guidelines in immunology and allergology for the 5-th and 6-th year students of the medical faculty

8/3/2019 GUIDELINES IN IMMUNOLOGY and ALLERGOLOGY for the 5-th and 6-th year students of the Medical Faculty

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State Educational Establishment of Higher Professional

Education Kursk State Medical University

Federal Agency of Public Health and Social Development

CLINICAL IMMUNOLOGY AND ALLERGOLOGY

DEPARTMENT

S.M. Yudina, A.V. Arkhipova, T.A. Lykina

GUIDELINESin CLINICAL IMMUNOLOGY and ALLERGOLOGY

for the 5-th and 6-th year students

of the Medical Faculty

KURSK 2010


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Authors:

Head of the immunology and allergology department pro-

fessor S.M. Yudina

Associated professor A.V. Arkhipova

Teacher T.A. Lykina


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GENERAL COMMENTS

The main purpose of Clinical Immunology and Allergology is

to give knowledge in development, individual variability, adaptation

to changing function, and defensive and pathological mechanisms of

the human organism.

The aim of the course is teaching the main types of immunopa-

thologies, basic principles of diagnostics and therapy.


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S U G G E S T E D R E A D I N G S

1.S. M. Yudina, A. V. Arkhipova Immunology. The educationalmanual for the students on actual questions of theoretical Immu-

nology, Kursk, 2004, 72 pp. ( )

2.Basic immunology, clinical immunology and allergology. S.M.Yudina, A. V. Arkhipova, T.A. Lykina, T.S. Rusanova. Kursk,

2008, 196 pp. ( )

3.Hyde, R.M. Immunology, 3- rd ed. New Delhi: B.I. WaverlyPVT LTD, 1997 316 pp.

4.Khaitov, R.M. Immunology: textbook. M.- 2008. - 256p.:il (- CD)

5.I. Roitt, J. Brostoff, D. Male. Immunology, St.Louis:Mosby,1993, 362 pp.

6.Immunology/ D. Male. J. Brostoff, D. Roitt, Canada, 2006, 552pp.

7.HIV infection and AIDS Ed. L.Deodhar, 2-nd ed. Bombay:VORA Medical Publications, 1996 - 150 pp.

8.Leonard C. Altman. Clinical allergy and immunology, Boston,Massachusetts, 1984, 491 pp.

9.Sharon J. Basic Immunology, Baltimore: Williamse & Wilkins,1999 303 pp.

10. C. A. Janeway, P. Travers, M. Walport, J.D. Carpa Immunol-ogy: The Immune system in health and disease, 4-th ed. Chur-

chill Livingstone, 1999 - 635 pp.


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C O N T E N T S

5-th course pp.

1.Diseases of the immune system. Immune status. 62.Primary and Secondary Immunodeficiency diseases. 73.HIV-infection. 104. Immunotherapy. 125. Immunoprophylaxis. 136.Autoimmune diseases. Credit. 16

6-th course

7. Allergy. Etiopahtogenesis. Diagnostics. 188.Non-specific and specific therapyof allergic disease. 209. Urgent status in allergology. Anaphylaxis. Serum sick-

ness.

21

10.Drug allergy. Acute toxic allergic reactions. 2311.

Food Allergy. Dermatitis. Urticaria. 2412.Pollinosis. Allergic bronchial asthma. Credit. 26Practical skills 29


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5-th course

Topic: Diseases of the immune system. Immune status.

Aim: To study the different types of immunopathologies. Should be ca-

pable determine an immunopathological condition. To study the different types

of immune status and methods of diagnostics.

Motivation section: Last years it is proved, that disorders in immune

system meet at many diseases. Knowledge of immunopathological conditions

will help to diagnose and appoint treatment correctly. The knowledge of typesof the immune status, principles of its estimation is necessary for well-timed

diagnostics, prophylaxis and adequate immunotherapy of various immunopa-

thological conditions.

Questions for Consideration:

1. Definition of immunopathologies.2. Classification of immune system diseases.3. B-cell immunity pathologies.4. Pathologies of T-cell immunity.5. The characteristic of autoimmune process.6. The role of autoimmune processes in norm and in pathology.7.

The immune mechanisms leading to autoimmune damage of tissues.

8. Definition of hypersensitivity.9. The main mechanisms leading to allergic response.10.Definition of the immune status.11.Enumerate the types of the immune status.12.Name the basic variants of the immune status at pathology.13.Characterize the main variants of the immune status.14.Evaluation stages of the immune status.


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15.The purpose of the immune status estimation in norm and at pathology.16.Characterize the anamnesis as one of evaluation stages of the immune

status.

17.Value of clinical inspection in estimation of the immune status.18.Classification of laboratorial step of diagnostics.19.Characterize tests of the first level of the immune status estimation.20.Name tests of the second level of the immune status estimation.21.The tests of estimation of the cellular immunity.22.The tests of estimation of the humoral immunity.23.Tests for estimation of phagocytic system.24.Use of monoclonal antibodies in diagnostics.25.The main methods of antibodies identification.26.Definition of the immunogramm.

Task-based activities.

Activity A: Draw the scheme of the allergic immune response.

Activity B: Draw the scheme of radioimmune assay.

Activity C: write the table Immunological tests

Index Analysis

Practical skills due

A student should examine the patient and to establish the type of im-

munopathological condition and administer diagnostic laboratory tests.

Topic: Primary and Secondary Immunodeficiency diseases.

Aim: To study the etiology, classification, pathogenesis, clinical symp-

toms, diagnostics and treatment of the primary and secondary immunodeficien-

cies.


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Motivation section: Secondary immune deficiencies frequently are

complication of many pathological processes. Its diagnostics is the important

problem of effective prophylaxis and treatment of many diseases. Diagnostics

of the primary immunodeficiencies is the important problem of effective pro-

phylaxis and treatment of many diseases.

Questions for consideration and discussion starters

1. Definition of the immunodeficiency.2. Classification of the immunodeficiencies.3. Classification of the primary immunodeficiencies.4. Mechanism of Bruton disease development.5. Patients with Bruton disease have high risk of allergic reactions. Why?6. Clinical symptoms of Bruton disease.7. Laboratory diagnostics of Bruton disease.8. Treatment of Bruton disease.9. Clinical symptoms and principles of treatment of selective IgA insuffi-

ciency.

10. Di George Syndrome: clinical symptoms, principles of treatment, prog-nosis.

11. Patients with Di George Syndrome have high risk of tetany. Explain thereason.

12. Patients with Di George Syndrome have negative delayed skin tests torecall antigens and prolonged survival of grafts with allogenic skin. Ex-

plain the reason.

13. Severe Combined immunodeficiency: clinical symptoms, principles oftreatment, prognosis.

14. Common variable immunodeficiency: clinical symptoms, principles oftreatment, prognosis.

15. Wiskott Aldrich Syndrome: clinical symptoms, principles of treatment,prognosis.


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16. Clinical symptoms, laboratory diagnostics, principles of treatment of he-reditary neutrophil dysfunctions.

17. Clinical disorder associated with hereditary complement deficiency.18. Definition of the secondary immunodeficiency.19. Classification of the secondary immunodeficiencies according to etio-

logic factors.

20. Characterize stages of diagnostics of the secondary immunodeficiencies.21. Clinical symptoms of T-cell deficiencies.22. Clinical symptoms of humoral deficiencies.23. Peculiarities of clinical symptoms of phagocytic insufficiency.24. Patients with diabetes more often have pyodermia. Explain the reasons.25. Definition and characteristics of the jatrogenic immunodeficiency.26. Pathogenesis of stress-dependent immunodeficiency.27. During pregnancy at women failure of immune system develops. Explain

the reason.

28. Laboratory diagnostics of the secondary immunodeficiencies.29. Principles of treatment of the secondary immunodeficiencies.


Activity A: Write the results of immunogramms describing various types

of primary immune deficiencies (Bruton disease, Di George Syndrome, Severe

Combined immunodeficiency, Common variable immunodeficiency, hereditary

neutrophil dysfunctions, hereditary complement deficiency).

Activity B: Draw the scheme of stress-dependent immunodeficiency

pathogenesis.


A student should know clinical symptoms, laboratory diagnostics, prin-

ciples of treatment of the patients with primary and secondary immunodefi-

ciencies.


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A student should examine the patient, put the diagnosis and administer

diagnostic laboratory tests.

Topic: HIV-infection.

Aim: To study the epidemiology, life cycle of HIV-infection, im-

munopathogenesis, classification, clinical picture of AIDS, methods of diag-

nostics, a new approaches in treatment and prophylaxis.

Motivation section. HIV-infection is the actual problem of modern

medicine. AIDS has no borders and patients are registered in all regions of the

world, their quantity is progressively increased. Now effective treatment is not

developed, all patients die. The main problem is well-timed diagnostics and

preventive maintenance of AIDS.

Questions for consideration

1. Definition of HIV-infection.2. Modern condition of a problem.3. Epidemiology of AIDS.4. Structure of virus, functions of single proteins of virus.5. Features of viral genome.6.Name target-cells for the virus.7. Life cycle of virus.8. Immunopathogenesis of HIV-infection.9. Immune disorders at HIV-infection.10.Mechanisms of T-lymphocyte destruction.11.Mechanisms of brain cells destruction at HIV-infection.12.Name the biological fluids containing the virus.13.Features of transmission of HIV-infection from mother to the fetus and

the child.

14.Transmission of HIV-infection.


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18.Side effects of corticosteroids.19.Scheme of treatment by corticosteroids.20.Relative and absolute indications for steroid therapy.21.Prophylaxis of complications of steroid therapy.22.Classification of cytostatics.23.Actions and side effects of cytostatics.24.Plasmapheresis: biological effects, indications and contra-indications.25.Haemasorbtion: biological effects, indications and contra-indications.26.Physical methods of treatment.27.Ultraviolet irradiation therapy: biological effects, indications and contra-

indications.

28.Laser irradiation therapy: biological effects, indications and contra-indications.

29.Extracorporal immunopharmacotherapy: gist of the method.30.Therapy by LAK-cells: action and indications.


Activity A: Write the principles of treatment of secondary immunodefi-

ciencies.

Activity B: Draw the scheme of monoclonal antibodies reception.


A student should examine the patient, put the diagnosis, administer the

treatment.

A student should know clinical and laboratorial criteria of the immuno-

therapy effectiveness.

Topic: Immunoprophylaxis.

Aim: To study mechanisms of vaccines action, a compound of modern


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vaccines, techniques of immunization, features of vaccination of patients with

the different pathological conditions.Motivation section: Immune prevention of some infectious diseases has

allowed to preserve millions human life during the last years. Immune prophy-

laxis has led to global eradication of a smallpox, poliomyelitis limitation, ap-

preciable reduction of diffusion and gravity of other diseases which are giving

in immune prophylaxis. Mass application of vaccines does necessary under-

standing of mechanisms of immunization, tactics of vaccination and features of

immunization of patients with the burdened anamnesis.


1. Definition of immunoprophylaxis.2. Enumerate the stages of antiinfectious immune responses.3. What purpose of immunization?4. Definition of immunologic memory.5. Explain necessity of booster (repeated vaccination).6. List mechanisms of immune responses formation to vaccines.7. Classification of immunization.8. Classification of vaccines.9. Characteristic of live vaccines.10.Characteristic of inactivated vaccines.11.Characteristic of subunit and peptidevaccines.12.Characteristic of DNA vaccines.13.Characteristic of vectors vaccines.14.Characteristic of anatoxins.15.Enumerate a compound of vaccines.16.Classification of reactions on bacterial and viral vaccines.17.List the measures referred on prevention of immunologic reactions on

vaccines.

18.Enumerate demands to modern vaccines.


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19.Tell about the technician of vaccines introductions.20.What perspectives of new vaccines making?21.Immune prophylaxis of a TB: scheme, indications, contraindications.22.Immune prophylaxis of a poliomyelitis: scheme, indications, contraindi-

cations.

23.Immune prophylaxis of measles: indications, contraindications.24.Immune prophylaxis of hepatitis: scheme, indications, contraindications.25.Immune prophylaxis of diphtheria and tetanus: scheme, indications, con-

traindications.

26.Immune prophylaxis of flu: indications, contraindications.27.Tell about passive immunization.28.Name rules of patients vaccination with allergic diseases.29.Name rules of patients vaccination with the immunodeficiency and

AIDS.

30.Name rules of patient vaccination with a liver and kidney pathologies.31.List mechanisms of postvaccinal allergic complications development.32.In what feature of postvaccinal reactions to bacterial anatoxins?


Activity A: Draw the scheme of specific anti-infectious antibodies pro-

duction.

Activity B:WWrite the scheme of a hepatitis immunization.Activity C:Write the scheme of specific treatment of rabies.


A student should know routine vaccination schedule.

A student should diagnose and treat postvaccinal allergic and not allergic

complications.

A student should administer vaccination of patients with the different pa-

thological conditions.


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Topic: Autoimmune disease. Credit.

Aim: To study the general mechanisms, classification, pathogenesis,

main clinical symptoms, diagnostics and principles of treatment. To know the

specific immunodiagnostics of autoimmune diseases.

Motivation section: Autoimmune diseases are widespread. Frequently

patients are young and middle-aged. Opportune diagnostics and treatment im-

prove the prognosis for life.


1. Definition of autoimmunity.2. The characteristics of autoimmune process.3. The role of autoimmune processes in norm and in pathology.4. Enumerate the immune mechanisms leading to autoimmune damage

of tissues.

5. Describe the 2nd types of immunopathological reactions (cells, me-diators, humoral factors).

6. Peculiarities of cytotoxic cells (T-killers, NK-cells, Killer cells).7. Cytotoxicity by macrophages: classification, mediators.8. Characteristics of Oxygen-dependent and Oxygen-independent kill-

ing mechanism, mediators.

9. Characteristics of antibody-dependent cellular cytotoxicity.10.Characteristics of the main components of complement.11.Main pathways of C3 activation.12.Biological effects of complement activation.13.Formation of membrane attack complex.14.Cell lysis by complement.15.Describe the 3rd types of immunopathological reactions (cells, me-

diators, humoral factors).

16.Conditions of pathogenic immune complexes formation.


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17.Describe the 4th types of immunopathological reactions (cells, me-diators).

18.Classification of autoimmune diseases.19.The main differences between organ-specific and organ-nonspecific

diseases.

20.Common clinical symptoms of autoimmune diseases.21.Principles of laboratory diagnostics of autoimmune diseases.22.The role of blood analysis for diagnostics of autoimmune diseases.23.Probable methods of laboratory diagnostics of autoimmune diseases.24.Reliable methods of laboratory diagnostics.25.Enumerate the main autoantibodies.26.What is rheumatoid factor?27.Principles of the treatment of autoimmune diseases.28.Use the extracorporal immunotherapy for treatment of autoimmune

diseases.


Activity A: Write the treatment of SLE.

Activity B: Write the immunotherapy of RA.


A student should examine the patient with autoimmune diseases, put the

diagnosis, and administer the treatment.

A student should know clinical and laboratorial criteria of the immuno-

suppressive therapy administration.


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6-th course

Topic: Allergy. Etiopathogenesis. Diagnostics.

Aim: To study the etiology of allergic disease. To be aware of mecha-

nism of tissue damage. To know the specific diagnostics of allergic diseases.

Motivation section: Allergic diseases are widespread. Frequently pa-

tients are children, young and middle-aged. Opportune diagnostics and treat-

ment improve the prognosis for life.

Questions for consideration and discussion starters

1. Definition of hypersensitivity.2. Definition of allergen.3. Classification of allergens.4. Characteristics of different allergens.5.

The main mechanisms leading to allergic response (Classification of Gelland Coombs).

6. Characteristics of IgE.7. Classification of mediators of immediate allergic response.8. Characteristics of main mediators of the 1-st type of allergic reaction.9. Mechanism of histamine inactivation.10.Participation of components of complement in allergic reactions.11.Cytotoxic reaction like mechanism of tissue damage in allergic reactions.12.Definition of pseudoallergy.13.Characteristics of pseudoallergic reactions.14.Definition of histamine liberator.15.The main differences between allergic and pseudoallergic reactions.16.Definition of latent sensitisation.17.Mechanisms of development of latent sensitisation.


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Topic: Non-specific and specific therapy of allergic disease.

Aim: To study the non-specific therapy of allergic diseases. To be aware

of specific therapy.

Motivation section: Allergic diseases are widespread. Each doctor

should know the basic antiallergic medicines for urgent help.


1. Principles of the treatment of allergic diseases in acute phase.2. The main groups of drugs for the treatment of allergic diseases.3. Etiotropic therapy of allergic diseases.4. Eliminate diet.5. Enterosorbtion: classification, actions, indications.6. Haemasorbtion and plasmapheresis: biological effects, indications

and contra-indications.

7. Pathogenetic treatment.8. Biological effects of corticosteroids.9. Side effects of corticosteroids.10. Scheme of treatment by corticosteroids.11. Relative and absolute indications for steroid therapy.12. Prophylaxis of complications of steroid therapy.13. Inhalation steroids: indications, complications, prophylaxis of

complications.

14. Classification of antimediator drugs.15. Classification of antihistamine drugs.16. Biological and side effects of antihistamine drugs.17. Membranestabilizer: biological and side effects.18. Inhalation membranestabilizers in treatment of asthma.19. Principles of the treatment of allergic diseases in remission.


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20.Non-specific hyposensitisation: preparations, biological effects, in-dications and contra-indications.

21. Specific hyposensitisation: biological effects, indications and con-tra-indications.

22. Specific hyposensitisation: schemes of the administration.


Activity A: Write the algorithm of treatment for the patients with food al-

lergy.

Activity B: Write the algorithm of treatment for the patients with pollen

allergy.


A student should examine the patient, previously detect the allergen, and

administer diagnostic tests and treatment.

Topic: Urgent status in allergology.

Anaphylaxis. Serum sickness.

Aim: To study the clinical symptoms, principles of diagnostics and

treatment of urgent status in allergology. To know the actions for immediate

therapy.

Motivation section: Anaphylactic shock is heavy complication of me-

dicinal therapy with a high level of mortality. Each doctor must know the ac-

tions for immediate therapy of anaphylaxis.


1. Definition of anaphylactic shock.2. Main groups of allergens inducing shock.


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3. Pathogenesis of shock.4. Classification of anaphylactic shock.5. Clinical symptoms of the light form of shock.6. Clinical symptoms of the middle form of shock.7. Peculiarities of severe form of anaphylactic shock.8. Differential diagnostics of shock.9. Stages of treatment of anaphylactic shock.10.Urgent therapy of anaphylactic shock.11.Anaphylactoid shock, its characteristics.12.Prophylaxis of the shock.13.Prophylaxis of insect allergy.14.More often radiographic contrast induces the development of anaphylac-

toid shock. Why?

15.Definition of serum sickness.16.Pathogenesis of serum sickness.17.Classification of serum sickness.18.Clinical symptoms of the serum sickness.19.Differential diagnostics of serum sickness.20.Pseudoserum reactions, its characteristics.21.Treatment of the serum sickness.


Activity A: Write the algorithm of treatment the patients with drug ana-

phylactic shock.

Activity B: Write the algorithm of treatment and prophylaxis for the pa-

tients with insect allergy.

Activity C: Patient has injected penicillin the first time in life. The shock

was developed. Can you differentiate between anaphylactic and pseudoallergic

shock?


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A student should examine the patient, previously detect the allergen, and

administer diagnostic tests and treatment.

A student should treat the patient with anaphylactic shock.

Topic: Drug allergy. Acute toxic allergic reactions.

Aim: To study classification of adverse drug reactions, the clinical

symptoms, and principles of diagnostics and treatment of drug allergy. Doctor

should know the actions for immediate therapy.

Motivation section: Prevalence of medicinal allergy is high enough. In

this situation ability of the doctor to expect and prevent negative action of

drugs is extremely important, and in case of the educed reaction to carry out

urgent actions for its cupping.


1. Classification of adverse drug reactions.2. Classification of non-immunologic adverse drug reactions.3. Factors that influence the development of drug allergy.4. Characteristics of drug allergens.5. Immune mechanisms to drug allergens.6. Characteristics of Penicillin allergy.7. Characteristics of Cephalosporin allergy.8.Notion of Ampicillin rash.9. Characteristics of Nonsteroid anti-inflammatory drugs10.Characteristics of Sulphonamide hypersensitivity.11.Definition of cross-reacting allergens.12.Classification of Acute toxic allergic reactions.13.Characteristics of Stevens-Johnson syndrome.14.Characteristics of Lyael syndrome.15.Definition of Nickolcky symptom.


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16.Treatment of Acute toxic allergic reactions.17.Diagnostic methods in drug allergy.18.Peculiarities of allergic anamnesis.19.Skin tests with drug allergens: indications, contraindications, estimation

of results.

20.Classification of provocative tests with drug allergens.21.Indications and contraindications for provocative tests with drug aller-

gens.

22.Characteristics of sublingual test, estimation of results.23.Characteristics of Leucocytes decreasing test, estimation of results.24.Desensitizationtodrug allergens.25.Prophylaxis of drug allergy.


Activity A: Write the table of cross-reacting drugs.

Activity B: Write the table of differential diagnostic of Acute toxic aller-

gic reactions.

Activity C: Write the algorithm of treatment the patients with Lyael syn-

drome.


A student should examine the patient, put the diagnosis of drug allergy,

and administer the treatment.

A student should know clinical and laboratorial criteria of the acute toxic

allergic reactions, their treatment and prophylaxis.

Topic: Food allergy. Dermatitis. Urticaria.

Aim: To study classification of alimentary intolerance, etiology, patho-


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genesis of food allergy, clinical implications, and methods of diagnostics and

treatment.Motivation section: The intolerance of food in the form of various syn-

dromes, from dermal before gastrointestinal implications, can be bound with

true and pseudo-allergic responses, failures of enzymes, etc. It proves necessity

of the differentiated approach to diagnostics of a food allergy and appointment

of adequate therapy.


1. Definition of food intolerances.2. Classifications of food intolerances.3. Enumerate most common food allergens for children and adults.4. Mechanism of food allergies development.5. Symptoms of food allergy.6. Risk factors for fatal food-induced anaphylaxis.7. Enumerate most common skin syndromes of food allergy.8. Potential triggers of atopic dermatitis development.9. Criteria of atopic dermatitis diagnosis.10.Peculiarities of atopic dermatitis in Infants, Children, Adults.11.Treatment of atopic dermatitis.12.Definition of urticaria.13.Main clinical symptoms of urticaria.14.Urgent therapy of urticaria.15.Definition of angioedema.16.Characteristics of angioedema.17.Urgent therapy of angioedema.18.Treatment of the throat angioedema.19.Explain pollen-food allergy syndrome.20.NonIgE-mediated gastrointestinal food allergy.21.Specific diagnostic of food allergy.


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22.Principles of food allergy treatment.


Activity A: Compound the text of conversation for patients Food al-

lergy: Preventive maintenance

Activity B: Write eliminative diet.

Activity C: Write the scheme of treatment by a hystoglobulin of a chronic

relapsing urticaria.

Activity D: Write standards of inspection of patients with an allergic urti-

caria.


A student should carry out differential diagnostics of a food allergy and a

pseudo-allergy with other kinds of alimentary intolerance.

A student should be able to administer an eliminative diet, to render an

acute management to patients in the acute season of various clinical implica-

tions of a food allergy.

Topic: Pollinosis.Allergic bronchial asthma.

Aim: To study classification of bronchial asthma (BA), etiopathogensis,

clinic, diagnostics, the differential diagnosis, complications, treatment of aller-

gic bronchial asthma. To study etiopathogenesis, clinic, diagnostics and princi-

ples of treatment of a pollinosis.

Motivation section: Last decades pollinosis and bronchial asthma be-

came the most frequent diseases leading to disability, an invalidism. Well-

timed diagnostics and therapy of a pollinosis often defines development and an

outcome of an allergic bronchial asthma. All it causes necessity of knowledge

of clinic and treatment of pollinosis and bronchial asthma.


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1. Name modern classification of BA.2. List the factors contributing to development of BA.

3. What allergens are the most frequent causes of development of allergic

BA?4. Describe a genesis of a dyspnea attack at allergic BA.5. Characterize a role of local protective factors of respiratory tracts in pa-

thogenesis BA.6. List the mediators causing bronchial obstruction.

7. List clinical criteria BA.

8. Characterize methods of specific and nonspecific therapy of allergic

BA?9. List the preparations which are the cores in treatment of allergic BA.

10. What is the feature of therapeutic action of Intalum at allergic BA?11. Characterize inhalation glycocorticosteroids (GCS) in treatment BA.12. What is the advantage of use IGCS in comparison with system GCS?13. List the preparations concerning to broncholitic.14. What effectively of extracorporal methods at treatment of allergic BA?15. List indications and contraindications to carrying out ASIT at sick of an

allergic bronchial asthma.16. Characterize an etiopathogenesis of pollinosis.17. Name clinical symptoms of pollinosis.18. What is the feature of diagnostics of pollinosis?19. List principles of treatment of pollinosis (in the acute phase and remis-

sion)


Activity A: Write the diagnostics and treatment standards of allergic bron-chial asthma.


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Activity B: Write the diagnostics and treatment standards of pollinosis.


A student should diagnose allergic bronchial asthma and pollinosis, to

stop the asthmatic status.

A student should administer treatment of bronchial asthma and pollinosis

in the different stages of illness.


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CLINICAL IMMUNOLOGY AND ALLERGOLOGY DEPARTMENT

Practical skills for the students of Medical faculty.

1. To be able to prove necessity of immunologic and allergic examination.2. To have skills of work with a card of immunologic examination of the

human. To estimate results of immunologic examination.3. To be able to carry out differential diagnostics of immune system dis-

eases, including HIV-infection.4. To know a principle of statement of the basic tests of immune and aller-

godiagnostics; preparation of blood, blood components, biological fluids for

immunologic analysis; count the number of T- and B-lymphocyte (immuno-

phenotyping), to determine phagocytic activity of neutrophils, quantity of anti-

bodies in blood.5. To be able to determine "risk group" on immunodeficiency using the uni-

fied diagnostic cards "Diagnostics of immunodeficiency and immunopathology

at primary immunologic inspection".6. To be able to estimate action of various immune preparations on immune

system.7. To make skin allergic tests with noninfectious allergens and provocative

test with drug. To estimate result of tests.8. To carry out specific hyposensitization under the instruction of the aller-

gologist.9. To put the diagnosis of allergic disease in acute stage and to stop the

acute allergic conditions (anaphylactic shock, asthma attack, serum sickness,

acute toxic allergic reactions, urticaria, Quincke's edema, etc.).10. To know the principles of immunorehabilitation and immunoprophy-

laxis (vaccination).

guidelines in immunology and allergology for the 5-th and 6-th year students of the medical faculty

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