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Rheumatology > 345 Urticaria, Angioedema > Flashcards

345 Urticaria, Angioedema Flashcards

1
Q

Tendency to manifest asthma, rhinitis, urticaria and atopic dermatitis

A

Atophy

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2
Q

Process that prepares mast cells and basophils for subsequent antigen specific activation

A

Sensitization

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3
Q

Dilation of vascular structures in the superficial dermis

A

Urticaria

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4
Q

Dilation from deeper dermis and subcutaneous tissues

A

Angioedema

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5
Q

Acute vs chronic angioedema

A

Acute occurs less than 6 weeks

Chronic persisting for more than 6 weeks

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6
Q

Lifespan most common for chronic urticaria/angioedema

A

3rd to 5th decade

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7
Q

Most common cause of chronic urticaria

A

Idiopathic

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8
Q

Acute Urticaria most often result from what?

A

Exposure to food, environmental or drug allergen or viral infection

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9
Q

Appearance of linear wheal with surrounding erythema at the site of a brisk stroke with a firm object

A

Dermographism

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10
Q

Lifespan commonly affected by dermographism

A

2nd to 3rd decade

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11
Q

Presents in response to a sustained stimulus such as shoulder strap or belt, running, or manual labor

A

Pressure urticaria

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12
Q

Time with greatest propensity to develop atopic allergy

A

Childhood and early adolescence

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13
Q

Modulates T cell phenotype

A

IL 4

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14
Q

When can angioedema without urticaria develop

A

C1 inhibitor deficiency

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15
Q

Most common site of angioedema

A

Periorbital and perioral

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16
Q

True or false: no residual scarring occur in Urticaria and angioedema unless there is an underlying Vasculitic process

A

True

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17
Q

Pruritic wheals are of small size 1-2 mm and surrounded by a large area of erythema; attacks precipitated by fever, hot bath, or shower or exercise attributed to rice in body temperature

A

Cholinergic Urticaria

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18
Q

Precipitated by exertion

A

Exercise induced anaphylaxis

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19
Q

True or false: there is an association with presence of IgE specific for alpha 5 gliadin in wheat

A

True

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20
Q

Best evidence for IgE and mast cell involvement in Urticaria and angioedema

A

Cold urticaria

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21
Q

True or false: 15% of patient with chronic urticaria have an autoimmune cause for their disease

A

False. 45%

22
Q

Full penetrant autosomal dominant disease due to mutation in SERPING1 gene leading to a deficiency in C1INH type 1

A

Hereditary angioedema

23
Q

Third less common type of HAE has normal C1INH but mutant form of what leading to excessive bradykinins

A

Factor XII

24
Q

Suggested by lack of pruritus and of urticaria lesions and prominent recurrebt gastrointestinal attacks of colic and episodes of laryngeal edema

A

Hereditary angioedema (HAE)

25
Q

Concomitant flushing and hyperpigmented papules that urticate with stroking in the absence of angioedema raise the question of mastocytosis

A

Mastocytosis

26
Q

Types of HAE. Deficiency of C1INH

A

Type 1

27
Q

Types of HAE. Nonfunctional protein by a catalytic inhibition assay

A

Type 2

28
Q

Type of HAE. Normal levels of complement proteins and a factor XII gene mutation

A

Type 3

29
Q

Used first in the treatment of urticaria

A

H1 antihistamines like: diphenhydramine, loratadine, desloratidine, fexifenadine, cetirizine, Levocetirizine

30
Q

Added when H1 antihistamines are Inadequate

A

H2 antihistamines: ranitidine, cimetidine, famotidine

31
Q

Important add on therapy in treatment of urticaria and angioedema

A

CysLT1 receptor antagonist: Montelukast and zafirlukast

32
Q

Given when long acting antihistamines and CysLT receptor antagonist fail

A

Monoclonal anti IgE antibodies: omalizumab

33
Q

When are systemic glucocorticoids useful?

A

Pressure urticaria
Vasculitic urticaria
Idiopathic angioedema
Chronic urticaria

34
Q

Given to patient with chronic urticaria that is severe and poorly responsive to other modalities

A

Cyclosporine

35
Q

May be used in acute attack of HAE

A

Bradykinin 2 receptor antagonist: Icatibant

Kallikrein inhibitor: Ecallantide

36
Q

How many patient with allergic rhinitis manifest asthma?

A

50%

37
Q

How many percent of individuals with asthma and chronic bilateral sinusitis have allergic rhinitis

A

70-80%

38
Q

Hallmarks of allergic rhinitis

A

Episodic rhinorrhea, sneezing, obstruction of the nasal passages with lacrimarion, pruritus of the conjunctiva, nasal mucosa and oropharynx

39
Q

Seasonal allergic rhinitis characterized by oropharyngeal pruritus and or mild swelling following the ingestion of raw plant-based foods which contain cross- reacting pollen- related allergens

A

Pollen associated food allergen syndrome

40
Q

Occurs in middle decades of life and is characterized by nasal obstruction, anosmia, chronic sinusitisand prominent eosinophilic nasal discharge in the absence of allergen sensitization

A

Perennial nonallergic rhinitis with eosinophilia syndrome (NARES)

41
Q

Most cost effective means of managing allergic rhinitis

A

Allergen avoidance

42
Q

Most potent drugs available for relief of established rhinitis, seasonal or perennial and effective in relieving nasal congestion as well as ocular symptoms

A

Intranasal glucocorticoids

43
Q

Most frequent side effect of intranasal glucocorticoids

A

Local irritation

44
Q

Examples of intranasal glucocorticoids

A

Beclomethasone, flunisolide, triamcinolone, budesonide, fluticasone propionate, fluticasone furoate, cicloswnide and mometasobe furoate

45
Q

Nasal spray that may benefit nonallergic rhinitis but with dysgeusia adverse effect

A

Azelastine

46
Q

Duration of alpha adrenergic agents is limite due to what?

A

Rebound rhinitis

7-14 days use can lead to rhinitis medicamentosa

47
Q

Approved for treament for both seasonal and perennial rhinitis and it reduced both nasal and ocular symptoms by 20%

A

CysLT1 blocker: Montelukast

48
Q

Nasal spray that inhibits mast cell degranulation and can be used prophylactically on a continuous basis during the season

A

Cromolyn sodium nasal spray

49
Q

Anticholinergic agent effective in reducing rhinorrhea including patients with perennial non allergic symptoms

A

Topical ipatropium

50
Q

Consisted of repeated exposure to gradually increasing concentration of the allergens considered specifically responsible for the symptom complex. What are the two types?

A

Immunotherapy: subcutaneous and sublingual

Rheumatology (15 decks)

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