Scott Exam Q's: Exam 1

Question 1

Most common type of physical urticaria

Answer 1

Dermographism

Question 2

Type of acquired urticaria that should be screened with cryoglobulins, cryofibrinogens, cold agglutinins, HIV and EBV testing.

Answer 2

Cold urticaria

Question 3

Hives appear after a shower at room temperature.

Answer 3

Aquagenic

Question 4

Observed in patients with ferrochelatase deficiency.

Answer 4

Solar urticaria - type 6

*Type I solar urticaria is caused by UVB

Type II is induced by UVA (ultraviolet A)

The wavelength range of type III and IV spans from 400 to 500 nm, while

type V can be caused by UVB radiation to visible light (280–600 nm).

Type VI has only been known to occur at 400 nm.

Question 5

Pruritic 1-2 mm wheals with surrounding erythema developing after exercising only when outside in winter.

Answer 5

cold induced cholinergic urticaria

Question 6

Deep, painful and pruritic swellings on the buttocks developing 4 hours after sitting in a hard chair.

Answer 6

Delayed pressure urticaria

Question 7

Urticaria developing within minutes over the back after application of a warm water bottle despite the patient not sweating over the area.

Answer 7

Heat contact urticaria

Question 8

Completely blanched small 1-2 mm papules surrounded by pink wheals induced by stress.

Answer 8

Adrenergi

Question 9

Hives elicited by the intracutaneous injection of methacholine chloride.

Answer 9

cholinergic

Question 10

Pruritic 1-2 mm wheals with surrounding erythema developing after exercise, consumption of spicy foods, or emotional stress that results in sweating.

Answer 10

cholinergic

Question 11

Patient who develops anaphylaxis when jogging only when he has rye bread within hours prior to jogging.

Answer 11

• Food and exercise induced anaphylaxis

Question 12

Marked augmentation of a linear wheal with stroking of the skin in a cold environment only.

Answer 12

• Cold-dependent dermographism

Question 13

Hives occurring on the back when toweling off after a lukewarm shower in a person who does not hive with exercise or stroking of the skin.

Answer 13

• Vibratory urticarial/angioedema or red dermographism

Question 14

Patient with a negative ice cube test developing hives, hypotension and syncope after jumping into a pool.

Answer 14

• Reflex cold urticaria

Question 15

Hives elicited by the intracutaneous injection of norepinephrine.

Answer 15

adrenergic

Question 16

Identify the three components of the Triple Response of Lewis and what causes each component:

Answer 16

Red line- capillary vasodilation from histamine

Flare- axonreflex causing arteriolar dilation

Wheal- Exudation of fluid from capillaries and venules

Question 17

What are the top 3 causes of acute urticaria?

Answer 17

Food
Medication
Viral illnesses

Question 18

What percentage of patients with chronic urticaria are free of lesions at 1 year?

Answer 18

50%

Question 19

What is the time frame for distinction between acute and chronic urticaria?

Answer 19

6 weeks

Question 20

What are 4 auto-antibodies that can be associated with chronic autoimmune urticaria?

Answer 20

IgE alpha receptor
IgE
Anti-thyroglobulin
Anti microsomal

Question 21

What are 3 allelic auto-inflammatory Syndromes presenting with hives that all result form mutations in NLRP3 (cryopyrin)?

Answer 21

• Muckle-Wells Syndrome
• Familial cold autoinflammatory Syndrome
• Neonatal-onset mutli-system inflammatory disease (NOMID/CINCA)

Question 22

What Syndrome is associated with an IgM monoclonal gammopathy, neutrophilic urticaria, fever, bone pain, and elevated ESR.

Answer 22

Schnitzlers