Allergy Immunology

Question 1

Primary defense against exogenous antigens

Answer 1

CD4+ T cells

Question 2

Cytotoxic cells against viruses and neoplastic cells

Answer 2

CD8+ T cells

Question 3

A child received penicillin 10 days ago for the first time, presents with fever, nausea, vomiting, pruritic skin rash, urticaria, angioedema, joint pain, lymphadenopathy, myalgia, and proteinuria

Answer 3

Serum sickness

Question 4

A common trigger of allergic reactions in a patient with spina bifida or congenital urogenital problems

Answer 4

Latex

Question 5

Antibody that has a major role in allergic conditions, e.g., anaphylaxis, atopy, asthma, allergic rhinitis, food allergies

Answer 5

IgE

Question 6

Antibody that mediates Type I hypersensitivity reaction

Answer 6

IgE

Question 7

First antibody produced in an infection

Answer 7

IgM

Question 8

Antibody found in body mucosal secretions

Answer 8

IgA

Question 9

Sudden onset of lip swelling, abdominal pain, swelling of both feet, non pruritic erythematous skin rash, one family member have the same condition

Answer 9

Hereditary angioedema

Question 10

What is the cause of hereditary angioedema?

Answer 10

Low levels of plasma protein C1 inhibitor (C1-INH). (Autosomal dominant)

Question 11

Initial screening test for patient with suspected hereditary angioedema

Answer 11

C4 levels

Question 12

The test that can differentiate between various types of hereditary angioedema

Answer 12

C1-INH functional assay

Question 13

Patient with recurrent meningococcal meningitis

Answer 13

Terminal complement C5-C9 deficiency

Question 14

Initial screening test for a patient with suspected complement deficiency, e.g., recur- rent ( Neisseria meningitidis) meningitis

Answer 14

(CH50) test

Question 15

Complement deficiency that increases the risk of SLE

Answer 15

C2 deficiency

Question 16

A 4-year-old boy with recurrent skin abscesses, spleen and liver abscesses, and
osteomyelitis

Answer 16

Chronic granulomatous disease

X-linked

Question 17

Test of choice in a patient with suspected chronic granulomatous disease?

Answer 17

DHR oxidation is preferred, NBT

reduction can be used

Question 18

An 8-year old boy presents with eczema, recurrent Staphylococcus aureus skin infections
without inflammatory response “cold abscess,” pneumatoceles, coarse facial
feature, eosinophilia, IgE level is 80,000 IU

Answer 18

Job syndrome (hyper-IgE
syndrome)

Question 19

Highly elevated white blood count in a 10-weeks-old infant who still has an umbilical
cord

Answer 19

Leukocyte adhesion defect type I

Question 20

Test of choice in a patient with suspected leukocyte adhesion defect

Answer 20

Flow cytometry beta 2 integrin

CD11b/CD18 on leukocytes

Question 21

Newborn with hypocalcemia, tetralogy of Fallot, interrupted aortic arch, and abnormal
facial features

Answer 21

DiGeorge anomaly
(Deletion of chromosome
22q11.2)

Question 22

An 8-week-old boy presents with diarrhea, pneumonia, persistent oral thrush,
eczematous-like skin lesions, sepsis, lymphopenia, and failure to thrive

Answer 22

Severe combined

immunodeficiency

Question 23

Recurrent ear infections, eczema, profuse bleeding during circumcision procedure,
thrombocytopenia, and small platelets

Answer 23

Wiskott–Aldrich syndrome

Question 24

A 5-month-old presents with Pneumocystis jiroveci pneumonia, mouth ulcers, severe
neutropenia, recurrent sinusitis, and otitis media, chronic diarrhea, failure to thrive,
negative HIV

Answer 24

X-linked hyper IgM syndrome

Question 25

Severe progressive infectious mononucleosis and Epstein–Barr virus (EBV) fulminant
hepatitis

Answer 25

X-linked lymphoproliferative

syndrome (Duncan syndrome)

Question 26

A 9-month-old boy, previously healthy, presents with recurrent otitis media, two
episodes of pneumonia in the last 2 months, persistent giardiasis. On examination,
the lymph nodes, the tonsils are absent

Answer 26

X-linked agammaglobulinemia
(Usually starts after first 6 months
of life)

Question 27

Persistent thrush, nail dystrophy, endocrinopathies

Answer 27

Chronic mucocutaneous

candidiasis

Question 28

Short stature, fine hair, severe Varicella infection

Answer 28

Cartilage hair hypoplasia with

short limbed dwarfism

Question 29

Oculocutaneous albinism, recurrent infection

Answer 29

Chédiak–Higashi syndrome

Question 30

Adolescent presents with recurrent sinus and pulmonary infections due to encapsulated
bacteria, malabsorption, hepatosplenomegaly, and low level of immunoglobulins
(IgG, IgM, and IgA)

Answer 30

Common variable

immunodeficiency

Question 31

Candidiasis with raw egg ingestion

Answer 31

Biotin-dependent carboxylases

deficiency

Question 32

The best treatment for a child with asymptomatic transient hypogammaglobulinemia
of infancy

Answer 32

Observation (no treatment is

necessary)

Question 33

Induration reaction to TB testing after 72 h is an example of

Answer 33

Type IV: cell-mediated

hypersensitivity

Question 34

A 4-year-old with short stature, micrognathia, telangiectasia, immunodeficiency,
learning disability, deficiency of DNA ligase I

Answer 34

Bloom syndrome

Question 35

An 8-year-old boy presents with recurrent ear and sinus infections, ataxia, oculocutaneous
telangiectasia, elevated α1-fetoprotein

Answer 35

Ataxia-telangiectasia

autosomal recessive