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Fundamentals > Allergy > Flashcards

Allergy Flashcards

1
Q

S__IT is associated w/a lower incidence of anaphylaxis compared to S__IT.

A

**Sublingual immunotherapy (SLIT) **is associated w/a lower incidence of anaphylaxis compared to subcutaneous immunotherapy (SCIT).

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2
Q

Anaphylaxis and Allergies are what type of Hypersensitivity Reactions?

A

Type I (immediate)

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3
Q

Autoimmune hemolytic anemia, Transfusion reaction, Bullous pemphigoid, and Goodpasture syndrome are what type of Hypersensitivity Reactions?

A

Type II (cytotoxic)

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4
Q

Serum sickness, PSGN (poststrep glomerulonephritis), lupus nephritis are what type of Hypersensitivity Reactions?

A

Type III (immune complex)

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5
Q

Contact dermatitis, Hashimoto’s thyroiditis Granulomatous diseases (sarcoidosis, Tb), and Tuberculin skin test are what type of Hypersensitivity Reactions?

A

Type IV (delayed types)

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6
Q

The following Humoral components apply to which type of Hypersensitivity reaction?
* IgE

A

Type I
immediate

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7
Q

The following Humoral components apply to which type of Hypersensitivity reaction?
* IgG
* IgM
* Complement activation

A

Type II
cytotoxic

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8
Q

The following Humoral components apply to which type of Hypersensitivity reaction?
* Deposition of Ab-Ag complexes
* Complement activation

A

Type III
immune complexes

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9
Q

The following Humoral components apply to which type of Hypersensitivity reaction?
* None

A

Type IV
delayed types

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10
Q

The following Cellular components apply to which Type of Hypersensitivity reaction?
* Basophils
* Mast cells

A

Type I
immediate

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11
Q

The following Cellular components apply to which Type of Hypersensitivity reaction?
* NK cells
* Eosinophils
* Neutrophils
* Macrophages

A

Type II
cytotoxic

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12
Q

The following Cellular components apply to which Type of Hypersensitivity reaction?
* Neutrophils

A

Type III
immune complex

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13
Q

The following Cellular components apply to which Type of Hypersensitivity reaction?
* T cells
* Macrophages

A

Type IV
delayed types

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14
Q

Grasses are most pronounced during what time of year?

A

Summer

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15
Q

Molds and pets can be a source of allergy symptoms during which time of year?

A

Perennially

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16
Q

Cromolyn is a ___ cell stabilizer, used to treat allergic rhinitis.

A

mast cell stabilizer

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17
Q

Cromolyn must be taken _____ to be effective, and can take several wks before improvement is noted.

A

Cromolyn must be taken prophylactically to be effective, and can take several wks before improvement is noted.

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18
Q

Which is the endpoint of intradermal testing

A

D.
One injects incrfeasing concentrations until a wheal 2mm larger is produced. If the following wheal size is larger by at least 2mm, then the initial positive wheal is considered the endpoint and the subsequent wheal is the confirmatory wheal.

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19
Q

IL-4, IL-5, and IL-13 are involved in ___ inflammation

A

Allergic inflammation

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20
Q

IL-__ is an acute phase protein that promotes B/T cell differentioation

A

IL-6 is an acute phase protein that promotes B/T cell differentioation

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21
Q

IL-__ promotes hematopoeisis and can promote recruitment of eosinophils and basophils.

A

IL-3 promotes hematopoeisis and can promote recruitment of eosinophils and basophils.

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22
Q

IL-__ promotes differentiation of TH17 cells and mediates acute phase reactions.

A

IL-1 promotes differentiation of TH17 cells and mediates acute phase reactions.

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23
Q

IL-__ is produced by TH1 cells

A

IL-2 is produced by TH1 cells

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24
Q

The serum specific ___/___ ratio is a predictor of favorable clinical response to allergen specific immunotherapy.

A

The serum specific IgE/total IgE ratio is a predictor of favorable clinical response to allergen specific immunotherapy.

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25
Q

Most ____ (meds) can inhibit the skin’s wheal-and-flare response and are recommended to be stopped 48-72hrs before testing.

A

Antihistamines

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26
Q

Antihistamines can inhibit the skin’s wheal-and-flare response and are recommended to be stopped ___ - ___hrs before testing.

A

48-72hrs

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27
Q

Oral ___ has not been shown to interfere w/skin prick testing.

A

Oral corticosteroids

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28
Q

activated T helper 1 (th1) cells secrete which chemokines?
1. ___
2. ___
3. ___

A

activated T helper 1 (th1) cells secrete which chemokines?
1. IL-2
2. TFN-beta
3. IFN-gamma

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29
Q

IL-__ is important in immune suppression, and is secreted by monocytes, macrophages, T, B, and dendritic cells

A

IL-10

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30
Q

Aspirin desensitization decreases the _____, asthma symptoms, and need for revision sinus surgery.

A

Aspirin desensitization decreases the # of URIs, asthma symptoms, and need for revision sinus surgery.

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31
Q

Aspirin desensitization decreases the # of URIs, _____, and need for revision sinus surgery.

A

Aspirin desensitization decreases the # of URIs, asthma symptoms, and need for revision sinus surgery.

32
Q

Aspirin desensitization decreases the # of URIs, asthma symptoms, and _____.

A

Aspirin desensitization decreases the # of URIs, asthma symptoms, and need for revision sinus surgery.

33
Q

Aspirin inhibits cyclo-oxygenase (COX1/2) and therefore decreases _____ and _____ production.

A

Aspirin inhibits cyclo-oxygenase and therefore decreases prostaglandin and thromboxane (TXA2) production.

34
Q

Aspirin inhibits COX1/2 and therefore decreases prostaglandin and thromboxane production. The arachidonic acid pathway is then shifted toward ___ production.

A

Aspirin inhibits COX1/2 and therefore decreases prostaglandin and thromboxane production. The arachidonic acid pathway is then shifted toward leukotriene production via action in lipoxygenase.

35
Q

Ig__ is most efficient in complement fixation.

A

IgM

36
Q

A flashpoint response during intradermal dilutional testing is a _____, and testing should be stopped and attempted at a later date.

A

A flashpoint response during intradermal dilutional testing is a vigorous positive wheal, and testing should be stopped and attempted at a later date.

37
Q

A RAST is more ______(sensitive/specific), but less ______(sensitive/specific) than skin testing?

A

A RAST is more specific, but less sensitive than skin testing?

38
Q

An in-vitro test is a ___ test.

A

blood test

39
Q

RAST stands for a ___.

A

Radioallergosorbent Test (RAST)

40
Q

Deficiency of which IgG subclass is most common in children?

A

IgG2

41
Q

Deficiency of which IgG subclass is the most common** hypogammaglobulin deficiency in adults**?

A

IgG3

42
Q

Which IgG subclass composes the majority of total serum IgG, and is rarely deficient?

A

IgG1

43
Q

_ to kill house dust mites reduce both allergen level and symptoms.

A

Acaricides (pesticides)

44
Q

Although the mechanism for AERD (aspirin exacerbated respiratory disease) is not fully understood, the increase in ___ and decrease in PGE2 is a driving force in its pathogenesis.

A

Although the mechanism for AERD (aspirin exacerbated respiratory disease) is not fully understood, the increase in Cys-LT (cysteinyl LT) , which can cause bronchoconstriction, and decrease in PGE2 is a driving force in its pathogenesis.

COX-1 inhibition diverts metabolism of arachidonic acid producing CysLT

45
Q

Selective COX-___ inhibitors (Celecoxib) are well tolerated in patients w/aspirin exacerbated respiratory disease.

A

Selective COX-2 inhibitors (Celecoxib) are well tolerated in patients w/aspirin exacerbated respiratory disease.

have no impact on the production of Cys-LT, which can cause bronchoconst

46
Q

The ___ immune system comrpises:
* skin
* toll-like receptors
* antibmicrobial peptides
* phagocytes
* NK cells
* Complement system

A

The innate immune system comrpises:
* skin
* toll-like receptors
* antibmicrobial peptides
* phagocytes
* NK cells
* Complement system

47
Q

The ___ immune system comrpises:
* B cells
* T cells

A

The adaptive immune system comrpises:
* B cells
* T cells

48
Q

30-50% of pts w/latex allergies will have allergies to ___, ___, and /or ___.

A

avocados, kiwis, and/or chestnuts

49
Q

The dose of epi in adults is ___ mg (1mg/1mL) IM.

A

The dose of epi in adults is** 0.3-0.5 mg** (1mg/1mL) IM.

50
Q

The dose of epi in kids is ___.

A

0.01 mg/kg

51
Q

What food allergy is least likely to resolve with age, in young children with h/o atopic dermatitis, asthma, and cow’s milk intorlerance?

A

Tree nuts

52
Q

Serum tryptase levels with anaphylaxis will remain elevated for up to ___hrs.

A

6hrs

53
Q

The Ig class is determined by the ___ chain.

A

heavy chain

54
Q

The light and hevy chain contribute to the ___ site on the immunoglobulin.

A

Ag binding site (Fab, N-terminus)

55
Q

The ___ chain makes up the constant segment (Fc, C-terminus)

A

Heavy chain

56
Q

Ig __ is a divalent immunoglobulin secreted into secretions.

A

IgA

57
Q

Ig __ is present in trace amounts in the serum, with unknown purpose

A

IgD

58
Q

Ig __ is the only antibody type to cross the placenta.

A

IgG

59
Q

Guess this disease

A

X-linked agammaglobulinemia (Bruton’s)

characterized by low levels of IgA, IgD, IgE, and IgM. Caused by a tyrosine kinase deficiency that prevents maturation of B cells and manifests around 6mos of age

60
Q

Compared to oral antihistamines or intranasal corticosteroids for allergic rhinitis, how effective is montelukast?

A

Less effective

61
Q

Montelukast is a ___ receptor antagonist.

A

Montelukast is a leukotriene receptor antagonist, used frequently to treat asthma.

62
Q

A topical steriod in addition to topical antihistamine has been shown to ___ (improve/worsen) symptoms in a faster and more complete manner compared to either med alone or placebo.

A

A topical steriod in addition to topical antihistamine has been shown to improve symptoms in a faster and more complete manner compared to either med alone or placebo.

63
Q

Intranasal corticosteroids help block the ___ phase allergic reaction, thus reducing inflammation and improving nasal congestion.

A

Intranasal corticosteroids help block the late phase allergic reaction, thus reducing inflammation and improving nasal congestion.

64
Q

Omalizumab (xolair) has demonstrated efficacy in the treatment of allergic___ and allergic ____.

A

Omalizumab (xolair) has demonstrated efficacy in the treatment of allergic rhinitis and allergic asthma.

65
Q

CD20, CD19, and CD22 are markers found on ___ cells.

A

B lymphocytes

66
Q

___Immunotherapy increases IL-10 and ___ levels and suppresses IgE-mediated degranulation, mast cells, and memory B cells.

A

Immunotherapy increases IL-10 and IgG4 levels and suppresses IgE-mediated degranulation, mast cells, and memory B cells.

67
Q

Within a LN, B cells mostly reside in the ___.

A

Cortex

68
Q

Within a LN, T cells mostly reside in the ___.

A

Paracortex

69
Q

The _____ contains B cells, T cells, and Ag presenting cells.

A

The medulla contains B cells, T cells, and Ag presenting cells.

70
Q

SCIT requires a total duration of treatment of ___ time.

A

3-5 years

71
Q

Azelastine is a __ receptor antagonist used to treat allergic, non-allergic and vasomotor rhinitisl.

A

second-generation H1 receptor antagonist

72
Q

___ inhibits production of IL-4.

A

IFN-gamma

73
Q

If SCIT is successful, what cytokine will be up-regulated?

A

IL-10 and IgG4 levels

74
Q

The specific antigen recognition (with memory) region is called an ___.

A

epitope

75
Q

IgG1 +n IgA + IgM deficiency

A

CVID

76
Q

Child w/recurrent sinusitis, otitis media, bronchitis. Deficiency in IgG specifically to polysaccharide capsular antigens

A

IgG2 deficiency (vulnerable to encapsulated bugs (S. pneumo, H. influenca, N. meningitidis)

77
Q

Inability to kill catalase+ organisms

A

Chronic Granulomatis Disease

Fundamentals (3 decks)

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