Allergo/Immuno Flashcards
- Which of the following prompts a diagnosis of primary immunodeficiency?
a. 19/M with recurrent pneumonia, otitis media and sinusitis
b. 20/M with persistent upper lobe infiltrates and severe weight loss
c. 23/F with recurrent herpes simplex oral ulcers
d. 36/F with intermittent myalgia
19/M with recurrent pneumonia, otitis media and sinusitis
Which of the following primary immune deficiency diseases is due to impaired survival, migration, and function of T-lymphocytes?
a. Common variable immunodeficiency (CVID)
b. DiGeorge’s syndrome
c. Hyper IgE syndrome
d. XL agammaglobulinemia
Hyper IgE syndrome
A 28/F was diagnosed to have chronic granulomatous disease after presenting with recurrent skin infections. Which of the following medications will prevent bacterial infections in her case?
a. Co-amoxiclav
b. Penicillin
c. Doxycyline
d. Co-trimoxazole
Co-trimoxazole
A patient develops fever, urticaria, cervical lymphadenopathy, and joint pains after a 7-day course of cefaclor for staphylococcal skin infection. What is the mechanism behind this manifestation?
a. IgE-dependent reactions
b. IgG-mediated cytotoxicity
c. Antigen-antibody immune complexes
d. Delayed type hypersensitivity
Antigen-antibody immune complexes
. A 38/M policeman is consulting for recurrent sneezing and rhinorrhea for 6 weeks, which apparently worsened upon transfer to a provincial detachment. His symptoms occur almost daily, with nasal pruritus, clear watery discharge and eye itching mostly when he is out doing field work. He has been on sick leave for almost two weeks due to persistence of symptoms. What will be the most appropriate pharmacotherapy?
a. Oral Prednisone 10 mg BID x 7 days
b. Oral Montelukast + Levocetirizine for 14 days
c. Intranasal Fluticasone for 1 month
d. Oral Bilastine for 1 month
Intranasal Fluticasone for 1 month
A 24/F call center agent is evaluated for a red, itchy rash on her chest, back, abdomen, arms and legs for 3 days. She notes that an area of redness and swelling arises and lasts less than 24 hours. There is no lip or tongue swelling. The lungs are clear and without wheezes. The rest of the examination is normal. Which of the following is the most appropriate initial treatment?
a. Diphenhydramine
b. Loratadine
c. Montelukast
d. Prednisone
Loratadine
Which of the following statements is true regarding allergic rhinitis?
a. Almost 70 to 80% of patients with asthma experience allergic rhinitis
b. In the acute attack of allergic rhinitis, TH1-mediated inflammation predominate over TH2-mediated inflammation
c. Atopy-associated allergic rhinitis and asthma commonly present with nasal polyps
d. Allergic rhinitis is often associated with atopic dermatitis, but rarely asthma
Almost 70 to 80% of patients with asthma experience allergic rhinitis
A 24/F medical intern with asthma was brought to the ER after feeling unwell during her first OR assist. She had big wheals noted on her hands and forearms and small erythematous plaques on the rest of her body. On examination, she had borderline BP 90/60, HR 115, wheezes all over lung fields. Which of the following is a LEAST LIKELY risk factor for anaphylaxis in this patient?
a. Antibiotics
b. Exercise
c. Latex
d. Peanuts
Antibiotics
What is a common histologic finding in the chronic phase of glomerular involvement in patients with antiphospholipid syndrome?
a. Diffuse cortical atrophy
b. Fibrous intimal hyperplasia
c. Fibrocellular venous occlusion
d. Thrombotic microangiopathy
Fibrous intimal hyperplasia
Which of the following pregnancy morbidities fulfills the clinical criteria of antiphospholipid syndrome?
a. Abortion of a fetus with anencephaly at 10th week of gestation
b. A premature birth of a morphologically normal neonate at the 30th week of gestation due to eclampsia
c. Three consecutive spontaneous abortions of unknown cause at the 10th week of gestation
d. Four consecutive spontaneous abortions of unknown cause at the 12th week of gestation
A premature birth of a morphologically normal neonate at the 30th week of gestation due to eclampsia
30/F comes to the ER because of 1 day of worsening right leg pain and swelling. Her only past medical history is related to difficulty getting pregnant, with two prior spontaneous abortions. Doppler studies reveal a large deep venous thrombosis in the femoral and iliac veins. Low-molecular-weight heparin therapy is initiated. Subsequent therapy should include which of the following?
a. Warfarin with INR goal of 2.0 to 3.0 for 3 months
b. Warfarin with INR goal of 2.0 to 3.0 for 6 to 12 months
c. Warfarin with INR goal of 2.5 to 3.5 for life
d. Warfarin with INR goal of 2.5 to 3.5 for 12 months in combination with daily aspirin for lif
Warfarin with INR goal of 2.5 to 3.5 for life
Of the medications used to treat antiphospholipid syndrome, which of the following is ineffective in preventing pregnancy morbidity?
a. Aspirin 80 mg daily
b. Prednisone 40 mg daily
c. Low molecular weight heparin daily
d. Intravenous immunoglobulin 400 mg/kg x 5 days
Prednisone 40 mg daily
