Immuno/Allergy

Question 1

Most common typical manifestation of immunodeficiency in children

Answer 1

Recurrent sinopulmonary infections

Question 2

most common type of immunodeficiency

Answer 2

Antibody defects

Question 3

This condition is suspected if a patient has recurrent staphylococcal abscesses or fungal infections

Answer 3

Chronic granulomatous disease

Question 4

this condition should be suspected if lymphoid hypoplasia is found in physical examination

Answer 4

X-linked agamaglobulinemia

Question 5

3 clinical presentation of SCID

Answer 5

• infection
• GVHD
• Omenn syndrome

Question 6

key feature of SCID

Answer 6

almost all patients will have a low lymphocyte count

Question 7

most common hematologic abnormality of allergic patients

Answer 7

eosinophilia
— >500 eosinophils/uL

Question 8

INTERMITTENT Allergic rhinitis

Answer 8

<4 days per week or
<4 weeks at a time

Question 9

PERSISTENT Allergic rhinitis

Answer 9

> 4 times a week and/or
4 weeks at time

Question 10

most common chronic relapsing skin disease in infancy and childhood

Answer 10

Atopic Dermatitis (AD)

Question 11

hallmark of AD

Answer 11

Severly dry skin

Question 12

cardinal features of AD

Answer 12

Intense pruritus (especially at night) and cutaneous reactivity

Question 13

3 major features of AD

Answer 13

• Pruritus
• eczematous dermatitis
• chronic/chronically relapsing course

Question 14

Major features of Atopic Dermatitis

Answer 14

• pruritus
• facial and extensor eczema in infants and children/ flexural eczema in adolescents
• chronic or relapsing dermatitis
• personal or family history of atopic disease

Question 15

first line therapy in Atopic dermatitis

Answer 15

Moisturizers

Question 16

cornerstone of antiinflammatory treatment for acute exacerbations of AD

Answer 16

Topical corticosteroids

Question 17

serious allergic reaction that is rapid in onset and may cause death

Answer 17

Anaphylaxis

Question 18

most common cause of anaphylaxis occuring outside the hospital

Answer 18

Food allergy

Question 19

this test remains elevated for several hours during anaphylaxis

Answer 19

Plasma tryptase

Question 20

how to diagnose anaphylaxis

Answer 20

highly likely when 1 of the ff 3 criteria is fulfilled
1. Acute onset of an illness with skin and/or mucosal tissue involvement and at least 1 of the ff:
a. respiratory compromise
b. reduced BP or associated symptoms of end-organ dysfunction (hypotonia, syncope, incontinence)

2. 2 or more of the ff that occur rapidly after exposure
   a. involvement of the skin/mucosal tissue
   b. respiratory compromise
   c. reduced BP or assoc symptoms
   d. persistent GI symptoms
3. Reduced BP ff exposure to known allergen
   a. Infants and children: low systolic BP or >30% drop in systolic BP

Question 21

most common cause of Food protein-induced enteropathy (FPE)

Answer 21

Cow’s milk sensitivity

Question 22

most severe form of Food protein-induced enteropathy

Answer 22

Celiac disease

Question 23

First line therapy for anaphylaxis

Answer 23

0.01 mg/kg epinephrine (1:1000) given IM every 5 to 15 minutes

Question 24

Biphasic reaction of anaphylaxis can occur and be delayed up to how many hours

Answer 24

72

Question 25

medications that can interfere serum testing for allergy

Answer 25

H1 blockers such as tricyclic antidepressants, first generation H1 blockers such as diphenhydramine, hydroxyzine, cryproheptadine second generation H1 blockers such as cetirizine, loratadine, fexofenadine H2 blockers such as ranitidine Muscle relaxants Intranasal antihistamines

Question 26

gold standard test for IgE mediated food allergy diagnosis

Answer 26

Food challenge

Question 27

what are the different types of hypersensitivity disorders?

Answer 27

Type I - Immediate Type II - Antibody mediated Type III - Immuno complex mediated Type IV - Delayed

Question 28

most common cause of acute urticaria in children

Answer 28

Infectious diseases - specifically viruses

Question 29

most common type of hereditary angioedema

Answer 29

Type I

Question 30

most common symptom of hereditary angioedema

Answer 30

cutaneous nonpitting and nonpruritic edema with no urticaria

Question 31

most feared complication of hereditary angioedema

Answer 31

Laryngeal edema

Question 32

Patient present with recurrent staphylococcal abscesses, staphylococcal pneumonia with pneumatocele formation and has a course facial features and pruritic dermatitis

Answer 32

HyperIgE syndrome

Question 33

What condition in children that presents with persistent thrush, failure to thrive, pneumonia and diarrhea

Answer 33

Severe combined immunodeficiency

Question 34

Patient presents with oculocutaneous albinism, nystagmus, recurrent bacterial infection and peripheral neuropathies

Answer 34

Chediak-Higashi syndrome

Question 35

cardinal features of atopic dermatitis (AD)

Answer 35

intense pruritus especially atnight and cutaneous reactivity

Question 36

Give the triggers for pruritus in Atopic Dermatitis

Answer 36

Foods — cow’s milk, egg, peanuts, tree nuts, soy, wheat, fish, shellfish Aeroallergens Infection Reduced humidity Excessive sweating Irritants — wool, acrylic, soap, toiletries, fragrances and detergents

Question 37

Pathophysiology in hereditary angioedema

Answer 37

low functional level of plasma C1 inhibitor (C1-INH)

Question 38

Which among the food protein induced GI syndromes will most likely cause shock (seen in 15%) and does not cause failure to thrive

Answer 38

FPIES will cause shock FPI Allergic Proctolitis (FPIAP) will not cause FTT