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peak flow
maximal flow of air occurring during a forced exhala on
what infants should be immunized against RSV?
infants at GSA 32-35 weeks with addi onal risk factors
symptoms of rheuma c fever
symptoms:
fever, cardiac changes, subcutaneous nodules, sydenham chorea, polyarthri s, erythema
marginatum
flu vaccine for 6 mon to 9 yr
needs 1 month booster, then annual vaccina on
flu vaccine given a+er 9 y/o
no booster, only annual vaccina on
trauma c injury
infec on
neoplasm
most important causes of limp that delay diagnosis and treatment
IGG with 4 subclasses (G,A,M,E)
CBC with diff (neut, lymph)
CH 50
What labs do you order as first line for determining immunodeficiency?
IGG w 4 subclasses
specific an body to vaccine
How do you test for humoral (B) immunodeficiency? (2)
CBC, total lymphocyte
delayed hypersensi vity skin test
, How do you test for cell-mediated (T) immunodeficiency? (2)
CBC, total neutrophil
NBT reduc on
How do you test for phagocy c immunodeficiency? (2)
CH50 or C3 and C4
How do you test for complement system deficiency? (2)
humoral deficiency
This type of immunodeficiency is indicated by recurrent infec on with encapsulated bacteria
and chronic sino-pulmonary infec on
selec ve IgA
The most common primary immune deficiency that affects only B cells is
cell-mediated deficiency
This type of immunodeficiency is indicated by recurrent infec on with low grade or
opportunis c agents
Associated with growth retarda on, was ng, and diarrhea
unexplained early death, sepsis, recurrent infec on
These (3) elements of family hx would raise suspicion for primary immunodeficiency
more than 8 OM per year
more than 1 PNA per year
NOT UTI
What recurrent infec ons, and how o+en, would make you suspect an immunity issue?
Lyme disease
ortho sx: acute mono-arthri s (usually knee), erythema, effusion, generalized muscle aches,
limp, popliteal cyst
labs: elevated ESR, CRP, posi ve ELISA and Western blot
Diff dx for joint pain
Lupus (SLE)