Allergology Chap 140-152

Question 1

Drug of choice for the treatment of anaphylaxis

Answer 1

Epinephrine

Question 2

Effective treatment for allergic NASAL disease

Answer 2

Alpha-adrenergic agents

• decongestant effect
• vasoconstiriction -> decrease nasal congestion

Question 3

S8de effect of alpha adrenegic agents

Answer 3

Rhinitis medicamentosa (rebound nasal congestion)
- must not be given for more than 3 days

Question 4

Inflammatory disorder of the nasal mucosa

Nasal congestion, rhinorrhea, itching, often accompanied by sneezing & conjuctival inflammation

Answer 4

Allergic Rhinitis

Question 5

Main cause of allergic rhinitis

Answer 5

Inhalant allergens

Question 6

Sneezing, rhinorrhea, nasal itching & congestion
Clear nasal secretions, edematous, boggy and bluish nasal mucosa
Elevated serum IgE
Positive allergy skin test

Answer 6

Allergic Rhinitis

Question 7

Allergic Rhinitis (AR) occuring in <4day/week
No change in sleep and daily activities

Answer 7

Mild Intermittent AR

Question 8

Allergic Rhinitis (AR) occuring in >4day/week
Sleep disturbances and impairment in daily activities

Answer 8

Moderate to severe Persistent AR

Question 9

Chronic inflammatory condition of the lung airways resulting in episodic airflow obstruction
Airway hyperresponsiveness

Answer 9

Asthma

Question 10

Strongest identifiable factor for the persistence of childhood asthma

Answer 10

Allergy in young children with recurrent cough &/or wheeze

Question 11

MC chronic symptoms of asthma

Answer 11

Intermittent dry coughing & expiratory wheezing

Question 12

T/F: Respiratory symptoms in asthma are worse at night

Answer 12

True

Question 13

T/F: Asthma produces clubbing

Answer 13

False

Question 14

Objective measure of airflow limitation

Answer 14

Spirometry

Question 15

Management of INTERMITTENT ASTHMA

Answer 15

SABA as needed

Question 16

Preferred treatment for all patients with PERSISTENT ASTHMA

Answer 16

Inhaled corticosteroids (ICS)

Question 17

Not intended for use as rescue medication in Asthma

Answer 17

Long acting Beta agonist (LABA)

- Salmeterol, Formoterol

Question 18

May be used to reduce exercise-induced bronchospasm

Answer 18

Nonsteroidal Anti-inflammatory agents

- Cromolyn, nedocromil (taken off market)

Question 19

Drug of choice for ACUTE asthma symptoms

Answer 19

Short acting beta agonists (SABA)

- Albuterol, levabuterol, terbutaline, pirbuterol

Question 20

T/F: Chest physiotherapy, incentive spirometry and mucolytics are NOT RECOMMENDED in the early acute period of asthma exacerbations

Answer 20

True.

They can trigger severe bronchoconstriction

Question 21

Preferred SABA for pregnant women

Answer 21

Albuterol

Question 22

Preferred ICS for pregnant women

Answer 22

Budesonide

Question 23

MC chronic relapsing skin disease in infancy & childhood

Answer 23

Atopic Dermatitis or Eczema

Question 24

Skin lesions characterized with marked intercellular edema (SPONGIOSIS)
With noted marked perivenular T-cell infiltrate with occasional monocyte-macrophages

Answer 24

Acute Atopic Dermatitis

Question 25

Characterized by hyperplastic epidermis with hyperkeratosis and minimal spongiosis

Answer 25

Chronic, lichenified Atopic Dermatitis (AD)

Question 26

Hallmark of Atopic Dermatitis

Answer 26

Severely Dry skin

Question 27

Infant, who came in with intenesely pruritic, erythematous papules on the face, scalp and extensor surfaces of the extremities Noted to have dry lackluster skin

Answer 27

Acute Atopic Dermatitis

Question 28

Child who came in with noted thickened skin lesions with accenuated surface markings (lichenification), and fibrotic papules on the flexural folds With intense pruritus, especially at night Chronically relapsing rashes when exposed to pollen (allergens)

Answer 28

Chronic Atopic Dermatitis

Question 29

Cardinal features of Atopic Dermatitis (2)

Answer 29

Intense pruritus, especially at night | Cutaneous reactivity

Question 30

Cornerstone of anti-inflammatory treatment for acute Atopic Dermatitis

Answer 30

Topical corticosteroids

Question 31

MC hypersensitivity response of the eye

Answer 31

Allergic Conjunctivitis

Question 32

Bilateral ocular itching, increased tearing, watery discharge Pe: bilateral conjunctival injection with congestion, conjunctival swelling (chemosis)

Answer 32

Allergic Conjunctivitis

Question 33

Severe Bilateral Chronic Inflammatory process of the Upper Tarsal Conjunctival surface Potentially sight threateninb with involvement of the cornea

Answer 33

Vernal Keratoconjunctivitis

Question 34

Patient came with SEVERE ocular itching exacerbated with exposure to light and perspiration. Note pf photophobia, foreign-body sensation and lacrimation With history of atopy Pe: giant papillae on the upper tarsal plate (COBBLESTONING); Stringy, ropey discharge; transient yellow-white points in the Limbus (Trantas dots) & conjuctiva (Horner points), long eyelashes

Answer 34

Vernal Keratoconjunctivitis

Question 35

Chronic inflammatory ocular disorder most common in the LOWER tarsal conjunctiva Sight-threathening Associated with Atopic dermatitis

Answer 35

Atopic Keratoconjunctivitis

Question 36

Severe bilateral ocular itching, burninh, photophobia & tearing with MUCOID discharge, and persists throughout the year Secondary staphylococcal blepharitis is common

Answer 36

Atopic Keratoconjunctivitis

Question 37

Mild bilateral ocular itching, tearing, foreign-body sensation with mild mucoid discharge that is clear on awakening but becomes thick ang stringy due to chronic exposure to FOREIGN BODIES

Answer 37

Giant Papillary Conjunctivitis

Question 38

Erythematous, pruritic, raised wheal that blanches with pressure, transient, and resolves without residual lesions

Answer 38

Urticaria (Hives)

Question 39

Lesions that burn more than itch, lasts for >24h, DO NOT BLANCH, blister, heal with SCARRING, or may have bleedinh into the skin (purpura)

Answer 39

Urticarial Vasculitis

Question 40

Development of localized pruritus, erythema and urticaria AFTER EXPOSURE to COLD STIMULUS

Answer 40

Cold Urticaria

Question 41

Onset of Small, Punctate, pruritic wheals surrounded by a prominent erythematous flare Associated with EXERCISE, HOT SHOWERS, & SWEATING

Answer 41

Cholinergic Urticaria

Question 42

Ability to write on skin

Answer 42

Dermatographism or Urticaria Factitia

Question 43

Noted cellular infiltrates predominantly around small venules Not an allergic reaction Skin reveals infiltrative hives with palpably elevated borders varying greatly in size and shape Biopsy: non necrotizing, perivascular, mononuclear cellular infiltration

Answer 43

Chronic Idiopathic Urticaria & Angioedema

Question 44

MC cause of Acute Urticaria

Answer 44

Drug | Food

Question 45

Serious allergic reaction that is rapid in onset and may cause death

Answer 45

Anaphylaxis

Question 46

An example of Type III hypersensitivity reaction caused by antigen-antibody complexes It is a systemic, immune complex-mediated hypersensitivity vasculitis attributed to THERAPEUTIC ADMINISTRATION of FOREIGN serum proteins

Answer 46

Serum sickness

Question 47

Child came in due to edema and erythema of the right deltoid. Noted to be given antitetanus toxoid in the site 7 days prior. Also complains of fever, myalgia, arthralgia and URTICARIAL rashes Labs: thrombocytopenia in cbc, ua showed microscopic hematuria, mild proteinuria, C3 is low

Answer 47

Serum sickness

Question 48

T/F: Serum sickness can be prevented by desensitization and pretreatment with corticosteroids

Answer 48

FALSE