Allergy, corticosteroids and antihistamines

Question 1

Both the innate and adaptive immune system play a role in allergy. True or false?

Answer 1

True

Question 2

What is atopy a result of?

Answer 2

Overproduction of TH2 cytokines in response to allergens

Question 3

The innate system is responsible for catalysing the sensitisation process which leads to allergic reactions. True or false?

Answer 3

True

Question 4

What are the 3 diagnostic tests for allergy?

Answer 4

Skin prick test - in vivo
Blood test - in vitro
Mast cell tryptase

Question 5

Patients with atopic dermatitis have reduced skin barrier function. True or false?

Answer 5

True

Question 6

What is the typical treatment for atopic dermatitis?

Answer 6

Topical corticosteroids

Question 7

Why should high-potency corticosteroids only be used over short period of time, in treating atopic dermatitis?

Answer 7

Due to adverse effects

Question 8

What is allergic rhinitis?

Answer 8

IgE inflammation of the nasal mucosa in response to outdoor and indoor allergens

Question 9

Allergic rhinitis is a risk factor for asthma. True or false?

Answer 9

True

Question 10

Birth by C section can increase the risk factor for allergic rhinitis. True or false?

Answer 10

True

Question 11

Symptoms of food allergy are mediated by IgE and non-IgE reactions. True or false?

Answer 11

True

Question 12

Angioedema can be caused by food allergy. True or false?

Answer 12

True

Question 13

IgE mediated reactions occur within minutes to hours of ingestion of food that patient is allergic to, whereas non-IgE mediated reaction take hours to days later. True or false?

Answer 13

True

Question 14

The health of the GIT has no influence on food allergy. True or false?

Answer 14

False - as it acts as a semipermeable barrier allowing only usable molecules into bloodstream after breakdown of food

Question 15

Steroids and and allergy shots can be used for treatment of allergies, but what is the first line treatment?

Answer 15

Antihistamines

Question 16

All four of histamine receptors subtypes are ligand gated ion channels. True or false?

Answer 16

False - GPC receptors

Question 17

Only H1 and H4 are of clinical interest. True or false?

Answer 17

False - H1 and H2

Question 18

What are the histamine physiological effects that are mediated by H1 receptors?

Answer 18

Contraction of bronchial smooth muscle
Contraction of intestinal smooth muscle
Stimulation of sensory nerve endings 
Enhancement of Ca2+ influx into cardiac myocytes leading to minor increases in inotropism and chronotropism 
Increased production of nasal mucus

Question 19

What effect does activation of H2 receptors have?

Answer 19

Potentiation of gastrin induced acid secretion

Question 20

H1 receptor antagonists block the action of histamine. They are also potent at H2 receptors. True or false?

Answer 20

False - no potency at H2 so don’t affect gastric acid secretion

Question 21

H2 blockers block histamine2 which is a producer of acid. True or false?

Answer 21

True

Question 22

What are the benefits of antihistamines?

Answer 22

Decreased histamine release
Decreased inflammation
Decreased antigen presentation

Question 23

What are the negative effects of antihistamines?

Answer 23

Decrease neurotransmission in CNS
Dry mouth
Hypotension, dizziness, reflex tachycardia
Increased sedation

Question 24

What are glucocorticoids?

Answer 24

Steroids synthesised in the adrenal cortex

Question 25

Glucorticoids inhibit cell-mediated immunity. True or false?

Answer 25

True

Question 26

What are the cytokines that are inhibited by glucorticoids?

Answer 26

IL1-6 and IL8

Question 27

What are the side effects of glucorticoids?

Answer 27

hyperglycaemia poor wound healing use in children can lead to growth retardation

Question 28

Inhibition of which cytokine by glucorticoids has the most crucial effect in immunosuppression?

Answer 28

IL2 - inhibits proliferation of Tcells and activation of cytotoxic T cells