Allergology

Question 1

What is allergy?
2. an itching rash
3. immune system responds to non harmful substances with inflammation and causes
damage to the organism
4. the patient has severe runny nose at a viral cold
5. a skin rash that appears while sunbathing
6. flatulence in stomach after a big meal

Answer 1

3. immune system responds to non harmful substances with inflammation and causes
   damage to the organism

Question 2

Atopy:
a. is a genetic susceptibility to produce IgE antibodies
b. is established with skin-prick tests or measurement of specific IgE in blood
c. it is obligatory that symptoms of an allergic disease are present
d. usually it manifests itself with contact allergic dermatitis
e. is rare, present in only 1% of the population

Answer 2

a. is a genetic susceptibility to produce IgE antibodies
b. is established with skin-prick tests or measurement of specific IgE in blood

Question 3

Symptoms of Coombs type I allergic reaction are due to:
a. direct influence of allergens on hystamine receptors
b. allergen toxic influence on tissue
c. hystamine that is released from mastocytes at presence of the allergen
d. hystamine that is released from lymphocytes Th2 at presence of the allergen
e. complement activation which is triggered by allergen+specific IgE immune complexes

Answer 3

c. hystamine that is released from mastocytes at presence of the allergen

Question 4

Allergic diseases:
a. frequency in population is around 20%
b. the most common allergic disease is allergic rhinitis
c. are systemic diseases
d. more frequently occur in developed countries
e. more frequently occur in cities than countryside

Answer 4

All of them

Question 5

Allergens, which cause the formation of antibodies type IgE, are chemically consisted mostly of:
a) proteins
b) heavy metals
c) lipids
d) carbohydrates
e) aromatic hydrocarbons

Answer 5

a) proteins

Question 6

When or where there is a lot of the pollen in the air?
a) when it’s raining
b) in a bedroom
c) in the winter
d) In a sunny and windy weather
e) at night

Answer 6

d) In a sunny and windy weather

Question 7

Pollen as allergen:
a) Symptoms of allergy for pollen are equally distributed during the whole year.
b) The main cause for allergy is pollens of wind-pollinated plants. Only small
portion of patients have a problem because of pollens of insect-pollinated plants.
c) Patients who are hypersensitive for pollen of birch, have characteristically the most
troubles during February.
d) Hazel and grasses bloom at the same time.
e) The biggest amount of pollen in the air is during rain.

Answer 7

b) The main cause for allergy is pollens of wind-pollinated plants. Only small
portion of patients have a problem because of pollens of insect-pollinated plants.

Question 8

In which order do allergenic plants blossom in calendar year?
a) common pelin (wormwood), hazel, willow, birch, grasses
b) grasses, hazel, willow, birch, common pelin
c) birch, hazel, willow, grasses, common pelin
d) hazel, willow, birch, grasses, common pelin
e) hazel, willow, grasses, common pelin, birch

Answer 8

d) hazel, willow, birch, grasses, common pelin

Question 9

Which conditions help house dust mites to survive?
a) temperature over 20°C
b) high relative humidity
c) frequent (at least once per week) thoroughly cleaning of the apartment
d) tapison, rugs and upholstered furniture
e) acaricidal agents

Answer 9

a) temperature over 20°C
b) high relative humidity
d) tapison, rugs and upholstered furniture

Question 10

Which conditions help house dust mites to survive?
a) temperature below 20°C
b) low relative humidity
c) frequent (at least once per week) thoroughly cleaning of the apartment
d) tapison, rugs and upholstered furniture
e) acaricidal agents

Answer 10

d) tapison, rugs and upholstered furniture

Question 11

Where can we find a lot of house dust mites?
a) bed
b) plush toys
c) carpets
d) fridge
e) altitude above 2000 meters

Answer 11

a) bed
b) plush toys
c) carpets

Question 12

Dust mites as an allergen:
a) belong among bacteria
b) good conditions for them is soil in flower pots
c) good conditions for them are cold and dry living areas
d) allergen of a dust mite is actually its skin scales
e) allergen of a dust mite is an ingredient of house dust

Answer 12

e) allergen of a dust mite is an ingredient of house dust

Question 13

Main allergen of a dust mite:
a) is in its feces
b) is in its saliva
c) is in its scales
d) is in its urine
e) is in its tears

Answer 13

a) is in its feces

Question 14

A patient with allergic rhinitis who is hypersensitive for birch pollen can get an allergic reaction
when he ingests:
a) milk
b) peanuts
c) apple
d) meat
e) eggs

Answer 14

c) apple

Question 15

A considerable amount of patients that have an anaphylactic reaction when they come in contact
with latex also have an allergic reaction to:
a) milk
b) peanuts
c) hazelnuts
d) eggs
e) banana (+ kiwi, avocado, melon)

Answer 15

e) banana (+ kiwi, avocado, melon)

Question 16

Treatment principles of type I hypersensitivity:
a) if we eliminate the allergen from the patients living environment, the clinical symptoms of an
allergic disease will disappear, too
b) if a patient is taking drugs with antihistamine effect, exposure to allergen would not cause any
problems
c) an oral antihistamine drug is much more efficient in diminishing allergic conjunctivitis symptoms
than a local antihistamine drug (eye drops)
d) an allergic disease can be completely treated and cured with specific immunotherapy
e) antihistamines are much more effective in allergic inflammation suppression than glucocorticoids

Answer 16

a) if we eliminate the allergen from the patients living environment, the clinical symptoms of an
allergic disease will disappear, too

Question 17

What is true for antihistamines:
a) when oral antihistamines are prescribed, the patient should be warned about dangerous side effects
b) the efficiency of eye drop antihistamines is much lower than the efficiency of oral antihistamines
c) the effect of oral antihistamines is noticeable after approximately 10 days of treatment
d) antihistamines block histamine release from mastocytes
e) An oral antihistamine drug is effective at least 24 hours after application. Antihistamine eye
drops are effective for a few hours.

Answer 17

e) An oral antihistamine drug is effective at least 24 hours after application. Antihistamine eye
drops are effective for a few hours.

Question 18

When do we start local glucocorticoid therapy in a patient with seasonal allergic rhinitis?
1. local glucocorticoid use on nasal mucosa is contraindicated
2. when symptoms of rhinitis become unbearable
3. when the allergogenic pollen appears in the atmosphere (the patient can find information
about this in pollen report)
4. when symptoms of rhinitis and conjunctivitis appear
5. the patient uses it throughout the whole year

Answer 18

3. when the allergogenic pollen appears in the atmosphere (the patient can find information
   about this in pollen report)

Question 19

Epidemiology of allergic diseases:
a) allergic diseases are rare (prevalence 10-20/100.000 people)
b) usually they start after 60 years of age
c) the most frequent allergic disease is allergic gastroenterocolitis
d) prognosis is bad, with a 5-year survival rate below 50%
e) the most frequent cause of death in anaphylactic shock is asphyxiation due to swelling of
the larynx and vocal cords

Answer 19

e) the most frequent cause of death in anaphylactic shock is asphyxiation due to swelling of
the larynx and vocal cords

Question 20

Allergic rhinitis:
1. the most frequent cause of allergic rhinitis is allergy to cow’s milk or chicken eggs
2. stuffed nose is a typical symptom of seasonal allergic rhinitis, which is a consequence of
hypersensitivity to hazel pollen
3. stuffed nose in persistent allergic rhinitis is most effectively cured with antihistamines
4. diagnosis is confirmed by determination of eosinophilic granulocytes’ share in blood - percentage
≥13% is a reliable diagnostic criteria for allergic rhinitis
5. if a patient is allergic to pollen, rhinitis is usually accompanied by conjunctivitis

Answer 20

5. if a patient is allergic to pollen, rhinitis is usually accompanied by conjunctivitis

Question 21

Which medication is the most efficient in treating symptoms of persistent allergic rhinitis?
a) antihistaminic in tablets
b) antihistaminic in the form of nasal droplets
c) local glucocorticoids
d) antileukotriene
e) cromolyn sodium

Answer 21

c) local glucocorticoids

Question 22

Symptoms of persistent allergic rhinitis are:
a) sneezing, watery discharge, itching of the eyes, everything lasts no more than one
month per year
b) nasal obstruction, pain in the muscles, fever
c) blocked nose, flowing of mucus into pharynx, frequent headaches, fatigue
because of sleep disturbances
d) bleeding from the nose, stinky breath
e) blocked one nostril, recurrent one-sided sinusitis

Answer 22

c) blocked nose, flowing of mucus into pharynx, frequent headaches, fatigue
because of sleep disturbances

Question 23

Symptoms of pollen allergic rhinitis because of hypersensitivity for birch are:
a) sneezing, watery discharge, itching of the eyes, everything lasts no more than
one month per year
b) nasal obstruction, pain in the muscles, fever
c) blocked nose, flowing of mucus into pharynx, frequent headaches, fatigue because
of sleep disturbances
d) bleeding from the nose, stinky breath
e) blocked one nostril, recurrent one-sided sinusitis

Answer 23

a) sneezing, watery discharge, itching of the eyes, everything lasts no more than
one month per year

Question 24

Which symptom of allergic rhinoconjunctivitis is poorly treated with antihistamine drugs?
a) itching of the nose
b) sneezing
c) discharge from nose
d) stuffy nose
e) itching of the eyes

Answer 24

d) stuffy nose

Question 25

What measures do we take if we have a patient with pollen allergic rhinitis, which has disturbing
symptoms of sneezing and burning eyes despite regular antihistamine pill intake?
1. we say him to stop taking antihistamine pills due to their inefficacy
2. we swap antihistamine pills for another sort of antihistamine pills
3. we swap antihistamine pills for antileukotriene
4. we add local antihistamine into nose and eyes
5. we swap antihistamine pills for vasoconstrictive nasal and eye drops

Answer 25

4. we add local antihistamine into nose and eyes

Question 26

A patient with pollen allergic rhinitis, who had severe problems with rhinitis and conjunctivitis last year,
is taking antihistamine pills during blooming season this year. He still has disturbing symptoms of sneezing
and discharge. What measures do we take?
1. we say him to stop taking antihistamine pills due to their inefficacy
2. we swap antihistamine pills for another sort of antihistamine pills
3. we swap antihistamine pills for antileukotriene
4. we add local nasal glucocorticoide
5. we swap antihistamine pills for vasoconstrictive nasal and eye drops

Answer 26

4. we add local nasal glucocorticoide

Question 27

What is oral allergy syndrome?
1. metal taste and stinging due to voltage between dental fillings
2. swelling of the oral mucosa during systemic anaphylactic reaction
3. immediate contact allergic reaction when eating stone fruit (i.e. fruit with pits) which arises
due to allergic cross-reaction to birch pollen
4. allergic reaction of the oral mucosa because of hypersensitivity for amalgam
5. inflammation of the oral mucosa due to hypersensitivity for compounds of tooth paste

Answer 27

3. immediate contact allergic reaction when eating stone fruit (i.e. fruit with pits) which arises
   due to allergic cross-reaction to birch pollen

Question 28

Food allergy:
1. approximately 1 % of kids and 6 % of adults have it
2. approximately 40 % of patients, who are sensibilized for birch pollen, fells itch in the mouth,
when eating prawns or calamari
3. patients, who get diarrhea and flatulence within few minutes to 1 hour after milk intake, have
specific IgE antibodies against lactose
4. is a consequence of presence of histamine and biogene amines in some foodstuff
5. can show up as clinical picture of anaphylaxsis

Answer 28

5. can show up as clinical picture of anaphylaxsis

Question 29

How would you differentiate between lactose intolerance and allergy to milk proteins?
1. it is not possible
2. symptoms of lactose intolerance appear already after a sip of milk whereas allergy appear only
after intake of min. 2 dcl of milk
3. a patient with lactose intolerance has “belly symptoms” (flatulence and diarrhoea) whereas a
patient with allergy has systemic symptoms (urticaria, suffocating, hypotension)
4. a patient with intolerance has specific IgE antibodies against lactose whereas a patient with allergy
has specific IgE antibodies against lactalbumin
5. symptoms of intolerance appear after the intake of fresh or boiled milk whereas symptoms of
allergy appear only after the intake of fresh milk (due to denaturation of proteins (which cause
allergy) while boiling milk)

Answer 29

3. a patient with lactose intolerance has “belly symptoms” (flatulence and diarrhoea) whereas a
   patient with allergy has systemic symptoms (urticaria, suffocating, hypotension)

Question 30

Which food contains histamine and biogene amines and can cause symptoms similar to allergy after
intake?
1. bread
2. milk
3. fermented food (wine, beer, sauerkraut)
4. citrus fruits
5. fresh stone fruit

Answer 30

3. fermented food (wine, beer, sauerkraut)

Question 31

Patient has hives (itchy, swollen, pale red bumps or plaques on skin) most days for the past 3 months.
Each new rash lasts a few hours. They are localized all over the body. There is no known cause for them.
What is the most plausible diagnosis?
1. acute urticaria
2. physical urticaria
3. chronic idiopathic urticaria
4. urticarial vasculitis
5. hereditary angioedema

Answer 31

3. chronic idiopathic urticaria

Question 32

Patient had an episode of urticaria lasting 5 days. What is the most plausible cause?
1. peanut allergy, he ate peanuts before hives appeared
2. paracetamol tablet he took for his headache
3. autoimmunity
4. physical urticaria
5. viral infection

Answer 32

5. viral infection

Question 33

When hives appear every day for few months, the most plausible cause is
1. daily consumption of acetylsalicylic acid
2. wheat flour allergy (IgE antibodies)
3. psychological stress
4. autoantibodies for IgE receptors on mastocytes
5. immediate hypersensitivity for pork

Answer 33

4. autoantibodies for IgE receptors on mastocytes

Question 34

Histological assessment of skin biopsy is required for determining diagnosis of
1. acute urticaria
2. physical urticaria
3. chronic idiopathic urticaria
4. urticarial vasculitis
5. hereditary angioedema

Answer 34

4. urticarial vasculitis

Question 35

The diagnosis of hereditary angioedema is determined when in patient with recurrent swelling we find
1. family history with recurrent swelling in many family members
2. high concentration of first complement component (C1) inhibitor in blood
3. autoantibodies against first complement component in blood
4. autoantibodies against mastocytes
5. low concentration of fourth complement component (C4)

Answer 35

5. low concentration of fourth complement component (C4)

Question 36

How do we treat angioedema in patient with recurrent swelling?
1. with epinephrine (adrenaline)
2. with antihistamines
3. with glucocorticoids
4. with C1 inhibitor, icatibant or fresh frozen plasma
5. with acetylsalicylic acid

Answer 36

4. with C1 inhibitor, icatibant or fresh frozen plasma

Question 37

How do we treat most patients with chronic idiopathic urticaria?
1. with systemic glucocorticoids
2. with local glucocorticoid ointment
3. with systemic non-sedative antihistamines
4. with local antihistaminic ointment
5. with antileukotrienes

Answer 37

3. with systemic non-sedative antihistamines

Question 38

The patient was stung by a bee in a finger on his hand. After few minutes his skin started itching and
became red. After 10 minutes he collapsed. His tongue was swollen. His heart rate was 120/min and his
blood pressure was 80/40 mmHg. What is the right sequence of treatment?
1. Supine position with legs elevated, intravenous access, intravenous glucocorticoids, intravenous
antihistamines, intramuscular epinephrine 0,5 mg.
2. Half-sitting position, intravenous glucocorticoids, intravenous antihistamines, intramuscular
epinephrine 0,5 mg.
3. Supine position with legs elevated, intramuscular epinephrine 0,5 mg, intravenous access,
intravenous antihistamines, intravenous glucocorticoids.
4. Sitting position, intramuscular epinephrine 0,5 mg, intravenous aminophilline, intravenous
glucocorticoids.
5. Supine position with legs elevated, intravenous access, intravenous epinephrin 0,5 mg ,
intravenous antihistamines, intravenous glucocorticoids.

Answer 38

3. Supine position with legs elevated, intramuscular epinephrine 0,5 mg, intravenous access,
   intravenous antihistamines, intravenous glucocorticoids.

Question 39

Which statement is correct? (patient with anaphylaxis after bee sting)
1. The patient had allergic reaction after a wasp sting. If this patient is stung by a bumblebee, it is
very likely, he will have an allergic reaction as well.
2. The patient had allergic reaction after a wasp sting. If this patient is stung by a hornet, it is
unlikely, he will have an allergic reaction as well.
3. The patient had allergic reaction after a bee sting. If this patient is stung by a hornet, it is very
likely, he will have an allergic reaction as well.
4. The patient had allergic reaction after a bee sting. If this patient is stung by a bumblebee, it is
unlikely, he will have an allergic reaction as well.
5. The patient had allergic reaction after a bee sting. If this patient is stung by a bumblebee, it
is very likely, he will have an allergic reaction as well.

Answer 39

5. The patient had allergic reaction after a bee sting. If this patient is stung by a bumblebee, it
   is very likely, he will have an allergic reaction as well.

Question 40

Typical symptoms/signs of allergic reaction after a bee sting are
1. skin itching, tachycardia
2. pins-and-needles sensation around the mouth, lightheadedness
3. localized pain at the sting site, high blood pressure
4. chills, high body temperature
5. nausea with urge to vomit, low blood pressure, bradycardia

Answer 40

1. skin itching, tachycardia

Question 41

Which patients with an allergy to insect bites and stings do we treat with
specific immunotherapy?
a. patients with anaphylaxis that occurred after a mosquito bite
b. patients who had a swollen upper arm for a week after being stung
in their forearm by a bee or wasp
c. patients who lost consciousness after being stung by a bee or wasp,
but showed no specific IgE antibodies against bee or wasp venom in
diagnostic tests
d. patients, who had generalized urticaria after being stung by a bee or
wasp and showed specific IgE antibodies against bee or wasp venom in
diagnostic tests
e. patients who lost consciousness after being stung by a bee or
wasp and showed specific IgE antibodies against bee or wasp venom in
diagnostic tests

Answer 41

e. patients who lost consciousness after being stung by a bee or
wasp and showed specific IgE antibodies against bee or wasp venom in
diagnostic tests

Question 42

For specific immunotherapy with bee venom, everything except the
following is true:
a. it is indicated in patients who had an anaphylactic reaction or lost
consciousness after being stung by a bee, but showed specific IgE
antibodies against bee or wasp venom in diagnostic tests
b. the initial phase of immunotherapy is performed at a hospital
c. it is performed with subcutaneous injections of a highly diluted
allergen in small amounts (the amount that corresponds to a
thousandth of the venom a bug spits out)
d. is it performed for 3–5 years
e. after immunotherapy is completed, the chances of a allergic
reaction to an insect bite or sting are less than 20% and even if a reaction
occurs, it is a mild one

Answer 42

c. it is performed with subcutaneous injections of a highly diluted
allergen in small amounts (the amount that corresponds to a
thousandth of the venom a bug spits out)

Question 43

43. Drug hypersensitivity:
    A) is a consequence of drug overdose
    B) is a consequence of a disease affecting drug effects, when a drug is
    prescribed for
    another disease
    C) occurs if the patient is taking multiple drugs at the same time and one
    drug affects the
    metabolism of another drug (interactions)
    D) is a consequence of normal pharmacological effect of a drug
    E) is an unexpected unfavorable effect of a correct drug dose

Answer 43

E) is an unexpected unfavorable effect of a correct drug dose

Question 44

Which drug reaction occurs as the type I hypersensitivity reaction?
A) skin rash at the site of antibiotic topic treatment
B) cough while taking ACE inhibitors
C) anaphylactic reaction to muscle relaxant for inducing general
anesthesia
D) serum sickness after administration of tetanus vaccine
E) hemolytic anemia after treatment with penicillin

Answer 44

C) anaphylactic reaction to muscle relaxant for inducing general
anesthesia

Question 45

Which drug reaction occurs as the type II hypersensitivity reaction?
A) skin rash at the site of antibiotic topic treatment
B) cough while taking ACE inhibitors
C) anaphylactic reaction to muscle relaxant for inducing general anesthesia
D) serum sickness after administration of tetanus vaccine
E) hemolytic anemia after treatment with penicillinvhj

Answer 45

E) hemolytic anemia after treatment with penicillinvhj

Question 46

Which drug reaction occurs as the type III hypersensitivity reaction?
A) skin rash at the site of antibiotic topic treatment
B) cough while taking ACE inhibitors
C) anaphylactic reaction to muscle relaxant for inducing general anesthesia
D) serum sickness after administration of tetanus vaccine
E) hemolytic anemia after treatment with penicillin

Answer 46

D) serum sickness after administration of tetanus vaccine

Question 47

Which drug reaction occurs as the type IV hypersensitivity reaction?
A) skin rash at the site of antibiotic topic treatment
B) cough while taking ACE inhibitors
C) anaphylactic reaction to muscle relaxant for inducing general anesthesia
D) serum sickness after administration of tetanus vaccine
E) hemolytic anemia after treatment with penicillin

Answer 47

D) serum sickness after administration of tetanus vaccine

Question 48

Diagnostic procedures after hypersensitivity reaction following drug
administration:
A) We measure IgE specific antibodies against suspected drug. If test is
positive (IgE antibodies are present) we can conclude, that the patient is
hypersensitive to suspected drug. If test is negative, the patient is not
hypersensitive.
B) IgE specific antibodies can confirm only type I hypersensitivity
reaction and not type II, III or IV hypersensitivity reactions
C) negative skin prick test can certainly rule out hypersensitivity
D) the presence of IgG specific antibodies against suspected drug confirms
diagnosis of hypersensitivity
E) the presence of specific lymphocites against suspected drug confirm
diagnosis of hypersensitivity

Answer 48

B) IgE specific antibodies can confirm only type I hypersensitivity
reaction and not type II, III or IV hypersensitivity reactions

Question 49

Which of the reactions are immunologic (caused by specific antibodies or
T cells specific)?
A cough when receiving inhibitors angiotenzinovekonvertaze?
B. swelling of the lips and the fingers after taking NSAIDs?
C. bronchospasm, and hypotension urikarija during the injection of
muscle relaxant during the introduction to the general
anesthesia
D. maculopapular rash on therapy with amoxicillin
E. collapse, pallor, bradycardia gums after infiltration with a local
anesthetic?

Answer 49

C. bronchospasm, and hypotension urikarija during the injection of
muscle relaxant during the introduction to the general
anesthesia
D. maculopapular rash on therapy with amoxicillin

Question 50

Which of the reactions to medication are immunologic (caused by specific
antibodies or specific lymphocytes T)?
a) cough while taking ACE-inhibitor
b) swelling of the lips and fingers of the hand after intake of NSAID
c) bronchospasm, urticaria and hypotension after muscle relaxant
injection at the beginning of general anesthesia
d) fall of blood pressure while examination with intravenous radiologic
contrast
e) collapse, paleness and bradycardia after use of local anaesthetic on the
gum

Answer 50

c) bronchospasm, urticaria and hypotension after muscle relaxant
injection at the beginning of general anesthesia

Question 51

Patient is having his skin nevus removed. That’s why the skin around the
nevus is infiltrated with subcutaneous injection of local anaesthetic. During
the anaesthetic injection, the patient’s skin turns pale, the patient starts to
sweat and he collapses. His pulse is 50 per minute and weak. What should
we do?
a. we inject 0,5 mg of adrenalin intramuscularly
b. we start an adrenalin infusion
c. we administer 1 ampulla of antihistaminic intravenously
d. we administer 1 ampulla of antihistaminic and 1 ampulla of
glucocorticoids (80mg metilprednisolone) intravenously
e. we lay the patient down and raise his legs (Trendelenburg
position)

Answer 51

e. we lay the patient down and raise his legs (Trendelenburg
position)

Question 52

Which sign/symptom is not typical for anaphylaxis?
a. itchy feet
b. stridor
c. pale, cold and sweaty skin
d. urinary and bowel incontinence
e. unconsciousness

Answer 52

c. pale, cold and sweaty skin

Question 53

The management principles of anaphylaxis:
A. adrenaline is a good inhibitor of histamine binding on receptors
B. intravenous glucocorticoids prevent release of histamine from
mastocytes
C. we are not allowed to give adrenaline intramuscularly, because
hypotension prevents absorption of adrenaline from muscle to blood
D. antihistamines prevent release of histamine from mastocytes
E. adrenaline is a functional antagonist of histamine

Answer 53

E. adrenaline is a functional antagonist of histamine

Question 54

The patient gets urticarial rash all over his body, swollen lips, becomes
hoarse and starts to breathe heavily after bee’s bite. What is the appropriate
order of measures?
A. measuring heart rate and blood pressure
B. giving methylprednisolone
C. giving antihistamine
D. giving adrenalin
E. giving oxygen

Answer 54

All of them

Question 54

What is the appropriate first dose of adrenaline when treating anaphylaxis?
A. 1 g in the muscle
B. 0,5 g under the skin
C. 0,5 mg intravenously
D. 0,3 mg in the muscle
E. 0,01 mg in the muscle

Answer 54

D. 0,3 mg in the muscle

Question 55

Determining total IgE antibodies in blood:
A. is a good (high sensitivity and high specificity) screening test for
allergic diseases
B. normal concentration of IgE antibodies in blood for sure excludes
allergic disease
C. almost all of the patients with allergic diseases have elevated
concentration of IgE antibodies in blood
D. the concentration of IgE antibodies in blood is correlated with the
severity of the allergic disease
E. high concentration of IgE antibodies in blood can be detected
during parasitic infections

Answer 55

E. high concentration of IgE antibodies in blood can be detected
during parasitic infections

Question 56

Total IgE antibodies in the blood:
A. They are allways increased in allergic diseases of imeddiate
hypersensitivity.
B. Can be increased in patients with HIV virus infection.
C. Almost every atopic has elevated concentration of IgE antibodies in
the blood.
D. Can be elevated in patients with liver cirrhosis.
E. In infections with intestinal or tissue paraites we find high
concentration of IgE antibodies in the blood.

Answer 56

B. Can be increased in patients with HIV virus infection.
D. Can be elevated in patients with liver cirrhosis.
E. In infections with intestinal or tissue paraites we find high
concentration of IgE antibodies in the blood.

Question 57

Specific IgE antibodies:
A. Almost 50% of all IgE antibodies are bound to basophils and mast
cells.
B. They are most effectively determined by skin prick test.
C. Every person, who has specific antibodies in the blood, has
symptoms of allergies, if he/she is exposed to alergen.
D. Determination of IgE specific antibodies with laboratoy methods
in-vitro is cheaper than skin prick test.
E. Antihistamin intake disturbs determination of specific IgE
antibodies with laboratory methods in-vitro.

Answer 57

B. They are most effectively determined by skin prick test.

Question 58

Skin prick tests:
a. are useful to test for class I and IV hypersensitivity
b. are only useful to test for class I hypersensitivity
c. are useful to test for class II and III hypersensitivity
d. are useful to test for class I, II, III and IV hypersensitivity
e. are useful to test non-immune mediated hypersensitivity

Answer 58

a. are useful to test for class I and IV hypersensitivity

Question 59

What applies to skin prick testing?
a. we perform the test by applying a drop of allergen concoction on the skin and
pricking the skin through the allergen drop, using a lancet
b. we use fresh foods (first we prick the food, then the skin)
c. we assess the results after 15-30 min
d. we don’t perform the test, if patient is receiving antihistamines per os
e. we don’t perform the test, if patient is receiving glucocorticoid inhalations

Answer 59

a. we perform the test by applying a drop of allergen concoction on the skin and
pricking the skin through the allergen drop, using a lancet
b. we use fresh foods (first we prick the food, then the skin)
c. we assess the results after 15-30 min
d. we don’t perform the test, if patient is receiving antihistamines per os

Question 60

Which of the following drug therapies needs to be discontinued at least 3 days before skin
allergy test?
a. nasal corticosteroid spray
b. systemic antihistamines
c. inhalatory glucocorticoids
d. anticoagulation treatment (switch Marevan to Heparin)
e. antileukotrienes

Answer 60

b. systemic antihistamines

Question 61

When a patient has a positive reaction to skin prick testing (urtica bumps, which are larger
than 3 mm) with all tested allergens, we can safely assume, that:
a. the patient is hypersensitive to all tested allergens
b. the patient is hypersensitive to all tested allergens and saline
c. the patient isn’t hypersensitive, but has dermatographic urticaria
d. the tests need to be repeated with softer pricking
e. the tests need to be repeated, when the patient is receiving antihistamines

Answer 61

c. the patient isn’t hypersensitive, but has dermatographic urticaria

Question 62

Which of the following doesn’t apply to primary immunodeficiencies?
a. group of genetic disorders, caused by mutations
b. manifested only during adulthood
c. all PID present with opportunistic infections
d. early recognition of PID patients is crucial for successful treatment and disease
outcome
e. some PID patients present with dysplastic features (microcephaly, abnormally shaped
nose …)

Answer 62

c. all PID present with opportunistic infections

Question 63

Which of the following doesn’t apply to selective IgA deficiency?
a. most common primary immunodeficiency
b. two thirds of patients are asymptomatic
c. 20-40% of patients have IgG and IgM antibodies, directed against IgA antibodies
d. if the patients have recurrent infections, they are treated with serum IgG
replacement therapy (prophylactic Ab treatment)
e. serum IgG replacement therapy may cause anaphylaxis, if the patients have specific
IgE antibodies against IgA antibodies

Answer 63

d. if the patients have recurrent infections, they are treated with serum IgG
replacement therapy (prophylactic Ab treatment)

Question 64

The following applies to H1 antihistamines:
a. are H1 receptor antagonists
b.are inverse agonists of H1 receptors
c. inhibit the late allergic reaction
d. maximum plasma concn. they reach after 8-10 hours, so we take them once a day

Answer 64

b.are inverse agonists of H1 receptors

Question 65

The 1st generation of antihistamines includes all, except:
a.Fexofenadine
b. Hydroxyzine
c. Diphenhydramine
d. Chlorpheniramine

Answer 65

a.Fexofenadine

Question 66

The 2nd generation of antihistamines includes all, except:
a. Cetirizine
b. Fexofenadine
c.Clemastine
d. Loratidine

Answer 66

c.Clemastine

Question 67

Mark the correct statement:
a.Loratidine dosage should be adjusted in patients with hepatic impairment
b. Elderly patients need to adjust the dosage of loratidine
c. Cetirizine dosage should be adjusted in patients with hepatic impairment
d. Cetirizine is characterized by cardiotoxicity

Answer 67

a.Loratidine dosage should be adjusted in patients with hepatic impairment
c. Cetirizine dosage should be adjusted in patients with hepatic impairment

Question 68

Mark the correct statement:
a. Nasal steroids are suitable for acute relief of allergic rhinitis symptoms
b. Clemastine is a H1 antihistamine of the 1st generation, has a sedative effect and is used only orally, in
the evening before going to bed
c. In children, nasal steroids slow down growth, so in the case of chronic treatment, they are
replaced with H1 antihistamines 2nd gen.
d.Nasal steroids prevent the development of inflammation and can be used for several weeks

Answer 68

d.Nasal steroids prevent the development of inflammation and can be used for several weeks

Question 69

Which two diagnostic methods for allergic rhinitis are used LEAST often?
a. skin prick tests
b. oral provocation test
c.measurement of IgE
d. status and medical history
e.some in vitro test

Answer 69

c.measurement of IgE
e.some in vitro test