ACAAI Review Book Ch 9: Allergens and antigens Flashcards
(22 cards)
Which of the following allergens have the most cross reactivity?
A. bahia B. johnson C. timothy D. bluegrass E. johnson
C. timothy
D. bluegrass
Northern grasses (Pooidae) have strong cross-allergenicity
I grew up in the NORTH where I got TO Relish Fresh, SWEET BLUEberries
Northern grasses:
- timothy
- orchard
- rye
- fescue
- sweet vernal
- bluegrass
Which of the following allergens have cross reactivity?
A. bahia B. johnson C. lovegrass D. bermuda E. corn F. prairie
C. lovegrass
D. bermuda
F. prairie
^ Southern grasses, subfamily Chloridoideae cross reacts
Bahia & Johnson have limited cross reactivity
Then I moved to the SOUTH for LOVE and my Boo Bought me JOHNSONS PRAIRIE
- lovegrass
- bermuda
- bahia
- johnson
- prairie
Most trees pollinate in the spring except which two of the following?
A. ash B. birch C. elm D. oak E. olive F. mountain cedar
C. elm- FALL
F. mountain cedar- midWINTER
All of the following cross react except?
A. ash
B. olive
C. privet
D. cedar
D. cedar
Oleaceae family
All of the following cross react except?
A. ash B. birch C. alder D. hazelnut E. hornbeam
A. ash
Betulaceae family
Bet v 1-7= birch
OAS = PAL-ABC pear peach potato plum apple pricot birch celery, carrot, cherry
protruding pores can make it look like a lemon
All of the following cross react except?
A. cypress
B. birch
C. juniper
D. cedar
B. birch
stellate cytoplasm breaks to look like pac-man
All of the following cross react except?
A. oak B. birch C. beech D. chestnut E. hazelnut
E. hazelnut
Fagaceae family- c/w Birch and Betulaceae fam.
which allergen cross reacts in people allergic to shrimp?
A. Der p 1 B. Der f 1 C. Der p 2 D. Der f 2 E. Der p 10
E. Der p 10
tropomysin
•Der p 1 and Der f 1 = cysteine proteases
the house / pyroglyphid mites = Dermatophagoides, Euroglyphus,
the storage mites = Bloomia, Lepidoglyphus, Tyrophagus
case reports of pts started on dust mite IT and then developed systemic reactions to crustaceans afterwards. However, this is uncommon and not much to do or counsel patients on
Evaluate patients who complain of oral symptoms or
symptoms consistent with an IgE-mediated reaction after
ingestion of grain flour for dust mite sensitization regardless of
whether they have wheat-specific IgE
Thumbs down, don’t use acaricides
The major cat allergen comes from what source?
A. urine B. salivary glands C. feces D. hair E. skin/sebaceous & anal glands
E. skin/sebaceous & anal glands
B. salivary glands
Fel d 1
secretoglobulin
(Fel d 2 albumin and Fel d 3 are minor antigens)
remains airborne even in undisturbed conditions and can take 4-6 months for cat alelergen levels to reduce in home after cat removal
Of the dog allergens, which are:
- lipocalin?
- major allergens?
- albumin?
- lipocalin (calycin) = Can f 1, 2, 4
- major allergens = Can f 1, & Can f 5
- albumin = Can f 3
The major dog allergen Can f 1 comes from what sources?
A. urine B. salivary glands C. feces D. hair E. skin / Sebaceous glands
B. saliva & D. hair
also E. skin / Sebaceous glands
not as easily airborne as cats, but also ubiquitous
Of the cockroach allergens, which are:
- lipocalin?
- aspartic proteases?
- tropomysin?
- lipocalin = Bla g 4
- aspartic proteases = Bla g 1 & 2 (2 is measured in house dust and levels >10 a/w disease)
- tropomysin = Per a 7
The primary school-based allergen is:
A. Bla g 1 B. Per a 7 C. Bla g 2 D. Mus m 1 E. Rat n 1
mouse allergen - Mus m 1
Cockroach and mold allergens contain protease enzymes and can only be mixed with which of the following:
A. tree B. cat C. dog D. dust mite E. grass F. weed
D. dust mite
grass pollens are especially susceptible to protease enzymes
Glycerin properties include all of the following except:
A. maximize stability of an extract
B. inhibit bacterial growth
C. inhibit proteolytic enzymes
D. preservative effect by reducing adsorption of allergenic proteins to the vial surface
D. preservative effect by reducing adsorption of allergenic proteins to the vial surface = HSA
phenol is added to prevent bacterial growth, but can break down allergen proteins in extract products containing 50% glycerin
allergen responsible for Cat-pork syndrome- cat allergic patients who react with pork ingestion 2/2 cross reactivity with pork albumin?
Fel d 2
dust mite IT dose
Patients receiving immunotherapy for dust mite ideally
should receive a dose that delivers approximately 7 mg of Der p 1
per injection or 500 to 2,000 AU per injection to obtain an
optimal balance between efficacy and safety.
Der p 1 can cleave the
CD23 IgE receptor from human B-cell membranes, thus ablating the
feedback inhibitory mechanism that normally limits IgE
synthesis.29 Der p 1 also can cleave the CD25 subunit of the T-cell
interluekin-2 receptor, which can promote TH2 responses
dvise patients to minimize exposure of susceptible children
to dust mite allergens to decrease their risk of developing mitespecific
IgE. Because
Advise patients to minimize exposure of dust miteesensitized
children to dust mite allergens to decrease their risk of developing
asthma and possibly rhinitis
The major dust mite allergen comes from what source?
A. urine B. salivary glands C. feces D. hair E. skin/sebaceous & anal glands
C. feces- pellets
allergen responsible for Alpha-gal sensitivity (IgE binding epitope is the carbohydrate galactose-alpha-gal)
Fel d 5
Oligosaccharide on cat IgA; main source is saliva
Lipocalin (also known as calycin) family proteins includes rat (Rat n 1), mouse (Mus m 1), horse (Equ c 1/Equ c 2), cow (Bos d 2/Bos d 5), cow’s milk (β-lactoglobulin), rabbit (Ory c 1), and cockroach (Bla g 4). Does not include cat!
Basal serum tryptase should be measured when there is a history of
severe insect sting anaphylaxis (especially with hypotension or the
absence of urticaria) and when skin and serum test results for
venom-specific IgE are negative.24e26 Tryptase measurement
should be considered when patients have systemic reactions during
VIT and when discontinuing VIT. Patients with mastocytosis should
be tested for Hymenoptera venom sensitivity. In
Mastocytosis occurs in approximately 2% of patients
with insect sting anaphylaxis, and insect sting anaphylaxis occurs
in approximately 25% of patients with mastocytosis.124
anaphylaxis. VIT reduces the risk of a subsequent systemic sting
reaction to as low as 5% compared with up to 60% in untreated
patients
Include in VIT all venoms for which
the patient has demonstrated specific IgE. (Recommendation;
VIT.37,209,215 Fatal reactions to stings have occurredafter stopping VIT
in patients with mastocytosis.134,135 Although this occurrence is rare,
some recommend continuation of immunotherapy indefinitely in
patients with a history of severe anaphylaxis or with mast cell disorders
• ANA = 50% chance of having it again
o Risk of a subsequent systemic sting with VIT
<5% vespids
15% with honeybee (not quite as effective)
Patients with Schnitzler syndrome caused by an IgM or
more rarely IgG monoclonal gammopathy present with nonpruritic
urticaria (that spares the face), bone pain, and intermittent
fever.
Manag
