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Flashcards in 2016 Deck (93)
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1

Which of the following symptoms are least likely due to food allergy:

sneezing and rhinorrhea

2

Complications of development of anaphylaxis

Food allergy

3

Prevalence of food allergy is highest among those with

Atopic dermatitis

4

Food allergy is more prevalent in younger children because

Immature state of their mucosal barrier

5

An allergy skin prick test will only

Identify the presence of IgE antibody against the food allergy

6

A 9 year old female develops periorbital edema …. They could not identify which specific food is causing the reaction. Which test will give the most reliable results?

Modified skin prick test.

7

Class 2 food allergens are:
A. Stable to heat and proteases
B. Allergens whose presence can be confirmed by skin prick test using standardized extracts
C. Plant-derived proteins
D. Primary sensitizers

C

8

In a 2-month old child with cow milk allergy who cannot breastfeed, what alternative milk form can you give?
A. Goat milk
B. Partially-hydrolyzed milk formula
C. Extensively-hydrolyzed milk formula
D. Amino acid-based milk formula

C

9

Which is NOT a risk factor in developing allergic rhinitis?
A. Male gender
B. Increasing age
C. Pollution
D. Higher socio-economic status

A

10

Instead of time exposure (perennial and seasonal), allergic rhinitis has been reclassified according to frequency and severity of symptoms (ARIA classification) because:
A. of the absence of an accurate pollen calendar to pinpoint seasonal allergens
B. exposure to perennial allergens is always constant
C. symptoms may occur throughout the year in polysensitized patients
D. molds only thrive during moist seasons or wet climates

C

11

An adult male consults at the OPD because of almost daily rhinorrhea for the past two months that interferes with his sleep. Symptoms recur when the weather changes. Based on the ARIA protocol, his rhinitis would be classified as:
A. Mild intermittent
B. Mild persistent
C. Moderate to severe intermittent
D. Moderate to severe persistent

D

12

Which is the predominant mediator for sneezing, rhinorrhea and nasal pruritus?
A. Leukotriene
B. Prostaglandin
C. Cytokines
D. Histamines

D

13

Which is the hallmark of allergic rhinitis?
A. Episodic rhinorrhea and sneezing
B. Recurrent sinus headache
C. Infraorbital darkening
D. Pale and boggy nasal mucosa

A

14

Which is FALSE about allergic rhinitis and its comorbid conditions?
A. Tha naso-ocular reflex is responsible for ocular symptoms after nasal allergen challenge
B. Abnormal sinus xrays are less common in asthmatics than in non-asthmatics
C. There are more asthmatics whith rhinitis than those with asthma alone
D. Otitis media results from Eustachian tube dysfunction

B

15

Which is TRUE about diagnostic tests for allergic rhinitis?
A. A negative skin prick test does not rule out an IgE-mediated disease
B. Nasal allergen challenge may establish allergen in occupational rhinitis
C. Nasal speculum exams are adequate and reliable to diagnose rhinologic disease
D. Serum IgE is not reliable if patient recently took antihistamines

B

16

Which is TRUE about the association between allergic rhinitis and asthma?
A. Patients with allergic rhinitis have a 4-fold higher risk of developing asthma
B. Asthma symptoms only correlate with the immediate phase of rhinitis exacerbations
C. Adequate control of rhinitis correlates with less asthma symptoms and ER visits
D. Introducing allergens in the nasal mucosa does not affect bronchial hyperreactivity

C

17

A patient consults because of bothersome and recurrent nasal congestion, facial pain and headache for the past 2 months. His treatment regimen should NOT include:
A. Oral steroids
B. Antibiotics
C. Intranasal steroids
D. Intranasal ipratropium

D [contested]

18

Mario has watery nasal discharge and nasal and ocular pruritus most days of the week. His symptoms are tolerable so he is hesitant to use medications. What will you advise him?
A. His symptoms warrant the use of intranasal steroids as first line of treatment
B. Antileukotrienes are not indicated because he is not asthmatic
C. Once medications are started symptoms must be reassessed after 2-4 weeks
D. If medications fail to control symptoms, surgery is indicated

C

19

Mariel has had asthma since childhood. Once a week, she has daytime shortness of breath, relieved by salbutamol inhaler, but she has no nocturnal symptoms. Her level of asthma control is:
A. Controlled
B. Partly controlled
C. Uncontrolled
D. In exacerbation

A

20

Which describes partly controlled asthma?
A. Daytime symptoms more than once a week
B. Nocturnal awakening twice a month
C. Limitation of activity in any week
D. FEV1 less than 70% predicted

C

21

James has partly controlled asthma despite compliance with low dose inhaled steroid and montelukast. Which is NOT an appropriate step up treatment for him?
A. Add an inhaled long acting beta agonist
B. Increase the dose of his inhaled steroid
C. Add sustained release theophylline
D. Add anti-IgE treatment

D

22

A 35-year old librarian consults for daily sneezing and teary eyes that are worse while she’s at work. She also has easy fatigability when doing chores and when arranging books at work but this is relieved with an inhaler. She occasionally wakes up at night for coughing. What is your diagnosis?
A. Allergic rhinitis, mild persistent AND asthma, partly controlled
B. Allergic rhinitis, moderate to severe persistent AND asthma, partly controlled
C. Allergic rhinitis, mild persistent AND asthma, uncontrolled
D. Allergic rhinitis, moderate to severe persistent AND asthma, uncontrolled

D

23

Mrs. Marquez suffers from allergic rhinitis. She consulted you about strategies to prevent the development of allergies in her children. Based on the ARIA 2010 update, which is TRUE about recommendations for preventing allergies?
A. Total avoidance of environmental tobacco smoke is recommended
B. The use of dustmite impermeable pillow covers is the only recommended method
C. Total avoidance of exposure to animal dander is suggested among infants and children
D. Exclusive breastfeeding for at least 4 months is recommended among infants of atopic parents.

A

24

Based on the ARIA 2010 update, which is TRUE about treatment recommendations for allergic rhinitis?
A. Prophylactic oral H1 antihistamine if given to atopic dermatitis children will prevent the development of wheezing and asthma
B. Intranasal H1 antihistamines are preferred over oral H1 antihistamines because of the sedation from oral preparations
C. Oral H1 antihistamines and oral LTRA can be used interchangeably because of comparable efficacy and costs
D. Intranasal steroids are preferred over oral H1 antihistamines and oral LTRA because of the proven efficacy of intranasal steroids.

D

25

The following statement is valid regarding histamine receptors
A. When in an active state (“on” switch), it allows the agonist, histamine, to produce its actions/effects
B. When in equilibrium, it does not allow any pharmacologic activity to occur
C. When in inactive (“off” switch), it allows a structurally unrelated substrate to block agonist action
D. It is a G protein-coupled receptor
E. All of the above

E

26

The pharmacologic actions/effects of antihistamines occur through the following:
A. Reverses agonist effect through an opposite physiologic action
B. Produces pharmacologic effects through switching on of the receptor
C. Prevents the agonist from occupying the receptor site to produce histamine-induced effects
D. It switches off the histamine1 receptor
E. C and D only

E

27

Pharmacologic features common to all H1 antihistamines
A. Sedation
B. Inhibition of gastric acid secretion
C. Inhibition of histamine induced wheal and flare reaction on skin
D. Decrease in alpha2 macroglobulin
E. Decrease in FEV1 in _____ airways

C

28

This is most likely to cause sedation
A. Loratidine
B.
C. Dipherihydramine
D.
E. Cimetidine

C

29

Value of antihistamines in allergic disorders
A. Ability to block nasal symptoms
B. Ability to block acute bronchospasm in asthmatics
C. Ability to block itching and congestion
D. all of the above
E. A and C

E

30

True about leukotrienes
A. Similar to histamines, are involved in early and late phase of upper and lower airway inflammation
B. When concentrations are high during allergic process, there is increase in nasal allergic symptom scores
C. Synthesis is inhibited when there is interaction of SLO and FLAP
D. all of the above
E. A and B only

B [contested]