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AI Boards > ACAAI Review Book Ch 9: Allergens and antigens > Flashcards

ACAAI Review Book Ch 9: Allergens and antigens Flashcards

1
Q

Which of the following allergens have the most cross reactivity?

A. bahia
B. johnson
C. timothy
D. bluegrass
E. johnson
A

C. timothy
D. bluegrass

Northern grasses (Pooidae) have strong cross-allergenicity

I grew up in the NORTH where I got TO Relish Fresh, SWEET BLUEberries

Northern grasses:

  • timothy
  • orchard
  • rye
  • fescue
  • sweet vernal
  • bluegrass
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2
Q

Which of the following allergens have cross reactivity?

A. bahia
B. johnson
C. lovegrass
D. bermuda
E. corn
F. prairie
A

C. lovegrass
D. bermuda
F. prairie

^ Southern grasses, subfamily Chloridoideae cross reacts

Bahia & Johnson have limited cross reactivity

Then I moved to the SOUTH for LOVE and my Boo Bought me JOHNSONS PRAIRIE

  • lovegrass
  • bermuda
  • bahia
  • johnson
  • prairie
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3
Q

Most trees pollinate in the spring except which two of the following?

A. ash
B. birch
C. elm
D. oak
E. olive
F. mountain cedar
A

C. elm- FALL

F. mountain cedar- midWINTER

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4
Q

All of the following cross react except?

A. ash
B. olive
C. privet
D. cedar

A

D. cedar

Oleaceae family

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5
Q

All of the following cross react except?

A. ash
B. birch
C. alder
D. hazelnut
E. hornbeam
A

A. ash

Betulaceae family
Bet v 1-7= birch

OAS = PAL-ABC
pear peach potato plum
apple pricot
birch
celery, carrot, cherry

protruding pores can make it look like a lemon

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6
Q

All of the following cross react except?

A. cypress
B. birch
C. juniper
D. cedar

A

B. birch

stellate cytoplasm breaks to look like pac-man

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7
Q

All of the following cross react except?

A. oak
B. birch
C. beech
D. chestnut
E. hazelnut
A

E. hazelnut

Fagaceae family- c/w Birch and Betulaceae fam.

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8
Q

which allergen cross reacts in people allergic to shrimp?

A. Der p 1
B. Der f 1
C. Der p 2
D. Der f 2
E. Der p 10
A

E. Der p 10
tropomysin

•Der p 1 and Der f 1 = cysteine proteases

the house / pyroglyphid mites = Dermatophagoides, Euroglyphus,

the storage mites = Bloomia, Lepidoglyphus, Tyrophagus

case reports of pts started on dust mite IT and then developed systemic reactions to crustaceans afterwards. However, this is uncommon and not much to do or counsel patients on

Evaluate patients who complain of oral symptoms or
symptoms consistent with an IgE-mediated reaction after
ingestion of grain flour for dust mite sensitization regardless of
whether they have wheat-specific IgE

Thumbs down, don’t use acaricides

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9
Q

The major cat allergen comes from what source?

A. urine
B. salivary glands
C. feces
D. hair
E. skin/sebaceous & anal glands
A

E. skin/sebaceous & anal glands
B. salivary glands

Fel d 1
secretoglobulin

(Fel d 2 albumin and Fel d 3 are minor antigens)

remains airborne even in undisturbed conditions and can take 4-6 months for cat alelergen levels to reduce in home after cat removal

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10
Q

Of the dog allergens, which are:

  • lipocalin?
  • major allergens?
  • albumin?
A
  • lipocalin (calycin) = Can f 1, 2, 4
  • major allergens = Can f 1, & Can f 5
  • albumin = Can f 3
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11
Q

The major dog allergen Can f 1 comes from what sources?

A. urine
B. salivary glands
C. feces
D. hair
E. skin / Sebaceous glands
A

B. saliva & D. hair

also E. skin / Sebaceous glands

not as easily airborne as cats, but also ubiquitous

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12
Q

Of the cockroach allergens, which are:

  • lipocalin?
  • aspartic proteases?
  • tropomysin?
A
  • lipocalin = Bla g 4
  • aspartic proteases = Bla g 1 & 2 (2 is measured in house dust and levels >10 a/w disease)
  • tropomysin = Per a 7
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13
Q

The primary school-based allergen is:

A. Bla g 1
B. Per a 7
C. Bla g 2
D. Mus m 1
E. Rat n 1
A

mouse allergen - Mus m 1

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14
Q

Cockroach and mold allergens contain protease enzymes and can only be mixed with which of the following:

A. tree
B. cat
C. dog
D. dust mite
E. grass
F. weed
A

D. dust mite

grass pollens are especially susceptible to protease enzymes

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15
Q

Glycerin properties include all of the following except:

A. maximize stability of an extract
B. inhibit bacterial growth
C. inhibit proteolytic enzymes
D. preservative effect by reducing adsorption of allergenic proteins to the vial surface

A

D. preservative effect by reducing adsorption of allergenic proteins to the vial surface = HSA

phenol is added to prevent bacterial growth, but can break down allergen proteins in extract products containing 50% glycerin

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16
Q

allergen responsible for Cat-pork syndrome- cat allergic patients who react with pork ingestion 2/2 cross reactivity with pork albumin?

A

Fel d 2

17
Q

dust mite IT dose

A

Patients receiving immunotherapy for dust mite ideally
should receive a dose that delivers approximately 7 mg of Der p 1
per injection or 500 to 2,000 AU per injection to obtain an
optimal balance between efficacy and safety.

Der p 1 can cleave the
CD23 IgE receptor from human B-cell membranes, thus ablating the
feedback inhibitory mechanism that normally limits IgE
synthesis.29 Der p 1 also can cleave the CD25 subunit of the T-cell
interluekin-2 receptor, which can promote TH2 responses

dvise patients to minimize exposure of susceptible children
to dust mite allergens to decrease their risk of developing mitespecific
IgE. Because

Advise patients to minimize exposure of dust miteesensitized
children to dust mite allergens to decrease their risk of developing
asthma and possibly rhinitis

18
Q

The major dust mite allergen comes from what source?

A. urine
B. salivary glands
C. feces
D. hair
E. skin/sebaceous & anal glands
A

C. feces- pellets

19
Q

allergen responsible for Alpha-gal sensitivity (IgE binding epitope is the carbohydrate galactose-alpha-gal)

A

Fel d 5

Oligosaccharide on cat IgA; main source is saliva

20
Q

Lipocalin (also known as calycin) family proteins includes rat (Rat n 1), mouse (Mus m 1), horse (Equ c 1/Equ c 2), cow (Bos d 2/Bos d 5), cow’s milk (β-lactoglobulin), rabbit (Ory c 1), and cockroach (Bla g 4). Does not include cat!

A

Basal serum tryptase should be measured when there is a history of
severe insect sting anaphylaxis (especially with hypotension or the
absence of urticaria) and when skin and serum test results for
venom-specific IgE are negative.24e26 Tryptase measurement
should be considered when patients have systemic reactions during
VIT and when discontinuing VIT. Patients with mastocytosis should
be tested for Hymenoptera venom sensitivity. In

Mastocytosis occurs in approximately 2% of patients
with insect sting anaphylaxis, and insect sting anaphylaxis occurs
in approximately 25% of patients with mastocytosis.124

anaphylaxis. VIT reduces the risk of a subsequent systemic sting
reaction to as low as 5% compared with up to 60% in untreated
patients

21
Q

Include in VIT all venoms for which

the patient has demonstrated specific IgE. (Recommendation;

A

VIT.37,209,215 Fatal reactions to stings have occurredafter stopping VIT
in patients with mastocytosis.134,135 Although this occurrence is rare,
some recommend continuation of immunotherapy indefinitely in
patients with a history of severe anaphylaxis or with mast cell disorders

22
Q

• ANA = 50% chance of having it again
o Risk of a subsequent systemic sting with VIT
 <5% vespids
 15% with honeybee (not quite as effective)

A

Patients with Schnitzler syndrome caused by an IgM or
more rarely IgG monoclonal gammopathy present with nonpruritic
urticaria (that spares the face), bone pain, and intermittent
fever.
Manag

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