-Mast cell granules contain large amounts of?

T/F...Macrophages are only capable of phagocytosis?

-Fcts ofComplement include what 4 things?

-histamine, heparin, and serotonin (inflammatory mediators)

-False they aso act as APCs (to T-cells via MHC)

-Lyse, stimulate chemostaxis of phagocytes, opsonize foreign particles for wbc phagocytosis, clearance of immune complexes

Which Ig am I?

 
- Second type produced in initial humoral  response
 -Four subclasses (1 constitutes 60%  of these and 1  and 3 can mainly activate complement)
- Only antibody that can cross placenta (thus provides early maternal humoral protection in neonate)

Most prevalent antibody

IgG

T/F...normal WBC counts mean that a WBC disorder doesn't exist?

False, it doesn't necessarily mean this.  (majority of lymphocytes are in secondary lymphoid tissue..peripheral blood counts may not catch this)

-Vaccine or toxoid induces a host’s immune system against specific pathogens (e.g. Hepatitis A or B, diphtheria, etc.)

-True immunologically mediated ALLERGIC rxns probably __ to __%

-What is the most common sign of these?

-Active IMMUNITY

-   6%-10%

-(rash most common)

-Type I Rxns usually take how long?

- Name some drugs that can cause them?

-Type II onset

-Name some

-30 minutes

-PCN, blood products, polypeptide hormones, vaccines, AND Dextran

-5-12 Hours

-PCN SUlfoamides, quinidine, phenylbutazone, thiouracils, AND methyldopa

-Type III (Imune Complex Rxns) onset time?

-Name some that cause?

-Type 4 (cell-mediated) onset?

-Name one?

3-8 hours

-PCN, Sulfoamides, Radiocontrast agents, Hydantoins

-24-48 hours

-Tuberculin Rxn

-T/F...Topical route is the safest for administering a drug?

-What is the most hazardous...but less in initial sensitivities?

-False...it is the highest in gaining sensitivities (ORAL IS THE SAFEST)

-Parental (IV or IM)

-is it ok to release a pt 6-8 hours after initial Anaphylactic Rxn?

-What 3 very common drugs cause a anaphylactic Rxn?

-no a recurance may occur...it is best to treat them with a steroid just to be sure an immune response won't occur.

-Aspirin, NSAIDs, PCN, and INSULIN

Anaphylactic Rxns are also what type of Allergic Rxn?

Type I

What is the cross-reactivity of PCN and Cephalosporin?

What  type of Abiotix are they?

If you are unsure of pt. allergy to PCN what should you do?

What is another drug that cross reacts with PCN?

10%

Beta-lactams

Skin test. 

carbapenems (Imipenem)  (50% cros-reactivity)

For those who need an NSAID but are allergic what might we do?

-With radioactive contrast agents (CT dye) a huge warming sign for ANAphylactic susceptibility is a seafood allergy?

What might we inject IM or SUBQ for Anaphylaxis?

 -POSSIBLY use a COX-2 inhibitor ...celexamab (Celebrex)

-False

-Epinephrine

 For Kidney Transplants:

-does SCr always refluct true CrCL

Delayed Graft Function (DGF) due to Acute Tubular Necrosis (ATN) may result from what 3 things?
 

-No

pre-transplant vasopressors

or toxic cyclosporine

or tacrolimus levels (an immunosuppresive Rx for transplants)

T/F...Avoidance or minimization of adverse effects of drug therapy is not a goal of post-transplant therapy?

-What are some of the affects of HEART DENERVATION (removing vagal stimulation?

-False it is a goal

-Heart denervation has multiple affects (or lack thereof – e.g. won’t respond to atropine, amplified bradycardia from adenosine, etc.)
 

Diagnosis of Lupus MUST INCLUDE what 3 aspects?

What is an ANA test....Is it diagnostic for LUPUS, by itself?

-What is the most common age/gender group affected by SLE?

-Serologic, Immunopathologic,, and CLINICAL criterias

-Anti-Nucleic Antibody Test...it is not diagnostic on its own

-  15-45 yo FEMALES (90% are females)

-What ethnic group is targetted the most?

-What is the dermatologic sign of SLE?

What 2 drugs may induce Lupus?

-Blacks and Hispanics

-Butterfly or MALAR rash.

-procainamide  (wide time course) and hydralazine (dose related) most common (THERE are others too)

For Corticosteroids and SLE...what dosage should we use for chronic application?

-What are some side effects?

For mild SLE...what may be the best drug Tx?

-Lowest dose

-hypertension, hyperglycemia, hyperlipidemia, hypokalemia HLA axis suppression.  

-NSAID

-Antimalarials work to shut down what part of the immune system for MILD DISCOID LUPUS?

-What is the safer Antimalarial?

When might we use cytotoxic drugs for SLE?

-Impairs T-cells and cytokines.

-Hydroxycholoroquine

-Severe or life-threatening dz....(lupus nephritis)

-what are possible side effects of using cytotoxic drugs to tx SLE?

-SYSTEMIC SCLEROSIS:  use of vasoconstictors okay?

-For Polymyalgia Rheumatica what bone drugs do we use?

-Myelosuppression (all)....Opportunistic infections when using (azathioprine)

-Avoid them (pseudophedrine and Beta-blockers)...ALSO avoid cold if Raynaud's is present

-Bisphosphonates (plus Calcium and Vit. D)