Hema-Immuno [Case 1] Urticaria, Angioedema, Hypersensitivities Flashcards
Which of the following is least likely to cause angioedema?
A. Captopril
B. Ondansetron
C. Naproxen
D. Verapamil
E. Bee sting
B. Ondansetron
Which of the following is true regarding angioedema?
A. ACE inhibitor-induced angioedema is caused by impaired degradation of bradykinin.
B. ACE inhibitor–induced angioedema usually develops within the first two days of starting the medication.
C. Urticaria and pruritus are common in bradykinin-mediated angioedema.
D. Severe angioedema exclusively affects the skin and subcutaneous tissues.
A. ACE inhibitor-induced angioedema is caused by impaired degradation of bradykinin.
Hereditary angioedema result from a deficiency of which of the following?
A. C5 convertase
B. Membrane attack complex
C. C3 convertase
D. C1 esterase inhibitor
E. C4 esterase inhibitor
D. C1 esterase inhibitor
Which of the following antihypertensive medications is most likely to cause angioedema in susceptible patients?
A. Phosphodiesterase inhibitors
B. Beta blockers
C. ACE inhibitors
D. Calcium channel blockers
E. Alpha-adrenergic blockers
C. ACE inhibitors
Which of the following antihypertensive medications is most likely to cause angioedema in susceptible patients?
A. Phosphodiesterase inhibitors
B. Beta blockers
C. ACE inhibitors
D. Calcium channel blockers
E. Alpha-adrenergic blockers
C. ACE inhibitors
What condition presents with recurrent episodes of self-limited but potentially life-threatening swelling of the upper respiratory tract, seen in older patients in association with an underlying disease?
A. Acquired angioedema
B. Hereditary angioedema
C. Allergic contact dermatitis
D. Chronic asthma
E. Chronic allergic rhinitis
A. Acquired angioedema
A 50-year-old man presents to the office with recent onset of dry cough and swelling of his lips. He takes amlodipine and recently started lisinopril for his hypertension. What is the most appropriate next step in management?
A. Continue current regimen and add antihistamines
B. Add oral steroids
C. Discontinue amlodipine
D. Discontinue lisinopril
E. Administer IV fresh frozen plasma
D. Discontinue lisinopril
Which of the following statements is true regarding urticaria?
A. Beta-lactam antibiotics can trigger urticaria by inhibiting arachidonic acid metabolism.
B. Opioids can cause urticaria through direct activation of mast cells.
C. Vancomycin induces mast cell degranulation through IgE-mediated mechanisms.
D. Immune-mediated urticaria is caused by nonspecific activation of T cells.
B. Opioids can cause urticaria through direct activation of mast cells.
In type I hypersensitivity reactions, IgE binds to which cells causing their degranulation upon re-exposure?
A. RBCs
B. Macrophages
C. Basophils
D. Neutrophils
E. Mast cells
E. Mast cells
Which antibiotic is the most common cause of anaphylactic allergic reactions?
A. Sulfonamide
B. Penicillin
C. Tetracycline
D. Fluoroquinolone
B. Penicillin
Which of the following is associated with urticaria?
A. Destruction of the dermoepidermal junction
B. Positive Nikolsky sign
C. Umbilicated papules
D. Lesions with central pallor
E. Type III hypersensitivity reaction
D. Lesions with central pallor
Which hypersensitivity reaction is associated with sarcoidosis?
A. Type I
B. Type II
C. Type III
D. Type IV
D. Type IV
What is an example of a type II hypersensitivity reaction?
A. Autoimmune hemolytic anemia
B. Tuberculin sensitivity
C. SLE
D. Eczema
E. Asthma
A. Autoimmune hemolytic anemia
The pathogenesis of a type III hypersensitivity reaction involves which of the following?
A. antibody-dependent cellular cytotoxicity
B. autophagy
C. cell-mediated cytotoxicity
D. the deposition of immune complexes in tissues and small blood vessels
E. the release of vasoactive amines and cytokines from mast cells
D. the deposition of immune complexes in tissues and small blood vessels
Histologic characteristics of a type IV hypersensitivity reaction include which of the following?
A. Eosinophils
B. Chemotactic factors
C. Cytokines
D. Leukotrienes and prostaglandins
E. Proteases
D. Leukotrienes and prostaglandins
Histologic characteristics of a type IV hypersensitivity reaction include cellular infiltrate composed of which of the following?
A. T cells and macrophages
B. NK cells
C. B cells
D. Eosinophils
E. Neutrophils
A. T cells and macrophages
Which type of hypersensitivity reaction can be caused by quinidine?
A. Type I
B. Type II
C. Type III
D. Type IV
B. Type II
In a type III hypersensitivity reaction, where are immune complexes typically deposited?
A. Mesothelium
B. Epithelium
C. Endothelium
D. Lamina propria
E. Basement membrane
E. Basement membrane
Which of the following is the main pathology in type III hypersensitivity reaction?
A. Accumulation of immune complexes
B. Binding of antibodies to cell membrane antigens
C. Pre-sensitized T cells
D. Mast cell sensitization
E. Antibody stimulation of specific cell targets
A. Accumulation of immune complexes
Which of the following diseases is an example of a type IV hypersensitivity reaction?
A. Graves disease
B. Contact dermatitis
C. Myasthenia gravis
D. Peanut allergy
E. Rhinitis
B. Contact dermatitis
Which of the following has the greatest published experience for efficacy for chronic urticaria?
A. Cetirizine
B. Montelukast
C. Hydroxyzine
D. Omalizumab
E. Cyclosporine
E. Cyclosporine
A 28-year old female has been diagnosed with an acute urticaria which affects different parts of her body. Which of the following would you prescribe her?
A. Fexofenadine
B. Hydroxyzine
C. Terfenadine
D. Azelastine
E. Doxepin
C. Terfenadine
All of the following are TRUE about drug allergic reaction/syndrome pairs EXCEPT:
A. Immune complex : Serum sickness
B. DRESS: fever, eosinophilia, hepatic dysfunction, lymphadenopathy
C. Blistering disorders : SJS, TEN
D. Delayed-type : Exanthems
E. None of the options
E. None of the options
Cefaclor and cefprozil most commonly cause which of the following?
A. Type II hypersensitivity
B. Immunologic nephropathy
C. Serum sickness-like reactions
D. Drug-induced granulomatous disease
E. DRESS
C. Serum sickness-like reactions
All of the following are TRUE about isolated angioedema EXCEPT:
A. Type 1 : most common; dysfunctional C1-inhibitor molecule
B. Autosomal dominant inheritance
C. Due to generation of bradykinin in the setting of C1 inhibitor (C1INH) deficiency
D. Mutations in the gene encoding for C1-inhibitor may lead to hereditary angioedema
E. None of the options
A. Type 1 : most common; dysfunctional C1-inhibitor molecule
Which of the following presents w/ wheals of conventional size and by not occurring w/ passive heating?
A. Cholinergic urticaria
B. Exercise-induced urticaria
C. Solar urticaria
D. Cold urticaria
E. Vibratory urticaria and angioedema
B. Exercise-induced urticaria
Which of the following is the most common form of physical urticaria?
A. Dermatographism
B. Cholinergic urticaria
C. Aquagenic urticaria
D. Solar urticaria
E. Pressure urticaria
A. Dermatographism
All of the following are TRUE about angioedema EXCEPT:
A. Most common sites include perioral region
B. Presents with more pain and pruritus
C. Lasts for hours to days
D. Usually leaves no residual scarring
E. None of the options
B. Presents with more pain and pruritus
All of the following are risk factors for ACE inhibitor induced angioedema EXCEPT:
A. Black race
B. Organ transplant
C. Women
D. Alcohol drinking
E. Increasing age
F. None of the options
D. Alcohol drinking
Which of the following is an IgM monoclonal gammopathy which presents with nonpruritic urticaria, bone pain, and intermittent fever?
A. Gleich syndrome
B. Melkerrson-Rosenthal syndrome
C. Cheilitis granulomatosa
D. Schnitzler syndrome
D. Schnitzler syndrome
