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AI Boards > ACAAI Review Book Ch 8: Diagnostic modalities > Flashcards

ACAAI Review Book Ch 8: Diagnostic modalities Flashcards

1
Q

false positives in SPT:

  • tree pollen
  • dust mite
A
  • tree: allergic to honeybee 2/2 cross reactive carbohydrate determinants in honeybee venom
  • DM : shellfish allergic
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2
Q

IDST:

  • dilution
  • injection amount
A

IDST:

  • dilution : 100-1000 fold
  • injection amount: 0.02-0.1 mL allergen
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3
Q

what is the IDEAL50 and what is measured?

A

IDEAL50 = intradermal dilution equals 50mm to standardize extracts
- ERYTHEMA!

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4
Q

Intradermal skin testing is useful in all of the following hypersensitivity reactions except:

A. venom
B. cephalosporins
C. chemotherapeutic agents
D. penicillin
E. muscle relaxants
F. insulin
G. heparin
H. HMW occupational sensitizers, latex, enzymes, flour
A

B. cephalosporins

SR rate: 0.02-3.6%

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5
Q

A patient has a positive hymenoptera IDST at 10 ug/mL. should this be included in the VIT Rx?

A

no. only up to 1 ug/mL

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6
Q

Cromons (N) and Corticosteroids (N & PO) can inhibit the EPR & LPR of NAC

A

3d & 7d

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7
Q

Unilateral NAC results in the following on which side- challenged nostril or contralateral nostril?

  • increased nasal airway resistance
  • increase PGD2 & histamine due to reflex activation of mast cells
A

CHALL - increased nasal airway resistance
CONTRA - increase PGD2 & histamine due to reflex activation of mast cells

Capsaicin: acts on TRPV1 vanilloid receptor. UNI prov = BIlateral response. response INCREASED in AR, not in NAR

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8
Q

true or false: histamine in NAC mimics sx of acute allergic response, but does not induce late inflammatory events

A

TRUE

methacholine does NOT induce nasal refelxes

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9
Q

location of the greatest nasal resistance is:

A

nasal valve

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10
Q

true or false: severity of airway hyperresponsiveness correlates with severity of asthma

A

FALSE

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11
Q

see tables 8-7 through 8-9 on pages 428-429 for bronchoprovocation testing

A

review tables

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12
Q

Direct bronchoprovocation testing has:

A. high sensitivity, low specificity
B. low sensitivity, high specificity
C. low sensitivity, low specificity
D. high sensitivity, high specificity

A

A. high sensitivity, low specificity

HIGHly SENSITIVE people will react strongly to LOW SPECIFIC criticism

binds receptors to directly activates contraction of smooth muscle cells

ex: MCT, histamine, PG, LT

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13
Q

PC20 FEV1 is what:

A

concentration of methacholine that causes a 20% decline in BL FEV1

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14
Q

a positive methacholine challenge is indicated by PC20 FEV1 less than?

A

8 mg/mL

normal is >16

methachOline = rule Out asthma (sensitive)
mannItol = rule In asthma if positive (specific) esp EIB
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15
Q

Exercise, EVH or hyperventilation, HTS, cold air, mannitol, adenosine, AMP, allergen have:
Direct bronchoprovocation testing has:

A. high sensitivity, low specificity
B. low sensitivity, high specificity
C. low sensitivity, low specificity
D. high sensitivity, high specificity

A

B. low sensitivity, high specificity

nonselective indirect challenges

fall FEV 15% diagnostic:

  • exercise
  • mannitol

fall FEV 10% diagnostic:
- EVH or hyperventilation

pathways. Most indirect
stimuli act through the release of mediators from inflammatory cells, predominantly mast cells. This effect can be osmotic (exercise, cold air, hyperventilation, mannitol, etc.) or nonosmotic (adenosine monophosphate [AMP])

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16
Q

However, a series of investigations have documented that the deep inhalations to TLC followed by a breathhold causes bronchoprotection in a substantial number of asthmatics with borderline or mild airway hyperresponsiveness (PC20 2 to 16 mg/mL) This results in a significant number of false-negative tests

A

nasal and sputum smears p 432

the mucin gene MUC5AC expression is increased in asthmatics

17
Q

review pictures of lab techniques pages 435-446, pg 447 antibodies in autoimmunity

A

review complement testing, p478

18
Q

see pages 454 & 455 for flow cytometry scatter, 471, 473

A

table 8-19 pge 457-461 for cell surface markers, page 463 for FcyR family table 8-25

  • complement and chemokine receptors page 465 table 8-28 and 8-29
19
Q

CR3 is the most potent complement receptor and binds:

A

iC3b

20
Q

coreceptors for HIV entry into CD4+ T cells are:

A

CXCR4 and CCR5

21
Q

activating mutations of CXCR4 cause:

A

WHIM syndrome, phagocytic defect

wart, hypogam, infection, myelokathexis

22
Q

DTH test:

  • positive
  • negative
A

DTH test:

  • positive = presence or h/o exposure to infectious agent
  • negative = lack of exposure or other conditions

(pg 470)

23
Q

defects in the following neutrophil chemotactic disorders:

  • Chediak Higashi
  • LAD1
  • LAD2
  • Ras related C3 botulinum toxin substrate 2 (RAC2) deficiency
A

defects in the following neutrophil chemotactic disorders:

  • Chediak Higashi - Lyst (CHS1) 1q42
  • LAD1- CD11 & CD18
  • LAD2- CD15a (Sialyl-Lewis x)
  • Ras related C3 botulinum toxin substrate 2 (RAC2) deficiency- looks like LAD2, AD
24
Q

Which two of the following are the membrane bound components of the NADPH oxidase system?

A. gp91 phox
B. p67 phox
C. p22 phox
D. p47 phox
E. p40 phox
F. rac
A

A. gp91 phox (CYBB) - XLR, most common
C. p22 phox (CYBA)

91 + 22 = 113

p47 phox next most common

25
Q

Which two of the following are the cytosolic components of the NADPH oxidase system?

A. gp91 phox
B. p67 phox
C. p22 phox
D. p47 phox
E. p40 phox
F. rac
A

B. p67 phox
D. p47 phox
E. p40 phox
F. rac

26
Q

What is the most common defect in the NADPH oxidase system leading to chronic granulomatous disease?

A. gp91 phox
B. p67 phox
C. p22 phox
D. p47 phox
E. p40 phox
F. rac
A

A. gp91 phox >65%

susceptible to catalase + organisms

  • Staph
  • Serratia
  • Salmonella
  • Pseudomonas

see pg 477 for flow examples

27
Q

when to test infants for HAE?

A

C1INH testing is still generally delayed until 12 months of age in the asymptomatic infant with a family history

28
Q

C1q autoantibodies are found in what disease?

A

hypocomplementemic vasculitis

29
Q

A patient with all but which of the following diseases would require PCR testing to screen for STDs including HIV, Chlamydia, and Neisseria gonorrhea?

A. CVID
B. XLA
C. a patient on gammaglobulin replacement therapy
D. CGD

A

D. CGD

p 484

30
Q

Which are these used for: RNA or DNA?

  • Southern blot
  • Northern blot
A
  • Southern blot - DNA
  • NoRthern blot - Rna
  • Western- gel electrophoresis separating size & shape

HLA typing is done via: PCR

31
Q

FISH is for:

A

duplications, deletions, translocations

22q11

32
Q

Which of the following is likely to have an increased FENO?

A. caffeine drinker
B. CF patient
C. smoker
D. active viral URI
E. pulmonary HTN patient
A

D. active viral URI

33
Q

Which of the following is likely to have an increased FENO?

A. alcohol drinker
B. allergic rhinitis patient
C. smoker
D. CF patient
E. patient who just did spirometry
A

B. allergic rhinitis patient

34
Q

Which of the following is likely to have an decreased FENO?

A. alcohol drinker
B. allergic rhinitis patient
C. patient with viral URI
D. nitrate rich diet

A

A. alcohol drinker

35
Q

Which of the following is not a validated asthma instrument?

A. ACT
B. ACQ
C. ACQOL
D. ATAQ

A

C. ACQOL

36
Q

Which of the following when co-administered can lead to an increased level of theophylline?

A. zileuton
B. phenytoin
C. carbamazepine
D. rifampin

A

A. zileuton

37
Q

Which of the following when co-administered can lead to an decreased level of theophylline?

A. alcohol
B. cimetidine
C. ciprofloxacin
D. erythromycin
E. OCPs
A

A. alcohol

38
Q

Which of the following is the correct combination of physiologic respiratory changes experienced in pregnancy?

A. Increased MV & RV, Decreased TV & FRC
B. Increased MV & FRC, Decreased RV & TV
C. Increased RV & FRC, Decreased TV & MV
D. Increased MV & TV, Decreased RV & FRC

A

D. Increased MV & TV, Decreased RV & FRC

normal compensatory respiratory alkalosis

related to increased levels of progesterone

Exac most likely in 2nd trim (unheard of during L&D)

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