Allergy and Immunology
Rotation Contacts
Kathleen Wang, MD – Rotation Director
kathleen_wang@med.unc.edu
Jessi Stark – Division Administrator
jtstark@email.unc.edu
Jacob McCauley – Administrative Specialist
jnmccaul@email.unc.edu
First Day Information
We will reach out to residents the week before your rotation to set up a time for orientation with Dr. Wang and talk about career plans so that the schedule can be tailored to the individual resident.
Rotation Information
The resident will be expected to directly participate in attending clinics through H&Ps, oral presentations and case discussion, and documentation. As per the schedule, when not in attending clinic, the resident will be expected to participate in pediatric allergy and immunology inpatient consults with the fellow on call. Lastly, residents will be expected to attend and may be asked to participate in didactic sessions on Wednesday mornings.
Overall Educational Goal:
The purpose of the elective is to introduce the resident to the field of allergy & immunology. Residents will learn to recognize and manage a broad array of allergy and immunology diseases and be introduced to the immunologic concepts behind these diseases.
Objectives:
Demonstrate competence in the recognition and basic management as well as understand indications for referral of children with the following conditions: (MK, PC, PBL)
- Allergic rhinitis and conjunctivitis
- Asthma
- Food allergies
- Anaphylaxis
- Atopic dermatitis
- Immune deficiency
- Urticaria and angioedema (acute and chronic)
- Drug allergies
- Stinging insect allergy
Describe indications for the following studies as well as the basics of interpreting them: (PC)
- Skin prick testing
- Intradermal skin testing
- Serum IgE testing (ImmunoCAP)
- Pulmonary function testing
- Oral food challenges
- Drug desensitization
Understand the basic pharmacology and indications for the use of the following drugs in allergy and immunology patients: (MK)
- Antihistamines
- Epinephrine
- Intranasal steroids
- Subcutaneous allergen immunotherapy (allergy shots)
- Inhaled steroids
- Anti-IgE therapy (omalizumab)
- Leukotriene antagonists
- Intravenous immunoglobulin
Evaluation:
Resident performance is evaluated by direct faculty assessment during clinical activities including oral presentations, written notes, evidence of outside reading, and professionalism. A composite online evaluation is completed at the end of the resident rotation by the rotation director. Residents also evaluate faculty preceptors and the overall effectiveness of the rotation.
Learning Activities of the Rotation:
The principle learning activity of residents involves the assessment of patients in outpatient allergy and immunology attending clinics. Residents will participate in attending clinics on Mondays, Tuesdays, Thursdays, and Fridays. Wednesday is a dedicated didactic day involving journal club, case conference, board review, and 1-2 times monthly “fever board” in conjunction with pediatric hematology/oncology. Finally, residents will also participate in inpatient pediatric allergy and immunology consults with the fellow on-call.
Readings and Resources
2010 Primer on Allergic and Immunologic Diseases
- Overview of the immune response
- Innate immunity
- Adaptive immunity
- Structure and function of immunoglobulins
- Immunologic messenger molecules: Cytokines, interferons, and chemokines
- IgE, mast cells, basophils, and eosinophils
- Genetics of allergic disease
- Asthma: Clinical expression and molecular mechanisms
- Rhinitis and sinusitis
- Food allergy
- Drug allergy
- Allergic skin diseases
- Environmental and occupational allergies
- Anaphylaxis
- Primary immunodeficiencies
- Secondary immunodeficiencies, including HIV infection
- Immunologic rheumatic disorders
- Vasculitis
- Immunologic endocrine disorders
- Diagnostic testing and interpretation of tests for autoimmunity
- Pulmonary disorders, including vocal cord dysfunction
- Mucosal immunology, eosinophilic esophagitis, and other intestinal inflammatory diseases
- Complement disorders and hereditary angioedema
- Immune responses to malignancies
- Clinical laboratory assessment of immediate-type hypersensitivity
- Laboratory evaluation of primary immunodeficiencies
- Allergen immunotherapy
- Immunomodulator therapy: Monoclonal antibodies, fusion proteins, cytokines, and immunoglobulins
- Transplantation immunology: Solid organ and bone marrow
- Embryonic and adult stem cell therapy