Which antibodies would be raised in rheumatoid arthritis?
Rheumatoid Factor
Anti-Cylic Citrullinated Peptide
A female feels unwell with symptoms of glomerulonephritis. She has had a BACTERIAL infection for 2 weeks, what type of hypersensitivity reaction is this?
Type IV
(DELAYED & INVOLVES IN MACROPHAGES)
What is the most appropriate screening test for Food Protein Induced Enterocolitis Syndrome (FPIES)?
Elimination diet
What antibody is responsible for a 2 year old presenting with abdo pain/constipation from FPIES?
Non IgE (older + abdo pain/constipation)
What antibody is responsible for a <1 year old presenting with vomiting/red face/diarrhoea from FPIES?
IgE (younger + vomiting)
What is the pathophysiology behind an anaphylaxis?
- Cross linking of IgE receptors on surface of mast cell.
- Which activates mast cells
List some mediators produced by mast cells.
Tryptase
Histamine
Platelet activating factor
Leukotrines C4
How do you use an epi pen safely?
- Remove safety cap
- Place device against mid anterolateral thigh
- Hold in place for 10 seconds once click is heard
- Massage injection site for 10 seconds
(blue to the sky, orange to the thigh)
What are some systemic features of anaphylaxis?
Urticaria
Stridor/Wheeze
Tachycardia/Bradycardia
Confusion/Loss of consciousness
N+V
What advice can you give to somebody being discharged after a food allergy?
Avoid food trigger
Training on how to use Epipen
Carry Epipen everywhere
Medic alert bracelet
What are the x-ray findings in RA?
Narrowing of joint space
Juxta-articular bony erosions
Subluxation
Other features of RA that don’t effect joints?
Pericarditis
Splenomegaly
Lymphadenopathy
Carpel tunnel
What monoclonal antibodies can be used in RA?
Infliximab + Adalimunab
(Inhibition of TNF-alpha)
What’s the pathophysiology behind SLE?
- Formation of self antigens and the failure of the immune system to inactive B/T cells that recognise these
- Development of autoantibodies that form circulating complexes
- Activation of the complement system
How do you diagnose SLE?
ANA +ve
Photosensitivity
Malar rash
Arthralgia
