditary angioedema
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- deficiency C1 esterase inhibitor
- after minor trauma, idiopathic - no pruritus - decreased C2, C4 |
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non-hereditary angioedema
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ACEI
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Types of hereditary angioedema
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1 - decreased CN1INH
2 - dysfunctional CN1INH 3 - no abnormality |
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Angioedema - treatment
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1. maintain airway
2. Acute - FFP, Ecallantide 3. Long term - androgens, danazole, stanazole |
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Urticaria
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- swelling superficial skin layers
-"write on skin" Causes: - insects - meds - pressure - cold - vibration |
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Urticaria- treatment
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1. Antihistamines: hydroxyzine, diphenhydramine, fexofenadine, loratidine, cetirizine, ranitidine
2. Leukotriene receptor antagonists: zafirlukast, montelukast |
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Allergic rhinitis: diagnosis
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1. Clinical
2. skin/blood - high IgE 3. Nasal smear with eosonophils |
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Allergic Rhinitis - Treatment
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1. Prevent + Avoid
2. Intranasal corticosteroids 3. H1 antihistamines 4. Intranasanal anticholinergics (ipatroprium) 5. Flooding and desensitization |
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CVID
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- B cells present but decrease in all Igs
- low B cell output, normal T cells - recurrent sinopulmonary infections - bronchitis, pneumonia, otitis media, sinusitis... - giardiasis, sprue-like intestinal malabsorption - AI deficiencies (pernicious anemia) ** normal number of B cells - normal lymphoid tissue ** increased risk lymphoma |
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CVID - Diagnosis
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- decreased Ig level
- AG stimulation --> decreased B cell response |
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CVID - Treatment
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- antibiotics for infections
- chronic maintenance: IVIG |
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X-linked agammaglobulinemia (Brutons)
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- low B, normal T
- males - sinopulmonary infections - decreased B cells and lymphoid tissue |
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X-linked agammaglobulinemia (Brutons) - Treatment
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- antibiotics for infections
- IVIG |
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SCID
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- low B and T
** like HIV - B cells: decreased Ig --> sinopulmonary infections - T cells: low number --> HIV type infections |
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SCID - Treatment
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BM transplant
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IgA deficiency
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- recurrent sinopulmonary infections
- atopic diseases - anaphylaxis to blood transfusions - sprue like infections, fat malabsorption - vitilago, thyroiditis, RA |
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IgA deficiency - Treatment
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- treat infections
- wash blood transfusions ** IVIG does NOT work --> anaphylaxis!! |
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Hyper IgE
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- recurrent staph skin infections
--> treat infections - infections look like zits, "pustule" * Prophylaxis = Dicloxacillin, Cephalaxin |
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Wiskott-Aldrich
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- normal number B and T cells --> decline with age
** thrombocytopenia + Eczema - decreased T cells in blood and lymph nodes ** Treatment = BM transplant |
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CGD
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- inflammatory reactions --> lymph nodes (purulent)
- apthous ulcers (inside mouth) - inflammation of nares - granulomas --> obstruction in GI/GU |
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CGD - Infection combination
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1. Staph
2. Burkholderie (gram -, pseudomonas) 3. Nocardia 4. Aspergillus |
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CGD -Test
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- abnormal nitro blue tetrazolium --> decreased respiratory burst (NADPH oxidase)
** test is negative, i.e NOT blue |
