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Step III - Imm

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
What is the treatment for anaphylaxis   SUBQ epi 1:1000, H1 antihistamine, corticosteroids  
What causes angioedema   Minor trauma to face/hands or ingestion of ACEI  
How does angioedema present   Sudden swelling of face, palate, lips, tongue, airway  
Where should you consider admitting pts with angioedema   ICU  
What causes hereditary angioedema   C1 esterase inhibitor deficiency  
What lab finding diagnoses angioedema   Low C2 and C4 (C1 esterase uses them up)  
What is the tx for acute angioedema   FFP  
What is the tx for chronic angioedema   Danazol/stanazol (androgens raise C1 esterase inhibitor)  
Pt presents w/ paroxymal sneezing, itchy eyes, rhinorrhea, wheezing, recurrent nasal stuffiness. Dx   Allergic rhinitis  
What is the first line tx of allergic rhinitis   Intranasal glucocorticoid  
What if patient with allergic rhinitis can not avoid allergen   Desensitization  
Adult pt c/o recurrent bronchitis, pneumonia, pharyngitis along with sprue-like abdominal complaints. Dx   Common variable immunodeficiency (CVID)  
Male child c/o recurrent bronchitis, pneumonia, pharyngitis w/o GI complaints. Dx   X linked agammaglobulinemia (Bruton’s)  
What is the pathophys of CVID   The machinery to make Igs, from lymph nodes, B and T cells is intact. However, not enough Igs are produced  
What does diagnostic testing show in CVID   low total IgG  
What is the tx for CVID   IV infusion of Igs  
In terms of physical exam findings, what distinguishes CVID from Bruton’s   CVID spleen, lymph nodes, adenoids are PRESENT and may be enlarged whereas in Bruton’s they are small or ABSENT  
What is the pathophys of Bruton’s   B cells are missing therefore NO Igs are made  
What is the tx for Bruton’s   same as CVID, IV Ig  
What is the MC primary immunodeficiency   IgA  
How do you distinguish it from CVID and Bruton’s   Most pts are ASYMPTOMATIC. But if they show S/S very similar to CVID and Bruton’s (this sucks for me on the exam!). Look for pt w/ atopic conditions or a pt who becomes anaphylactic after blood transfusion  
Atopy, sprue-like GI complaints, recurrent sinopulmonary infections, anaphylaxis after blood transfusion. Dx   IgA deficiency  
What is the tx and why is it different from the tx for CVID and Bruton’s   Tx infections as they come; IV Ig has very little IgA in it so won’t help  
Pt has recurrent skin infections from STAPH. Dx   HYPER IgE syndrome  
Tx for HYPER IgE syndrome   Tx the infection as it comes  


   


 

 

 
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Created by: DrINFJ on 2010-09-29




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