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Step III

Step III - Imm

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
Created by: DrINFJ



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