Board Vitals Allergy and Immunology Flashcards

1
Q

Which antibody is associated with type 1 hypersensitivity?

A

Immunoglobulin E

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2
Q

Which cells is immunoglobulin E produced by?

A

Plasma cells

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3
Q

What is type 1 hypersensitivity?

A

An allergic reaction provoked by re-exposure to an allergen

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4
Q

What is the main immunoglobulin found in secretions?

A

Secretory IgA (immunoglobulin A)

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5
Q

What is the first line treatment for anaphylaxis after medication?

A

IM epinephrine

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6
Q

Which vaccines are necessary before heart transplant?

A
  • Herpes zoster (non-live or live attenuated; though non-live preferred)
  • Pneumococcal vaccine (both PCV13 and PPSV23)
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7
Q

Which transplant patients should get influenza vaccine?

A

Annually, all patients, pre- and post-transplant

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8
Q

Which transplant patients should get Hepatitis B vaccine?

A

All patients who are HBsAg negative

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9
Q

Which transplant patients should get Hepatitis A vaccine?

A

All liver transplant recipients

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10
Q

Which transplant patients should get human papilloma virus (HPV) vaccine?

A

Any patient at risk

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11
Q

Which transplant patients should get meningococcus vaccine?

A
  • Patients with asplenia
  • Patients receiving eculizumab
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12
Q

Which transplant patients should get Haemophilus influenza vaccine?

A
  • Pediatric patients
  • Asplenic patients
  • Stem cell transplant recipients
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13
Q

Which transplant patients should get rotavirus vaccine?

A
  • Pediatric patients (before transplant)
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14
Q

What is the treatment of drug induced lupus?

A

Discontinue drug

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15
Q

Does hereditary angioedema have recurrent episodes with urticaria or pruritus?

(Yes/No)

A

No

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16
Q

Is the complement component 4 (C4) level high or low in hereditary angioedema?

A

Low

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17
Q

Patient has the following symptoms 2 - 3 times a year: nasal drainage, sneezing, postnasal drip, periodic coughing and fatigue; along with mild infraorbital edema, rhinorrhea and edematous nasal mucosa.

Diagnosis?

A

Allergic rhinitis

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18
Q

What does a patient with a nasal polyp typically present with?

A

Unilateral rhinitis

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19
Q

Patients with which selective immunoglobulin deficiency have a high risk of reaction with receiving blood products?

A

IgA deficiency

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20
Q

Is vaccination against pneumonia recommended in adults who smoke?

A

Yes

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21
Q

Is vaccination against pneumonia recommended in adults who have diabetes mellitus?

A

Yes

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22
Q

Which pneumonia vaccine should be given to adults in which it is indicated?

A

PSV20

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23
Q

What is the treatment of rhinitis medicamentosa?

A

Topical steroids

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24
Q

What screening needs to be done for patients who get recurrent sinopulmonary infections over a number of years?

A

Measure IgG, IgA, and IgM levels (screening for immunodeficiency)

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25
Q

What kind of hypersensitivity reaction occurs in contact dermatitis?

A

Type IV hypersensitivity reaction

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26
Q

What is a type IV hypersensitivity reaction?

A

Delayed reaction mediated by cellular response

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27
Q

What is a type I hypersensitivity reaction?

A

Reaction mediated by IgE antibodies

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28
Q

What is a type II hypersensitivity reaction?

A

Cytotoxic reaction mediated by IgG and IgM antibodies

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29
Q

What is a type III hypersensitivity reaction?

A

Reaction mediated by immune complexes

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30
Q

What is a key mediator of eosinophil activation and atopic disease?

A

Interleukin 5

31
Q

When should vaccines be administered before elective splenectomy?

A

At least 10 -12 weeks; minimum of 2 weeks.

32
Q

CD4 is expressed by which cells?

A

Helper T-cells

33
Q

CD8 is expressed by which cells?

A

Cytotoxic T-cells

34
Q

CD20 is expressed by which cells?

A

B-cells

35
Q

What is the gold standard for diagnosing a food allergy?

A

Oral food challenge

36
Q

Systemic mastocytosis is often associated with gain-of-function mutations in genes encoded KIT receptors, as well as increased expression of KIT ligand.

True or false?

A

True

37
Q

Is systemic mastocytosis associated with peptic ulcer disease?

A

Yes

38
Q

Is systemic mastocytosis associated with hepatic fibrosis?

A

Yes

39
Q

Is systemic mastocytosis associated with anaphylactic reaction?

A

Yes

40
Q

Is systemic mastocytosis associated with cytopenias?

A

Yes

41
Q

Is systemic mastocytosis associated with autoimmune hemolytic anemia?

A

No

42
Q

What’s the dose of epinephrine for anaphylaxis if weight is less than 50 kg?

A

0.3 mg IM

43
Q

What’s the dose of epinephrine for anaphylaxis if weight is more than 50 kg?

A

0.5 mg IM

44
Q

Making a diagnosis of eosinophilic esophagitis requires the presence of both symptoms and histologic findings.

True or false?

A

True

45
Q

Is a trial of proton pump inhibitor required for the diagnosis of eosinophilic esophagitis?

A

No

46
Q

What is the minimum number of eosinophils required to diagnose eosinophilic esophagitis?

A

15 eosinophils/hpf

47
Q

Do people with selective IgA deficiency with Ig A level over 7 mg/dL (partial deficiency) get frequent infections?

A

No

48
Q

What kind of malignancy is IgA deficiency associated with?

A

GI malignancy

49
Q

Are patients with IgA deficiency predisposed to inflammatory bowel disease?

A

Yes

50
Q

Do symptoms of eosinophilic esophagitis return if treatment is discontinued?

A

Yes

51
Q

Is there utility of a food allergy evaluation in eosinophilic esophagitis?

A

Yes

52
Q

If biopsy of grafted renal artery shows fibrosis and smooth muscle proliferation - what does this mean?

A

Chronic transplant rejection

53
Q

If biopsy of grafted renal artery shows ischemia of the tunica media - what does this mean?

A

Hyperacute allograft rejection

54
Q

If biopsy of grafted renal artery shows vasculitis involving CD8 T-cells and antibodies - what does this mean?

A

Acute allograft rejection

55
Q

What testing should be done after an anaphylactic reaction to an insect bite etc?

A
  • Venom specific IgE level
  • Tryptase
56
Q

What kind of allergic reaction is aspirin-exacerbated respiratory disease?

A

Pseudo-allergic reaction

57
Q

Is granulomatous or lymphocytic infiltrative disease a common manifestation of common variable immunodeficiency (CVID)?

A

Yes

58
Q

Are infections a common manifestation of common variable immunodeficiency (CVID)?

A

Yes

59
Q

Is autoimmunity a common manifestation of common variable immunodeficiency (CVID)?

A

Yes

60
Q

Are malignancies a common manifestation of common variable immunodeficiency (CVID)?

A

Yes

61
Q

Are congenital abnormalities a common manifestation of common variable immunodeficiency (CVID)?

A

No

62
Q

How long do symptoms of laryngospasm typically last?

A

Less than 60 secs.

63
Q

If it has been more than 10 years since last known reaction then what are the chances that IgE mediated penicillin allergy has resolved?

A

80%

64
Q

What season does ragweed cause allergies in?

A

Fall/autumn

65
Q

What season do trees cause allergies in?

A

Spring

66
Q

What is the chemical mediator in allergic rhinitis?

A

Histamine

67
Q

Is bronchiolitis obliterans a common manifestation of common variable immunodeficiency (CVID)?

A

No

68
Q

Is bronchiectasis a common manifestation of common variable immunodeficiency (CVID)?

A

Yes

69
Q

In a patient who presents with blistering in sun exposed areas (with small white papules) after using a new medication (e.g. naproxen, dapsone, furosemide, tetracycline, etc) what diagnosis should be considered?

A

Drug induced porphyria cutanea tarda

70
Q

What dose of aspirin do patients need to continue to take to remain desensitized?

A

325 mg daily

71
Q

What is the most fungal infection in patients who are treated with TNF-alpha inhibitors?

A

Histoplasmosis

72
Q

Which immunity does TNF-alpha inhibition interfere with?

A

Cellular immunity

73
Q

What is the empiric treatment for acute bacterial rhinosinusitis?

A

Amoxicillin/clavulanate