Allergy

Question 1

It is the most common relapsing skin disease in infancy and childhood:

Contact dermatitis
Psoriasis
Seborrheic dermatitis
Atopic dermatitis

Answer 1

Atopic dermatitis

Question 2

Patients with decreased C6 levels are susceptible to:

Neisserial infections
Pneumococcal infections
Meningococcal infections
Pneumo and meningococcal infection

Answer 2

Meningococcal infections

Question 3

Patients with Bruton’s agammaglobulinemia usually can overcome common viral infections
EXCEPT: **

Dengue fever
Varicella zoster
Rotavirus infection
Echovirus infection

Answer 3

Echovirus infection

Question 4

Which of the following is TRUE in the prevention of Food Allergy?

Introduce low-risk complementary
foods altogether
Breastfeed exclusively for 4 months
Probiotic supplements may reduce the
incidence and severity of eczema
Avoid allergenic foods during
pregnancy or nursing

Answer 4

Breastfeed exclusively for 4 months

Question 5

What is the MOST important predisposing factor for a child to develop allergies?

Presence or absence of other allergic
diseases
Positive family history of allergies
Exposure to common allergens
Early onset of allergic disease in the
patient

Answer 5

Positive family history of allergies

Question 6

You examined a patient that you are entertaining for Allergic rhinitis, one of the pertinent physical examination findings is a horizontal skin fold over the bridge of the nose. What do you call this presentation?

Allergic gape
Nasal crease
Allergic salute
Nasal bridge

Answer 6

Nasal crease

Question 6

This is a common complication of Allergic rhinitis that is associated with purulent infection but with negative bacterial cultures despite marked mucosal thickening.
*

Nasal polyposis
Childhood asthma
Chronic sinusitis
Rhinitis medicamentosa

Answer 6

Chronic sinusitis

Question 6

Tiffany, 6 months old infant has been having recurrent rashes that are quite reddish with skin thickening, confined on the neck area and folded areas of the skin. Mother also noted that her baby is fussy attempting to scratch the said affected areas. If you are to categorize the type of Eczema for this case, what will it be?
*

Severe Atopic dermatitis
Mild Atopic dermatitis
Moderate Atopic dermatitis
Clear

Answer 6

Moderate Atopic dermatitis

Question 7

Autosomal recessive inheritance; oculocutaneous albinism, neuropathy, giant neutrophilic cytoplasmic inclusions; malignancy, and neutropenia are features of one of the following phagocytic disorders
*

chronic granulomatous disease
Chédiak-Higashi syndrome
Hyperimmunoglobulin E (Job syndrome)
Lazy leukocyte syndrome

Answer 7

Chédiak-Higashi syndrome

Question 8

This immunodeficiency condition is considered an medical emergency right afterbirth as the neonate will need immune reconstitution to survive.

DiGeorge syndrome
X-linked Agammaglobulinemia
Chronic Granulomatous disease
Severe Combined Immunodeficiency Disorder

Answer 8

Severe Combined Immunodeficiency Disorder

Question 9

Neonatal seizures secondary to this deficiency is associated with thymic hypoplasia.
*

Hypoglycemia
Hypokalemia
Hypocalcemia
Hypogammaglobulinemia

Answer 9

Hypocalcemia

Question 10

What treatment option for patients with Allergic rhinitis should be considered if children have IgE-mediated allergic symptoms but cannot be adequately controlled by avoidance and medication, especially in the presence of comorbid conditions?
*

Intranasal inhaled corticosteroids
Topical corticosteroids
Allergen-specific immunotherapy
Systemic corticosteroids

Answer 10

Allergen-specific immunotherapy

Question 11

Patrick, a 7 year old child came in for difficulty of breathing, flushing, intense pruritus, dry cough and hoarseness of voice. Symptoms manifested an hour after eating peanuts for snacks. You were entertaining Anaphylaxis secondary to food allergy (peanuts) for this patient. What will be your initial intervention?
*
Give Epinephrine (0.01mg/kg) IM or IV and Oral Antihistamine

Give Oxygen, start IV fluids, give Epinephrine (0.1mg/kg) IM

Give Epinephrine intramuscularly or intravenously (0.01mg/kg), supplemental oxygen and inhaled beta agonists and corticosteroids

Give Epinephrine intramuscularly or intravenously (0.01mg/kg), supplemental oxygen and inhaled beta agonists and corticosteroids, IV fluids

Answer 11

Give Epinephrine intramuscularly or intravenously (0.01mg/kg), supplemental oxygen and inhaled
beta agonists and corticosteroids, IV fluids

Question 12

It is a severe bilateral chronic inflammatory process of the upper tarsal conjunctival surface that occurs in a limbal or palpebral form. There is severe ocular itching exacerbated by exposure to irritants, light or perspiration. This condition is called:
*

Vernal keratoconjunctivitis
Atopic keratoconjunctivitis
Contact allergy
Giant papillary conjunctivitis

Answer 12

Vernal keratoconjunctivitis

Question 12

Allergic diseases are characterized by peripheral blood and tissue eosinophilia, Of the many roles that Eosinophils play, which mechanism is the one that is responsible for the pathogenesis of Asthma?
*

Induce airway hyperresponsiveness
Causes bronchoconstriction
Damage epithelial cells
Cause degranulation of basophils and mast cells

Answer 12

Induce airway hyperresponsiveness

Question 13

Technique in Allergen testing that utilizes an allergen extract and is injected in to the dermis of the skin:
*

Intradermal technique
Puncture technique
Metacholine test
Dermatographism

Answer 13

Intradermal technique

Question 13

It is the most common hypersensitivity response of the eye:
*

Allergic conjunctivitis
Vernal keratoconjunctivitis
Atopic keratoconjunctivitis
Giant papillary conjunctivitis

Answer 13

Allergic conjunctivitis

Question 14

Infants with eczema are predisposed to Atopic march which is comprised of:
*

Food allergy and asthma
Allergic rhinitis and Asthma
Food allergy, Asthma, Allergic rhinitis
Contact dermatitis, Allergic rhinitis and Asthma

Answer 14

Food allergy, Asthma, Allergic rhinitis

Question 15

Agnes an 6 month old infant was brought for consult due to erythematous fine rashes confined on the cheek area, neck area, arm pit, folded areas of the arms and legs. She was also noted to be slightly irritable This was noted a day after she was introduced with pureed brocolli as her complementary feeding. You managed this as a case of Mild Atopic Dermatitis, management for this patient will be by giving:
*

Application of emolients and Fluticasone propionate ointment

Daily bath with cold water, use of moisturizers and application of Desonide cream afterwards

Daily bath with lukewarm water, use of moisturizers as occlusive emolient and application with Hydrocortisone cream afterwards

Daily bath with lukewarm water and use of moisturizers afterwards. Application of Betamethasone ointment as the anti-inflammatory treatment.

Answer 15

Daily bath with lukewarm water and use of moisturizers afterwards. Application of Betamethasone ointment as the anti-inflammatory treatment.

Question 16

Immunodeficiency disorders involving a T-cell defect will have increased susceptibility to what type of infectious agents?

Gr. (+) organisms
Pyogenic organisms
Catalase (+) organisms
Gm. (-) organisms, mycobacterium, viruses

Answer 16

Gm. (-) organisms, mycobacterium,
viruses

Question 17

Patients with XLA usually starts having recurrent infections at this age?

Birth
6 months
2 years old
3 years old

Answer 17

6 months

Question 18

Stephen, a 4 year old child came in for difficulty of breathing associated with cough and colds of 2 days. He was noted also to be tachycardic (HR 110bpm),tachypneic (RR 40 cpm) with desaturations (O2sat 90%), O2 inhalation via nasal cannula was provided which improved 2 saturations to 92%. He prefers to sit and is able to talk in phrases when asked how he was. Other pertinent PE findings revealed: alar flaring, tight air entry, wheezes both lung fields on auscultation, subcostal and intercostal retractions. How would you categorize this patient based on Severity of Asthma exacerbation?

Bronchial asthma in mild excacerbation
Bronchial asthma, respiratory arrest imminent
Bronchial asthma in moderate exacerbation
Bronchial asthma in severe exacerbation

Answer 18

Bronchial asthma in moderate
exacerbation

Question 19

One of the following is NOT a clinical features of Ataxia Telangiectasia

Cerebral ataxia
Ocular telangiectasia
Chronic otitis media
High incidence of Adenocarcinoma

Answer 19

Chronic otitis media

Question 20

A 2 week old managed as sepsis neonatorum with oral candiadisis, with absent tonsils and with markedly decresaed lymphocytes will give you an initial diagnosis of:
*

Common variable deficiency
Severe combined immunodeficiency
Leukocyte adhesion defects
Chronic Granulomatous disease

Answer 20

Severe combined immunodeficiency

Question 21

One of the closest differential diagnosis for infant patients presenting with colds, cough and wheezing that is often interpreted as bronchial asthma? * Foreign body aspiration Viral bronchiolitis Bronchopulmonary dysplasia Pediatric community acquired pneumonia

Answer 21

Viral bronchiolitis

Question 22

One of the current goals of treatment in the latest Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines is to promote safe, effective prevention and relief of symptoms. Which of the following specific measure is a very helpful method to reduce the symptoms of allergic disease: Allow pets at home Bed linens and blankets washed 3 times a week Keep windows open to facilitate exit of pollens and dust Allergen proof encasings

Answer 22

Allergen proof encasings

Question 23

This feature is found in 60% of allergic patients and is described as blue-gray to purple discolorations beneath the child’s lower eyelids. * Allergic duck Allergic conjunctivitis Allergic shiners Dennie lines

Answer 23

Allergic shiners

Question 23

Light microscopy of neutrophils for the presence of giant granules can help to diagnose chronic granulomatous disease Chédiak-Higashi syndrome hyperimmunoglobulin E (Job syndrome) lazy leukocyte syndrome

Answer 23

Chédiak-Higashi syndrome

Question 24

Failure to thrive, diarrhea, malabsorption, and infections with opportunisticinfections (i.e., fungi, Candida sp, Pneumocystis jiroveci [carinii]) suggest… B-cell defects omplement defects T-cell defects neutrophil defects

Answer 24

T-cell defects

Question 24

Patients with decreased C6 levels are susceptible to: * Neisserial infections Pneumococcal infections Meningococcal infections Pneumo and meningococcal infections

Answer 24

Meningococcal infections

Question 25

This proposes that childhood exposure to germs and certain infections helps the immune system develop. This teaches the body to differentiate harmless substances from the harmful substances that trigger asthma. In theory, exposure to certain germs teaches the immune system not to overreact. * Immune enhancement hypothesis Atopic hypothesis Autoimmune hypothesis Hygiene hypothesis

Answer 25

Hygiene hypothesis

Question 25

It is the cornerstone of anti-inflammatory treatment for acute exacerbations of AD: * Moisturizers Emollients Topical corticosteroids Ointments

Answer 25

Topical corticosteroids

Question 25

Dane, a 3 year old child came in for consult due to cough and colds associated with sneezing and nasal congestion more prominent at night, no febrile episodes noted, patient is not tachypneic. Condition started around 4 days prior to consult, and according to the mother she usually wakes up at night because of her nasal congestion. Based on her symptoms which ARIA classification does the patient belong? * Moderate to severe persistent Mild persistent Mild intermittent Moderate to severe intermittent

Answer 25

Moderate to severe persistent

Question 26

What is considered as a primary treatment for Ocular allergies? * Topical tacrolimus or topical cyclosporine Topical decongestants Oral or topical antihistamines Avoidance of allergens, cold compresses and lubrication

Answer 26

Avoidance of allergens, cold compresses and lubrication

Question 26

Asthma is a chronic inflammatory condition of the lung airways resulting in episodic airflow obstruction. The etiology behind asthma is said to be: A combination of environmental and genetic factors in early life shape how the immune system develops and responds to environmental exposures Caused by exposure to indoor allergens such as house dust mites, animal danders, mice and cockroaches Always associated in the presence of having Allergic rhinitis Associated with environmental factors such as living in rural areas and strongly linked to female gender

Answer 26

A combination of environmental and genetic factors in early life shape how the immune system develops and responds to environmental exposures

Question 27

DiGeorge syndrome, also known as velocardiofacial syndrome or CATCH 22syndrome. One of the following IS NOT a feature of this syndrome cardiac anomalies abnormal facies thymic hypoplasia cleft lip hypocalcemia

Answer 27

cleft lip

Question 28

Abigail, a 6 months old infant presented with intense itching on the face and neck more prominent at night time, no other associated symptoms were noted. Upon physical examinations, lesions were red, scaly, patchy like formation distributed on the cheek and neck area. You were entertaining Atopic dermatitis; to further strengthen your initial impression, what are the 3 major features that must be present for the said condition? * Eczematous dermatitis that fits the typical pattern of skin inflammation; Positive family history of asthma; Immediate skin test reactivity Pruritus; Eczematous dermatitis that fits the typical pattern of skin inflammation; Chronic or chronically relapsing course Family history of asthma, Chronic or chronically relapsing course; Pruritus Pruritus; Positive family history of asthma, Chronic or chronically relapsing course

Answer 28

Pruritus; Eczematous dermatitis that fits the typical pattern of skin inflammation; Chronic or chronically relapsing course

Question 29

Among the Early Childhood Risk Factors for developing Asthma, which is considered a major risk factor? * Food allergy Formula feeding Male gender Parental asthma

Answer 29

Parental asthma

Question 30

This is one of the key elements of Allergic diseases which are likely involved inthe induction of Asthma, Allergic rhinitis, Eosinophilic esophagitis and Atopicdermatitis? * Immunoglobulin E (IgE) Innate Lymphoid cells (ILC) 2 T-Helper cells Antigen Presenting Cells (APCs)

Answer 30

Innate Lymphoid cells (ILC) 2

Question 30

Immunodeficiency disorders involving the cellular immunity usually occurs at this age: * 2-6 months 6-9 months 9-12 months 2 years old

Answer 30

2-6 months

Question 31

A 15-month-old male child presented with thrombocytopenic purpura, atopic dermatitis, and recurrent infections caused by cytomegalovirus and P.jiroveci. Immunoglobulin assay revealed elevated IgE and IgA with decreased IgM levels. Of the following, the MOST likely diagnosis is * Wiskott-Aldrich syndrome Hyper Ig E syndrome Chediak-Higashi Syndrome Lazy Lekocyte Syndrome

Answer 31

Wiskott-Aldrich syndrome

Question 31

Emmanuel, 12 year old child is diagnosed for Allergic Rhinitis classified asModerate-Severe Persistent disease. Based on this classification what treatmentis BEST for the patient? * Oral antihistmaine + Leukotriene modifying agents Oral antihistamine alone Intranasal antihistamine + Intranasal Inhaled Corticosteroids Intranasal antihistamine + Sympathomimetic + Intranasal Inhaled Corticosteroids

Answer 31

Intranasal antihistamine + Intranasal Inhaled Corticosteroids

Question 32

You examined a patient that you are entertaining for Allergic rhinitis, one of the pertinent physical examination findings is a horizontal skin fold over the bridge of the nose. What do you call this presentation? * Nasal bridge Nasal crease Allergic gape Allergic salute

Answer 32

Nasal crease

Question 32

Findings of pneumatocoeles, typical facies, "cold abscesses" will give you an impression of this deficiency. * DiGeorge Syndrome Hyper IgE Syndrome Selective Ig A deficiency Wisckott Aldrich Syndrome

Answer 32

Hyper IgE Syndrome

Question 32

Peak Expiratory Flow (PEF) is a less sensitive and reliable diagnostic method than spirometry to detect airflow obstruction. It is diagnostic for bronchial asthma if there is diurnal variation of PEF: * >30% ≥20% >20% ≥30%

Answer 32

>20%

Question 33

This type of vaccine will cause paralysis in patients 6-9 months old with absent tonsils and nonpalpable lymph nodes. * Polio Tetanus Varicella Measles

Answer 33

Polio

Question 34

A 5-month-old infant presented with reluctance to feed, lethargy, abdominaldistension, and severe gingivitis. The parents are healthy relatives and gavehistory of non-purulent omphalitis with separation of umbilical stump at the ageof 2 months. His peripheral smear showed neutrophil count 24,000/mm3.Of thefollowing, the MOST likely diagnosis is: * Lazy leukocyte syndrome Hyperimmunoglobulin E (Job syndrome) Chronic granulomatous disease Chediak-Higashi syndrome

Answer 34

Lazy leukocyte syndrome

Question 35

Majority of immunodeficiency disorders in the pediatric population involve thisarm in the immune system. Humoral Cellular Phagocytic Complement

Answer 35

Humoral?

Question 36

Patients with decreased C2 levels are susceptible to : * Neisserial infections Pneumococcal infections Meningococcal infections Pneumo and meningococcal infections

Answer 36

Pneumococcal infections

Question 37

This kind of physical urticaria results to localized pruritus, erythema andurticaria/angioedema after exposure to a cold stimulus: Aquagenic urticaria Cold urticaria Solar urticaria Cholinergic urticaria

Answer 37

Cold urticaria

Question 38

Delayed separation of umbilical cord, absence of pus at site (s) of infection, and poor wound healing suggest * B-cell defects complement defects T-cell defects neutrophil defects

Answer 38

neutrophil defects

Question 39

It is a complication of Atopic dermatitis that presents with itching, burning, tearing and copious mucoid discharge; It involves the eyes and is usually bilateral with Tantras dots or Giant papillae may be present, this is a case of: * Allergic conjunctivitis Exfoliative dermatitis Keratoconus Atopic keratoconjunctivitis

Answer 39

Atopic keratoconjunctivitis