Step III - Imm
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| 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