Immunology and Allergy – Exam Review Set 3

What this deck covers

Immunology and Allergy – Exam Review Set 3 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Abscesses that were never hot
2. Only one antibody type survived
3. Thrush since she was two
4. He has never sweated
5. The film told them at once
6. The vaccine itself spread
7. Only ever viruses
8. There was no thymus to find
9. Well-looking, and culture positive
10. Just how he is, they were told
11. Well at eight days, but flagged
12. T lymphocytes from nowhere
13. The feed nobody questioned
14. Ten days after the blood
15. Twenty-eight weeks, and a drain
16. Three good years, still coughing
17. Four months of breathlessness
18. Three scans requested this year
19. Eight months of loose stool
20. Vomiting after every meal
21. Five courses, and the trough is fine
22. A new garden and an old shed
23. Nothing has been tried yet
24. Well until the tablets changed
25. His mother does the infusions
26. Three samples, each higher
27. Big glands, and a climbing load
28. Ninety-five per cent, then twenty
29. The card says he had them all
30. No match on the register
31. Nine at night, and a temperature
32. The same tablet, four times over
33. A name nobody recognised
34. Two courses, and no better
35. Nobody added them up
36. Warts that nothing would shift
37. The dentist noticed first
38. Second blood problem this year
39. She stopped when she found out
40. Two hundred, and still spreading
41. Is it worth him having it
42. Two quiet years, and a question
43. They lost the first boy
44. Forty days, and two letters
45. Nothing on the register
46. Well until she was eleven
47. A change nobody has seen before
48. Her asthma, for thirty years
49. The same lobe, five times
50. But his heel prick was fine

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Atopic eczema, Terminal complement deficiency, Absent natural killer cell function, Anatomical factors alone, Stop the breast milk until it can be checked, Poor adherence to his infusions, Coeliac disease, He should not go outdoors here, Start moving his care across while he is still well, Ordinary fluctuation that needs no action, Give paracetamol and telephone again in the morning, A fungal infection that his neutrophils cannot kill, The gum disease is the presenting sign of his defect, Cryotherapy under anaesthesia.

Clinical pearls from this deck

• A high IgE is common. A high IgE with baby teeth behind the adult ones is a diagnosis.
• Read which class survived. IgM standing alone is a switching problem, and it behaves like a combined defect.
• Thrush that never leaves, and glands that fail one by one. The adrenal is the one that kills her.
• Odd teeth and no sweating in a boy with invasive infection is one diagnosis, not two.
• Silver hair and a pale child with infections. Ask the laboratory to look at the neutrophil granules.
• A normal panel does not mean a normal immune system. Some defects are in the conversation, not the cells.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all immunology and allergy case decks · pediatric reference values.