ALLERGIC AND IMMUNOLOGIC DISORDERS 1.4 (AB)

Question 1

What are milia in newborns?

Answer 1

White lesions that are common and normal.

Question 2

What is the appearance of erythema toxicum?

Answer 2

Flea-bite appearance. not extremely dry and only on the face.

Question 3

What distinguishes measles from atopic dermatitis?

Answer 3

Measles has fever. conjunctivitis and infection signs.

Question 4

What is the most common chronic relapsing skin disease in infants and children?

Answer 4

Atopic dermatitis (eczema).

Question 5

What is the ‘atopic march’?

Answer 5

Progression from AD in infancy to food allergy. allergic rhinitis and asthma.

Question 6

What causes atopic dermatitis?

Answer 6

Genetic defects in the skin barrier and immune response to allergens/microbes.

Question 7

What percent of AD cases are IgE-mediated?

Answer 7

70-80%

Question 8

What type of immune cells are increased in AD?

Answer 8

Eosinophils

Question 9

What skin barrier functions are compromised in AD?

Answer 9

Moisture retention. lipid content. immune defense and structural integrity.

Question 10

Why is severe dryness a hallmark of AD?

Answer 10

Due to defective skin barrier causing transepidermal water loss.

Question 11

What are the categories of physical severity of AD?

Answer 11

Clear. Mild. Moderate. Severe

Question 12

Describe mild AD.

Answer 12

Dry skin. infrequent itching. may have small red areas.

Question 13

Describe severe AD.

Answer 13

Widespread dry skin. constant itching. excoriation. bleeding and thickening.

Question 14

Where are AD lesions found in infants?

Answer 14

Face and extensor limbs; napkin area spared.

Question 15

Where does AD present in adolescents?

Answer 15

Flexural folds. wrists. ankles. eyelids.

Question 16

What are the major features of AD?

Answer 16

Pruritus. eczema pattern. chronic/relapsing course. atopic history.

Question 17

What are associated features of AD?

Answer 17

Xerosis. infections. ichthyosis. hyperlinearity. high IgE. keratoconus. etc.

Question 18

Is there a definitive lab test for AD?

Answer 18

No

Question 19

What lab findings support AD diagnosis?

Answer 19

Eosinophilia and increased serum IgE.

Question 20

What is the gold standard for identifying allergens?

Answer 20

History and environmental challenges.

Question 21

How is AD diagnosed?

Answer 21

Based on pruritus. eczema pattern and chronic relapsing course.

Question 22

What is the mainstay of AD treatment?

Answer 22

Skin moisturization and anti-inflammatory therapy.

Question 23

Why is hydration important in AD?

Answer 23

It improves barrier function and symptom relief.

Question 24

When should moisturizers be applied?

Answer 24

Right after bathing while skin is still moist.

Question 25

What are wet dressings used for?

Answer 25

To promote healing. hydrate skin. and enhance topical steroid absorption.

Question 26

What are risks of wet dressing therapy?

Answer 26

Maceration and secondary infection.

Question 27

What is the cornerstone of AD anti-inflammatory therapy?

Answer 27

Topical corticosteroids.

Question 28

Why avoid high-potency steroids on the face?

Answer 28

They may cause skin atrophy and are for short-term use only.

Question 29

How is long-term AD control achieved?

Answer 29

Twice weekly low-dose steroids and daily moisturizers.

Question 30

When are topical calcineurin inhibitors used?

Answer 30

For steroid-resistant AD. steroid phobia and facial/neck areas.

Question 31

What are examples of calcineurin inhibitors?

Answer 31

Pimecrolimus (mild-moderate). Tacrolimus (moderate-severe).

Question 32

What is crisaborole?

Answer 32

A topical PDE-4 inhibitor for mild to moderate AD.

Question 33

What are coal tar preparations used for?

Answer 33

Scalp dermatitis and as antipruritic agents.

Question 34

What are side effects of coal tar?

Answer 34

Irritation. folliculitis and photosensitivity.

Question 35

Why use sedating antihistamines in AD?

Answer 35

To reduce night-time itching and help with sleep.

Question 36

What role do systemic corticosteroids play in AD?

Answer 36

Short-term use for severe exacerbations; not first-line.

Question 37

Why taper systemic steroids?

Answer 37

To prevent rebound flaring and transition to topical treatment.

Question 38

What is cyclosporine used for?

Answer 38

Severe. refractory AD.

Question 39

What are side effects of cyclosporine?

Answer 39

Renal impairment and hypertension.

Question 40

What is dupilumab?

Answer 40

A monoclonal antibody that inhibits IL-4 and IL-13 signaling in AD.

Question 41

What is the effect of dupilumab?

Answer 41

Reduces itch and improves skin clearance.

Question 42

What are examples of antimetabolites for AD?

Answer 42

Methotrexate. azathioprine. mycophenolate mofetil.

Question 43

What is a risk of antimetabolites?

Answer 43

Myelosuppression

Question 44

What is the use of phototherapy in AD?

Answer 44

For refractory AD when standard treatments fail.

Question 45

What kinds of phototherapy are used for AD?

Answer 45

UVA-1. narrow-band UVB and PUVA.

Question 46

What kind of diet should a mother of a patient with AD consider?

Answer 46

A hypoallergenic diet.

Question 47

What bedroom conditions are recommended for patients with AD?

Answer 47

Cool temperature and minimal bed covers.

Question 48

Why should emollient use be increased during cold weather?

Answer 48

Cold weather worsens skin dryness.

Question 49

What should be done if a patient with AD is exposed to herpes sores?

Answer 49

Seek urgent consultation due to risk of widespread flare-up.

Question 50

What type of clothing should be avoided in patients with AD?

Answer 50

Irritating fibers (e.g.wool). tight or overly warm clothing.

Question 51

Why is Perla white soap recommended for clothing?

Answer 51

It contains no coloring and is a gentle coconut-based soap.

Question 52

What should be done to the tags on clothing for patients with AD?

Answer 52

They should be removed.

Question 53

What kind of laundry detergent is recommended for AD patients?

Answer 53

One designed for sensitive baby skin.

Question 54

What clothing characteristics are preferred for children with AD?

Answer 54

White. smooth. soft and non-irritating.

Question 55

What exposure should be avoided for AD patients related to air quality?

Answer 55

Tobacco smoke.

Question 56

Can vaccines be given to AD patients?

Answer 56

Yes

Question 57

Why should vaccines be given in non-infected skin for AD patients?

Answer 57

To prevent deeper skin infections.

Question 58

Is there a restriction on sun exposure for AD patients?

Answer 58

No; it is usually helpful.

Question 59

What are recommended vacation spots for AD patients?

Answer 59

Beach resorts or high-altitude areas during summer.

Question 60

Are there restrictions on physical exercise for AD patients?

Answer 60

No restriction. but gradual adaptation if sweating causes flares.

Question 61

What should be done after sweating or swimming?

Answer 61

Pat dry immediately and apply emollients after a shower.

Question 62

Until what age should exclusive breastfeeding be maintained in infants with AD?

Answer 62

4-6 months.

Question 63

Should a normal diet be maintained in AD patients?

Answer 63

Yes. unless proven otherwise by an energy workup.

Question 64

What are indoor aeroallergens that should be avoided in AD?

Answer 64

House dust mites.

Question 65

How should rooms be ventilated to reduce aeroallergens?

Answer 65

Keep them well-aerated even in winter.

Question 66

What kind of cleaning tools should be avoided for AD patients?

Answer 66

Feather dusters.

Question 67

How should dust be removed in AD-prone homes?

Answer 67

With a wet sponge.

Question 68

How often should bedsheets be washed for AD patients?

Answer 68

Every 10 days at over 55°C (131°F).

Question 69

What type of bed and pillow encasings should be used for AD?

Answer 69

Made of Gore-Tex or similar materials.

Question 70

Are soft toys allowed in cradles of AD patients?

Answer 70

Only washable ones.

Question 71

What is the advice regarding pets for patients with AD?

Answer 71

Avoid furred pets.

Question 72

What should be done if a pet allergy is confirmed in AD?

Answer 72

Firm avoidance including pet removal.

Question 73

What should be done during pollen season for AD patients?

Answer 73

Close windows during warm. dry weather and avoid exposure.

Question 74

When is it safe to open windows for AD patients during pollen season?

Answer 74

At night. early morning or during rainy weather.

Question 75

How can aeroallergens be brought inside by clothing and pets?

Answer 75

They can act as vectors for pollen and allergens.

Question 76

What serious skin condition may occur in AD patients with extensive involvement?

Answer 76

Exfoliative dermatitis.

Question 77

What are signs of exfoliative dermatitis?

Answer 77

Generalized redness. scaling

Question 78

What causes exfoliative dermatitis in AD?

Answer 78

Superinfection or inappropriate therapy.

Question 79

What ocular complication can result from AD?

Answer 79

Eyelid dermatitis or chronic blepharitis leading to visual impairment.

Question 80

What is keratoconus and how is it linked to AD?

Answer 80

A conical corneal deformity from chronic eye rubbing.

Question 81

How does AD severity change with age?

Answer 81

It tends to become milder as children grow older.

Question 82

When does spontaneous resolution of AD occur in many cases?

Answer 82

After age 5 in 40-60% of infants with mild disease.

Question 83

What percent of children with AD may outgrow it by adolescence?

Answer 83

Approximately 84%.

Question 84

What kind of dermatitis is common in adult relapse of AD?

Answer 84

Hand dermatitis.

Question 85

What are predictive factors for poor AD prognosis?

Answer 85

Widespread AD in childhood. FLG null mutations. allergic rhinitis/asthma. family history. early onset. being an only child. very high IgE.

Question 86

What percentage of AD patients experience remission?

Answer 86

50-60%.

Question 87

Why is breastfeeding beneficial for infants with AD?

Answer 87

It is the most hypoallergenic milk.

Question 88

What role do probiotics play in AD prevention?

Answer 88

They may reduce incidence or severity but evidence is not conclusive.

Question 89

Why might a breastfeeding mother need to eliminate allergens?

Answer 89

Some allergens can pass through breast milk.

Question 90

When should peanut introduction occur for infants with severe eczema?

Answer 90

At 4-6 months. after other solids and medical consultation.

Question 91

What is the benefit of early peanut introduction in AD patients?

Answer 91

It may prevent peanut allergy.

Question 92

What should be avoided if an AD patient shows signs of peanut allergy?

Answer 92

Do not repeat exposure.

Question 93

What is the mainstay of long-term AD prevention and treatment?

Answer 93

Identification and elimination of triggering factors.

Question 94

How does emollient therapy help in AD prevention?

Answer 94

It enhances the skin barrier and reduces eczema risk when used early.