AI

Question 1

foods somebody with latex allergy should avoid

Answer 1

papaya, avocado, banana, chestnut, passion fruit, fig, melon, mango, kiwi, pineapple, peach, tomato

Question 2

chronic urticaria treatment

Answer 2

> 6 weeks

longterm tx 2nd or 3rd generation antihistamine fexofenadine (Allegra), loratidine (Claritin) or cetirizine (zyrtec)

Question 3

what to do with patient who needs contrasted imaging study and has shellfish allergy?

Answer 3

no pretreatment needed
risk of rxn is negligible, just reassure
pretreat with Benadryl and prednisone only if there has been a documented adverse rxn to contrast

Question 4

types of hypersensitivity reactions

Answer 4

type 1: IgE mediated (anaphylaxis, milk protein allergy, PCN allergy (w/i 24 hours of exposure))
type 2: Ab mediated (RBCs in Hemolytic Anemia, Ach rec in Myasthenia Gravis, and TSH receptors in Grave’s Disease, Goodpastures)
type 3: immune complex mediated (SLE, Arthrus, serum sickness, HSP)
type 4: delayed hypersensitivity (poison ivy)

Question 5

false negative skin testing

Answer 5

antihistamines

antidepressants (TCAs)

Question 6

what test is not impacted by antihistamine treatment?

Answer 6

radioallergosorbent test (RAST), blood test - detects specific IgE antibodies.  Also carries no risk of anaphylaxis.   Good for kid with extensive eczema
skin testing though is more sensitive and less expensive

Question 7

absent CD40 ligand, frequent OM and sinopulmonary infections, can have PCP without h/o HIV, males present after 6 mo

Answer 7

x linked hyper IgM

T cell abnormality that prevent conversion of IgM to IgG

Question 8

diagnosed with nitroblue tetraxolium test

Answer 8

assay of phagocytic oxidase activity for chronic granulomatous disease

• staph, serratia infections
• 2/3 xlinked, rest AR

Question 9

high WBC but no pus in infected areas

Answer 9

leukocyte adhesion deficiency

chemotaxis defect

Question 10

testing for cell-mediated immunity

Answer 10

TB/candida skin test

Question 11

testing for humoral immunity

Answer 11

Ig levels, if levels normal, can test subclasses from vaccination (tetanus, rubella, pneumococcus)

Question 12

A child develops tongue swelling after eating a banana. What pollen is he most likely allergic to?

Answer 12

Ragweed pollen- bananas, watermelon, cantaloupe

Birch pollen- apple, potato, carrot, celery, hazel nuts, kiwi