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Allergy and Immunology - Coggle Diagram

- - - - a/w EBV
      - CD4 <50
      - treatment
        
        start HAART therapy
        
        radiation thearpy
        
        corticosteroids
      - prognosis
        
        improves with inc CD4
- - - - fever
      - rash
      - transient lymphadenopathy
    - - anaphylaxis to
        
        MMR
        
        neomycin
        
        gelatin
      - immunodeficiency
        
        CD4 < 200
        
        leukemia
      - pregnancy
        
        risk of congenital rubella
  - - - inc those with h/o
        
        genital warts
        
        abn cytology
        
        papillomavirus DNA test
    - - causes
        
        genital warts
        
        types 6 and 11
        
        cervical, vulvular, vaginal, penile, and anal cancers
        
        types 16, 18
      - MC STD
      - spread by skin-skin contact
      - does not cause infertility
    - - 2 doses if < 15
      - 3 doses if > 15
  - - - Diphtheria toxoid
      - Tetanus toxoid
      - Conjugated Pertusis Ag
    - - 5 doses
      - 2 , 4, 6 mo
      - 15-18 mo
      - 4-6 yrs
    - - encephalopathy after previous dose
      - anaphylaxis
    - - extremely high fever (> 105)
      - seizures following vaccine
      - ongoing eval for neuro condition
  - - - give if pt can eat eggs or only gets hives
      - give in medical setting if rxn includes hypotn, resp sx, persistent emesis, or needs emergent intervention
    - - inactivated IM
  - - - toxoid only (Td/Tdap)
      - no Ig
    - - toxoid only (Td/Tdap) if last dose was 10+ yrs ago
      - NO Ig
    - - Td/Tdap + TIG
      - give Ig
    - - toxoid only (Td/Tdap) if last dose 5+ years ago
      - no Ig
- - - - itching
      - hives
      - swelling of lips +/- tongue
    - - N/V
      - Diarrhea
      - crampy abd pain
    - - may be only sign
    - - IM epi
      - place pt in supine/semi-recumbent position and elevate LE
      - fluid resuscitation if hypotension doesn't resolve
      - IV epi if no response to above
- - - - anaphylaxis
    - - acute hemolytic
        
        prevention
        
        cross-matching
        
        sxs
        
        fever
        
        chills
        
        flank pain
        
        hemoglobinuria
        
        progress to renal failure and DIC
        
        DX
        
        positive direct Ag test (Coombs)
        
        plasma free Hb > 25
        
        UA shows Hguria
    - - Febrile nonhemolytic
        
        most common reaction
        
        due to cytokines released during storage
        
        sxs
        
        fever
        
        chills
        
        malaise w/o hemolysis
        
        treatment
        
        stop infusion
        
        administer antipyretics
        
        use leukoreduced blood in future
      - transfusion-associated circulatory overload (TACO)
      - transfusion related acute lung injury (TRALI)
      - transfusion-transmitted bacterial infection (TTBI)
      - Urticarial
    - - delayed hemolytic
  - - - BMT recipients
      - cellular immunodeficiency
      - bld components donated by 1st/2nd deg relatives
    - - chronically transfused pts
      - CMV seroneg at-risk pts (AIDS, transplant)
      - potential transplant recipients
      - previous febrile nonhemolytic transfusion reaction
    - - IgA def
      - complement-dependent autoimmune hemolytic anemia
      - cont allergic rxns w/ red cell transfusion despite antihistamine treatment