Anaphylaxis

Question 1

potentially life-threatening systemic allergic reaction involving one or more organ systems that typically occurs within seconds to minutes of exposure to the anaphylactic trigger, most often a drug, food, or hymenoptera sting.

Answer 1

Anaphylaxis

Question 2

While 80–90% of anaphylactic episodes are uniphasic, about 10–20% of cases are biphasic in which anaphylactic symptoms return about an hour or longer after resolution of initial symptoms

Answer 2

T

Question 3

microscopic findings in the bronchi, however, are

Answer 3

limited to luminal secretions, peribronchial congestion, submucosal edema, and eosinophilic infiltration, and the acute emphysema is attributed to intractable bronchospasm that subsides with death.

Question 4

Findings due to death

Answer 4

the acute emphysema is attributed to intractable bronchospasm that subsides with death.

Angioedema

Question 5

microscopic examination, there is wide separation of the collagen fibers and the glandular elements; vascular congestion and eosinophilic infiltration

Answer 5

T

Question 6

Gastrointestinal manifestations represent another severe presentation of anaphylaxis, and include nausea, vomiting, crampy abdominal pain, and/or fecal incontinence. Angioedema of the bowel wall may also cause sufficient intravascular volume depletion to precipitate cardiovascular collapse.

Answer 6

T

Question 7

Cutaneous manifestations are among the most common presentations of anaphylaxis

Answer 7

(>90% of cases).

Question 8

Atopy is not generally thought to be a risk factor for anaphylaxis from drug reactions or hymenoptera stings,

Answer 8

T

Question 9

signal transduction events leading to hypersensitivity syndromes including anaphylaxis.

Answer 9

T

Question 10

IgE-mediated drug allergies are most common with——- and certain chemotherapy drugs,

Answer 10

antibiotics

Question 11

case of allergy to carboplatin, the incidence of hypersensitivity is 27% in patients who have had ≥7 lifetime infusions and as high as 46% in patients who have had ≥15 lifetime infusions.

Answer 11

27%, 7

46% 15 infusions

Question 12

derived from a mouse cell line expressing a transferase that tags the Fab’ portion of the ———heavy chain with alpha-gal.

Answer 12

Cetuximab

Question 13

patients with a history of multiple bites from Amblyomma americanum ticks commonly found in the Carolinas, Arkansas, and Tennessee are more likely to have anti-alpha-gal IgE

Answer 13

Amblyomma americanum has

Question 14

In a process known as ————

Answer 14

Mast cells and basophils c tain preformed granules comprised of histamine, proteases (tryptase, chymase), proteoglycans (heparin, chondroitin sulfate), and TNF-α, which are rapidly released into surrounding tissue upon cell activation, a process known as degranulation.

Question 15

Cysteinyl leukotrienes and prostaglandin D 2 cause bronchoconstriction and increased microvascular permeability.

Answer 15

T

Question 16

——— levels correlate with anaphylaxis severity and are inversely proportional to the constitutive level of PAF acetylhydrolase, which is necessary for PAF inactivation

Answer 16

SERUM PAF

Question 17

This dorectly activates the complement c cade, resulting in complement-dependent induced histamine release from mast cells and basophils.

Answer 17

Cremophor oil of paclitaxel

Question 18

exception is delayed anaphylaxis to meats in alpha-gal sensitized patients

Answer 18

MEAT

Question 19

The most obvious serum biomarker to assay, histamine, has an extremely short half-life with a measurable time-window that expires <1 h from the onset of anaphylaxis

Answer 19

Histamine

Question 20

peaks 60–90 min after the onset of anaphylaxis and can be m sured as long as 5 h after the onset of anaphylaxis

Answer 20

Serum tryptase

Question 21

treatment of first choice is intramuscular a tration of 0.3–0.5 mL of 1:1000 (1 mg/mL) epinephrine, with repeated doses at 5–20 min intervals as needed for a severe reaction.

Answer 21

IM EPI

Question 22

The failure to use epinephrine within the first 20 min of symptoms is a risk factor for poor clinical outcomes in various studies of anaphylaxis.

Answer 22

20min

Question 23

Another important variable that may affect anaphylaxis survival is body posture, as an upright or sitting posture may lead to the “empty heart syndrome” in which there is insufficient venous return to the heart from sudden onset hypotension secondary to intravascular volume depletion.

Answer 23

T

Question 24

For this reason, it is recommended that patients who suffer from anaphylaxis be placed in the supine position before receiving epinephrine.

Answer 24

T

Question 25

In the case of hymenoptera allergy, patients receive VIT extracts containing actual hymenoptera venom with a maintenance dose equivalent to 2–5 stings.

Answer 25

VIR of 2-5 atongs in 3-5 years

Question 26

tendency to manifest asthma, rhinitis, u caria, and atopic dermatitis alone or in combination, in association with the presence of allergen-specific IgE

Answer 26

Atopy

Question 27

key effector cells in allergic rhinitis and asthma, and the dominant effector in urticaria, anaphylaxis, and systemic mastocytosis, its developmental biology, activation pathway, product profile, and target tissues will be considered in the introduction to these clinical disorders

Answer 27

Key effector cells

Question 28

binding of IgE to human mast cells and basophils, a process termed

Answer 28

sensitization,