Browse topics
Immunology and allergy
26 notes, 80 questions and 224 flashcards.
Tier 1 is core knowledge expected of every trainee. Tier 2 is deeper or less common.
Presentations
Key conditions
- AngioedemaSeparating mast cell from bradykinin angioedema, ACE inhibitor angioedema, hereditary and acquired C1 inhibitor deficiency, the C4 screen, and acute, short-term and long-term treatment of HAE with current PBS options.Tier 1, condition, 3 questions, 10 flashcards
- CryoglobulinaemiaBrouet types I to III, hepatitis C and B-cell clones as causes, purpura, arthralgia, neuropathy and MPGN, collecting the sample at 37 °C, the very low C4 and positive rheumatoid factor, and treatment by cause and severity (antivirals, rituximab, plasma exchange).Tier 1, condition, 3 questions, 8 flashcards
Allergic disorders
- Acute and chronic rhinosinusitisFree sampleEPOS 2020 definitions, when acute rhinosinusitis needs antibiotics, type 2 versus non-type 2 chronic rhinosinusitis, nasal polyps and N-ERD, secondary causes, and the criteria for biologics including PBS mepolizumab.Tier 1, condition, 3 questions, 9 flashcards
- Adverse drug reactions and drug allergyClassifying ADRs (types A to F), immune mechanisms from IgE to T cells and mast cell MRGPRX2, the high-yield ADRs of each drug class, putting the drug in the differential, penicillin and beta-lactam allergy (PEN-FAST, PALACE, ASCIA 2026), sulfonamide, NSAID, contrast and perioperative allergy, and TGA reporting.Tier 1, condition, 3 questions, 10 flashcards
- Allergic rhinitis and allergic conjunctivitisDiagnosing allergic rhinitis and conjunctivitis, the ARIA-EAACI 2024-2025 intranasal treatment ladder, allergen immunotherapy, thunderstorm asthma, and the eye presentations that need an ophthalmologist.Tier 1, condition, 3 questions, 9 flashcards
- AnaphylaxisRecognising anaphylaxis, giving IM adrenaline early, refractory management, observation periods and what to arrange at discharge.Tier 1, condition, 3 questions, 10 flashcards
- Eosinophilic oesophagitisDysphagia and food bolus obstruction in a young atopic man, the 15 eosinophils per high-power field threshold, why biopsy beats symptoms for monitoring, PPI, orodispersible budesonide (PBS), empirical diets, dupilumab and dilation, and food bolus management.Tier 1, condition, 3 questions, 8 flashcards
- Food allergyIgE and non-IgE food allergy in adults, the adult-onset syndromes (pollen-food, wheat-dependent exercise-induced, alpha-gal, shellfish, FPIES), reading sensitisation tests and components, oral food challenge, adrenaline and action plans, immunotherapy and omalizumab, and infant allergy prevention.Tier 1, condition, 3 questions, 10 flashcards
Immunodeficiency syndromes
- Acquired immunodeficiency (HIV, drugs, post-transplant)Free sampleCauses of secondary immunodeficiency, HIV as an immunodeficiency (CD4 thresholds, opportunistic infection prophylaxis, ART timing and IRIS), drug-induced and haematological hypogammaglobulinaemia with NBA immunoglobulin criteria, and the immune deficit after transplantation.Tier 1, condition, 3 questions, 9 flashcards
- Agammaglobulinaemia and hypogammaglobulinaemia (CVID)Working up a low IgG, excluding secondary causes, diagnosing CVID and XLA, testing vaccine responses before replacement, immunoglobulin dosing and trough targets under the NBA Criteria, and the non-infective complications of CVID.Tier 1, condition, 3 questions, 9 flashcards
- Combined T- and B-cell immunodeficiencies (SCID)SCID as a newborn-screened emergency (TRECs), the immunophenotypes and genes, protecting the infant before transplant, HSCT outcomes, and the less severe combined defects that adult physicians meet (CD40L, Wiskott-Aldrich, ataxia-telangiectasia, DOCK8, late-onset combined immunodeficiency).Tier 1, condition, 3 questions, 9 flashcards
- Primary defects of cellular immunityMatching the organism to the broken pathway in T-cell and innate cellular defects, with the conditions adults present with (22q11.2 deletion, chronic mucocutaneous candidiasis, mycobacterial susceptibility, hyper-IgE syndromes, GATA2 deficiency, XLP, idiopathic CD4 lymphocytopenia and anti-cytokine autoantibodies).Tier 1, condition, 3 questions, 8 flashcards
Less common or complex conditions
Investigations and procedures
- Specialised imaging including arteriographyChoosing and reading vascular imaging in suspected vasculitis. Halo and compression signs on ultrasound, FDG-PET and MR angiography in large vessel vasculitis, CT or catheter angiography for polyarteritis nodosa microaneurysms, cerebral angiography and its mimics, and when imaging replaces biopsy.Tier 2, medical sciences concept, 3 questions, 7 flashcards
- Tissue biopsies with immunofluorescenceHow direct immunofluorescence on kidney, skin and other tissue works, how to send it, and how to read the patterns that matter to an immunologist (linear, granular, pauci-immune, full house, IgA-dominant, C3-dominant), with worked kidney and skin examples and the errors that waste a biopsy.Tier 2, medical sciences concept, 3 questions, 7 flashcards
Laboratory investigations
- Allergy testing: skin prick tests and specific IgEWhat skin prick tests and serum specific IgE measure, the 3 mm and 0.35 kU/L thresholds, controls and medicines that blunt the skin, sensitisation versus allergy, component (recombinant) allergens for peanut, nuts, wheat and venom, and when a result changes management.Tier 2, medical sciences concept, 4 questions, 9 flashcards
- Antibodies in inflammatory myositisMyositis-specific versus myositis-associated antibodies, why the ANA can be negative, how to read a line blot (band strength, one MSA per patient, matching the HEp-2 pattern), anti-HMGCR by ELISA, and the results that change management today (MDA5, TIF1-gamma and NXP2, HMGCR, SRP).Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Autoantibodies in autoimmune neurological disease and myasthenia gravisHow to order and read neural antibody results (AChR, MuSK, LRP4, VGCC and SOX1, AQP4 and MOG, NMDA and other glutamate receptors, LGI1 and CASPR2 in place of VGKC, gangliosides, MAG and GAD65), which assay to trust, serum versus CSF, and the false positives that mislead.Tier 2, medical sciences concept, 4 questions, 10 flashcards
- Autoimmune liver disease antibodiesReading ANA, smooth muscle (F-actin), anti-LKM1, anti-LC1, anti-SLA, AMA (M2) and the PBC-specific ANA (sp100, gp210) with IgG and IgM, how immunofluorescence patterns and titres feed the simplified AIH score and PBC criteria, and the low-titre and look-alike results that mislead.Tier 2, medical sciences concept, 3 questions, 7 flashcards
- Interpreting ANA, ENA and anti-dsDNA antibodiesHow the HEp-2 immunofluorescence ANA is reported (titre and ICAP pattern), how often healthy people test positive, which ENA antibody goes with which disease, the three anti-dsDNA assays and their trade-offs, and when a result should change management.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Interpreting ANCAPR3 and MPO immunoassays as the first-line test (2017 consensus), who should be tested, what a positive result means in GN, lung haemorrhage or sinus disease, the mimics (endocarditis, drugs, levamisole-cut cocaine, IBD), double positivity with anti-GBM, and why a rising titre alone isn't treated.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Interpreting complement profilesReading C3 and C4 (with CH50, AH50, C1q and C1 inhibitor when needed) by pattern, separating consumption from low synthesis and inherited deficiency, using complement to narrow glomerulonephritis and track lupus activity, and the acute phase, sample and drug effects that mislead.Tier 2, medical sciences concept, 3 questions, 7 flashcards
- Interpreting immunoglobulins and protein electrophoresisReading IgG, IgA and IgM levels, serum protein electrophoresis patterns, immunofixation, serum free light chains (including kidney-adjusted ratios) and urine studies, when to screen for a paraprotein, polyclonal versus monoclonal rises, and the artefacts and drug interference that mislead.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Interpreting rheumatoid factor and anti-CCP antibodiesWhat RF and anti-CCP detect, their sensitivity and specificity, the low- versus high-positive cut-off (3 times the upper limit) in the 2010 ACR/EULAR criteria, the many non-RA causes of a positive RF, prognostic meaning of double positivity, and anti-CCP-positive arthralgia without arthritis.Tier 2, medical sciences concept, 3 questions, 8 flashcards