Clinical Science VII - X

Question 1

solar urticaria type VI is associated with what condition?

Answer 1

Erythropoietic photoporphyria

Question 2

hypocomplementemic urticarial vasculitis is associated with what cell type on skin biopsy?

Answer 2

Neutrophils

Question 3

normocomplementemic urticarial vasculitis is associated with what cell type of skin biopsy?

Answer 3

Eosinophils

Question 4

which autoantibody is always associated with hypocomplementemic occur urticarial vasculitis?

Answer 4

Anti C1q

Question 5

where does C1 inhibitor act?

Answer 5

inhibits the classical pathway, MBL pathway, FXIa, FXIIa and kallikrein

Question 6

which gene codes for C1 inhibitor?

Answer 6

SERPING1

Question 7

what lab value distinguishes acquired angioedema from hereditary angioedema?

Answer 7

Low C1q

Question 8

Inflammation in hypersensitivity pneumonitis occurs through what mechanism?

Answer 8

immune complex deposition; activated T cells

Question 9

What cytokine is elevated in hypersensitivity pneumonitis?

Answer 9

IL17

Question 10

What is characteristic in the BAL in hypersensitivity pneumonitis?

Answer 10

lymphocytosis with decreased CD4/CD8

Question 11

What is characteristic in the BAL in sarcoidosis?

Answer 11

lymphocytosis with increased CD4/CD8

Question 12

What is the major allergen in fire ant venom?

Answer 12

piperdines

Question 13

Which stinging insect has the highest risk and the least effective VIT?

Answer 13

honeybee

Question 14

which cytokines increase during immunotherapy?

Answer 14

IFN-gamma, IL-12

Question 15

Which cell types increase during immunotherapy?

Answer 15

Tregs

Question 16

Which cell types decrease during immunotherapy?

Answer 16

eosinophils, Th2

Question 17

List the colors of IT vials from most concentrated to least.

Answer 17

Red, yellow, blue, green, silver

Question 18

which cytokines are associated with hypotension in anaphylaxis?

Answer 18

IL-6, tryptase, histamine

Question 19

What is the mutation associated with idiopathic anaphylaxis?

Answer 19

D816 - c-kit

Question 20

Gal-alpha-gal allergy cross reacts with which medication?

Answer 20

cetuximab

Question 21

What are the dominant muscarinic receptor subtypes in the lung?

Answer 21

M1, M2, M3

Question 22

Which muscarinic receptor is responsible for smooth muscle bronchoconstriction?

Answer 22

M3

Question 23

What does the M2 muscarinic receptor do?

Answer 23

inhibits acetylchoine release

Question 24

How can ipratropium cause worsening of asthma symptoms?

Answer 24

binds to M2 receptor, increasing Ach release leading to bronchoconstriction

Question 25

what cardiac effects can be associated with first generation antihistamines?

Answer 25

torsade de points; prolonged QT

Question 26

Chromolyn inhibits which phase of the allergic response?

Answer 26

early and late

Question 27

What rash is characterized by monomorphic, punched out erosions/ulcerations?

Answer 27

eczema herpticum

Question 28

Staph superantigen has been shown to induce which cytokine in eczema?

Answer 28

IL31

Question 29

What is the diagnosis in a person with rhinitis, eosinophils on nasal smear, and negative SPT?

Answer 29

NARES - non-allergic rhinitis with eosinophils

Question 30

Gustatory rhinitis is due to what?

Answer 30

stimulation of sensory C-fibers

Question 31

What are the indications for tympanostomy tubes?

Answer 31

otitis with structural damage; persistent otitis x >4 months; hearing loss

Question 32

give examples of direct and indirect bronchprovocation tests

Answer 32

Direct: histamine; methacholine Indirect: manatol, exercise

Question 33

What is the best biomarker for detecting eosinophilic airway inflammation?

Answer 33

periostin followed by FeNO

Question 34

which is better at predicting a future asthma exacerbation, asthma severity or control?

Answer 34

control

Question 35

Which drugs increase theophylline levels?

Answer 35

alcohol, cimetidine, copro, clarithromycin, erythromycin, oral contraceptives, verapamil, zileuton

Question 36

Which drugs decrease theophylline levels?

Answer 36

aminoglutethamide, carbamazepine, isoproterenol, pnenobarbitol, phenytoin, rifampin

Question 37

Which ICS is pregnancy category B?

Answer 37

budesonide

Question 38

Which leukotriene modifier is category C?

Answer 38

zileuton

Question 39

What serum marker is not increased in food allergy related anaphylaxis, which is different from other forms of anaphylaxis?

Answer 39

tryptase

Question 40

What are the risk factors for fatal food anaphylaxis?

Answer 40

asthma, symptom denial, adolescent, increased platelet activating factor

Question 41

Which vaccines are contraindicated in a pt with hx of severe reactions to egg?

Answer 41

Yellow fever; rabies is use caution

Question 42

When does airflow obstruction begin in the early allergic asthmatic response?

Answer 42

5-10 minutes

Question 43

When does airflow obstruction peak in the early allergic asthmatic response?

Answer 43

20-30 minutes

Question 44

Which medication inhibits the early phase asthmatic response?

Answer 44

cromolyn - not ICS

Question 45

Which medications inhibit the late allergic asthmatic response?

Answer 45

Beta agonist, single dose ICS prior to or immediately after allergen exposure, cromolyn