Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ACAAI Review for the Allergy/Immunology Boards > Chapter 5. Hypersensitivity Disorders > Flashcards

Chapter 5. Hypersensitivity Disorders Flashcards

1
Q

What does ICD feel like, relative to ACD

A

stinging and less pruritic

almost immediate reaction

decrescendo pattern (decreases in severity between readings)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

+++, ++, +, +/-

A

+++

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T/F the degree of skin test sensitivity correlates well with degree of sting reaction

A

False, of course

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is photocontact dermatitis

What are some examples of photoallergic chemicals

What are some examples of phototoxic chemicals

A

photoallergic or phototoxic chemical that requires light-induced excitation in UV spectrum to cause dermatitis

photoallergic (requires prior sensitization) - PABA, chlorhexidine, thiourea, NSAIDs, thiazide diuretics, dapsone, sulfonylureas

phototoxic (no prior sensitization) - psoralens, furocoumarins, tar, lime, celery, parsnip, tetracyclines, amiodarone, diuretics, quinine, and NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some examples of nonimmune-mediated adverse food reactions that are additive/toxins (not host-specific)

A

food poisoning, monosodium glutamate (MSG - numbness), sodium metabisulfite (bronchospasm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Review recommendations based on skin history and results of testing

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

There are 2 insect allergens for ants. What are they

A

Sol i 1

Sol i 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the protein for fish

A

Gad d 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the species name for bumblebee

A

Bombus species

not aggressive, have subterranean or concealed nests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some examples of nonimmune-mediated adverse food reactions that are psychologic

A

food aversion, anorexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

There are 3 insect allergens for hornet/yellow jacket. What are they

A

Ves v 1

Ves v 2

Ves v 5

frequently cross reactive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bonus round - systemic reactions from venom stings are reported in what percentage of adults and kids

How many fatal stings per year

A

3% adults

0.4-0.8% kids

40 fatal stings per year, half are in folks with no history of allergic reaction to stings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some characteristics of honeybees and their stings

A

domestic not particularly agressive, but females sting when provoked

Africanized killer bees - very agressive. tend to swarm and sting in large number

die when they sting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the protein for soy

A

Gly m 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

in children, what are the causes of 90% of food allergies (8)

A

cow’s milk, hen’s egg, soybean, wheat, peanut, tree nut, fish, and shellfish

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the protein for egg

A

Gal d1-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What cells mediate contact hypersensitivity

A

type IV hypersensitivity

mediated by CD4 and CD8 lymphocytes, stimulated by Langerhans and dermal dendritic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the predominant histologic features of contact dermatitis

A

lymphocytic infiltration

spongiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Frey’s syndrome (auriculotemporal syndrome)

A

transient, unilateral, and bilateral facial flushing or sweating after ingestion of spicy or flavored foods due to damage to the auriculotemporal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the syndrome where patients exhibit symptoms of pruritis limited to the oral mucosa when eating fresh fruits and vegetables

A

pollen-food allergy syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are reasons to continue VIT indefinitely

A

severe initial reaction, systemic reactions to injection or sting while on shots, honeybee, (elevated tryptase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the protein for peanut

A

Ara h 1-11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What percent of patients have positive serum but negative skin test to venom

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what medication has the alpha-gal carbohydrate group

A

galactose-alpha-1,3-galactose

this is a carbohydrate also found as part of the glycoproteins, including the chemotherapy monoclonal antibody cetuximab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the difference in presentation of normal and large local reactions to venom
normal = immediate, local, and transient erythema. Also edema and tenderness large local = large surface area, **peaking at 48 hours** after sting. lasting **one week**
26
What are the major classes (**3**) of plant allergen
prolamin superfamily cupin superfamily PR10 protein family
27
what is "alpha-gal"
Galactose-alpha-1,3-galactose urticaria, angioedema, or anaphylaxis 3-6 hours after ingesting beef, lamb, or pork. Not chicken. Associated with lone star tick. Unlike common allergens, which are usually proteins, this is a carbohydrate
28
What is the protein for hazel nut
Cor a 8, 9
29
What is the protein for milk
Bos d4-8
30
What are paper wasps
subfamily Polistinae Polistes species nests are on eaves or window sills
31
What is Heiner's syndrome
this is milk-induced pulmonary disease in infants. it is rare and not IgE-mediated
32
What are the three major families of animal food allergens
tropomyosin parvalbumins/EF-hand proteins caseins
33
What are some examples of nonimmune-mediated adverse food reactions that are **pharmacologic**
caffeine (jittery), tyramine in aged cheeses (headaches), scombroid fish poisoning (releases histamine-like chemicals)
34
What are characteristics of Vespula spp
yellow jackets scavengers, aggressive, especially in the autumn when food supplies are scarce sting for no reason at all nests are concealed most common cause of stings like to hide nests in wall cavities, underground, or decaying logs
35
There are 5 major insect allergens for Honeybee. What are they
Api m 1 Api m 2 Api m 3 Api m7 Api m 10
36
What are the 4 etiologic categories of contact hypersensitivity
Allergic Contact Dermatitis Irritant Contact Dermatitis Photocontact Dermatitis Contact Urticaria
37
What family of bees are yellow jackets and hornets
subfamily Vespinae can sting repeatedly without losing sting apparatus agressive
38
What are WBEs and what are they good for
"whole body extracts". They are good for fire ants but terrible for flying hymenoptera (not enough venom in them)
39
what is the efficacy rate for VIT what is a VIT maintenance dose
75-95% efficacy for preventing a systemic reaction 100 mcg venom (single antigen) 300 mcg venom (mixed vespids) 0.5ml of a 1:10 to 1:200 wt/vol extract given monthly (fire ant)
40
What technique is used for venom intradermals
concentrations between 0.001 and 0.01 micrograms/mL, increase in tenfold increments until positive or a max concentration of 1 mcg/mL is reached
41
+++, ++, +, +/-
+
42
What percentage of patients have a positive skin test to venom but negative serologic testing
20% in other words, don't trust serum alone
43
what is gustatory rhinitis
runny nose from spicy or hot foods
44
Where do yellow jackets (vespula) hide out
garbage cans, around food, empty soda cans
45
What is the "order" of stinging insects we care about
Order Hymenoptera
46
What causes irritant contact dermatitis (ICD) is previous sensitization required?
most prevalent form of contact dermatitis induced by chemicals, oxidants, alkali, surfactants, solvents that directly damage the skin previous sensitization **not** required
47
What are Class 2 Allergens
these allergens are formed primarily from **respiratory sensitization** sensitization to labile proteins encountered via the respiratory route, like pollens, results in IgE antibodies that recognize homologous epitopes on food proteins from plants
48
What is the protein for shrimp
Lit v 1, Pen a 1
49
+++, ++, +, +/-
++
50
Why not keep testing venoms at concentrations \> 1 mcg/mL
false positives due to irritant effects
51
What is in fire ant venom (key fact)
**95% piperidine alkaloids** sterile pustules within 24 hours post sting
52
What are some examples of nonimmune-mediated adverse food reactions that are **metabolic**
lactose intolerance, fructose intolerance, alcohol intolerance
53
How dangerous is rush venom compared to standard
not much higher than traditional regimens in more recent studies
54
Once sensitized, how long is contact dermatitis delayed upon re-exposure
12-48 hours
55
What family are stinging ants
Family Formicidae
56
+++, ++, +, +/-
+/-
57
Review the scoring system for patch test reactions
58
Contact Urticaria
can be either immunologic or nonimmunologic IgE dependent - dairy, seafood, fruits, grains, topical antibiotics, metals, preservatives, and plants IgE independent - fragrances, arthropods, jellyfish, and coral
59
what percent of children \<5 have food allergy
6%
60
What percent of the general population has food allergy
3.5-4%, mostly shellfish in adults
61
When do you discontinue VIT
generally after 3-5 years
62
What are some stats on VIT safety
during buildup, 50% of patients have large local reactions and 5-15% have systemic symptoms. The majority are mild. \<5% require epi
63
Allergic Contact Dermatitis (ACD) - what locations are typically involved - what is the typical pattern of positive reactions - itch?
normally on hands, generalized, face, eyelids **crescendo** phenomenon where positive reactions to patch test become more marked between first and second readings **severe** itch which takes 12-48 hours to develop
64
What are Class 1 Food Allergens
primarily food that is ingested (GI sensitized). can also invade through the skin examples are cow's milk protein (casein and whey), egg (ovalbumin and ovomucoid), peanut (vicilin, conglutin, and glycinin), fish (parvalbumin), shellfish (tropomyosin)
65
There are 3 insect allergens for paper wasp. What are they
Pol a 1 Pol a 2 Pol a 5
66
What is the protein for apple
Mal d 1,2
67
Explain the practical aspects of patch testing
patch is placed on day 1, read and removed on day 3, and again on day 5
68
What patients should definitely get venom prick testing
Arguably patients with history of severe anaphylaxis who may be extremely sensitive to venom
69
What is the fancy/scientific name for the honeybee
Apis Mellifera note the beeswax nest has numerous vertical combs
70
name five of the top ten contact allergens in the United States
nickel, neomycin, balsam of Peru, fragrance mix, thimerosal, sodium gold thiosulfate, quaternium-15, formaldehyde, bacitracin, cobalt chloride
71
What is Potassium Dichromate used in
stainless steel, chrome plating other metals, tanned leather
72
what are chromates used in
textiles, leather tanners, and construction worker using wet **c**ement
73
what is Cobalt dichloride used in
(uncommon) dental implants, artificial joints, engines or rockets
74
what is nickel used in
jewely, **dimethylglyoxime test of nickel-containing material (pink=positive)**
75
what is Toxicodendron dermatitis what is it cross-reactive with
secondary to poison ivy, oak, sumac usually develops after several encounters with plants, sometimes years after exposure 10-15% of population highly susceptible and will have systemic symptoms cross reactive with **mango peels**
76
Which fraction of a plant contains the sensitizing substances in ACD
**oleoresin** fraction most of the time plants have to be crushed to release these antigenic chemicals
77
What plant causes the most hand eczema in flower workers in the United States
Alstroemeria, also called Peruvian lily classic dermatitis that is very itchy and affects the first three fingers and exposed areas of dorsal hands, forearms, V-region of the neck, and the face
78
What is Balsam of Peru used in
it is used in the manufacture of pefumes, but also a flavoring agent. Has wide cross-reactivity, most prominently with cinnamon and vanillin.
79
What two broad categories of preservatives are there
formaldehyde donors (high prevalence of positive patch tests to these, and most fabrics contain these) nonformaldehyde donors
80
What preservative is the most frequent cause of ACD in the US
Quaternium-15 formaldehyde donor
81
What type of products are second only to skin care products as the most common cause of cosmetic allergy
hair products
82
cocamidopropyl betaine
important allergen that is in shampoos, eye/face cleaners, bath prodcuts
83
paraphenylenediamine (know this)
most common cause of contact hypersensitivity in hair dressers
84
glycerol thioglycolate
found in permanent wave hair products
85
ethylacrylate
has been demonstrated to detect a higher number of acrylate-allergic patients. acrylics are in nail products
86
what type of contact dermatitis do sunblocks/sunscreens cause
photoallergic ACD
87
topical corticosteroids - what are most common screening agents in patch testing - how are they classified
can cause ACD test them 7 days after application - budesoinde and tixocortol pivalate 1% - Group A hydrocortisone type - Group B triamcinolone type - Group C betamethasone type - Group D hydrocortisone-17-butyrate type
88
epoxy resin
when cured is nonsensitizing ACD occurs to uncured resin or to hardener
89
colophony
type of resin made from pine trees. appears in cosmetics, topical meds, and industrial products. may cross-react with Balsam of Peru
90
what kind of products have ethylenediamine dihydrochloride
topical creams, aminophylline, generic nystatin EDTA does not appear to cross react
91
paraphenylenediamine
benzene derivative and common, epidemic with henna tattoos. this is what people with allergies to henna tattoos are actually reacting to
92
topical antibiotics (resin)
common and iatrogenic with risk of anaphylaxis that can be delayed neomycin is crossreactive with bacitracin
93
what is systemic contact dermatitis (SCD)
generalized ACD rash from systemic administration of a drug, chemical, or food to which the patient previously experienced ACD for example, patients who had ACD to topical benadryl can get SCD when given IV benadryl **baboon** **syndrome -** indurated erythema that appears in the groin of afflicted patients
94
What are symptoms of EoE
GERD. intermittent vomiting, abdominal pain, dysphagia, food impaction, irritability, food avoidance, insomnia
95
What is required for definite diagnosis of EoE
15 eosinophils/hpf
96
T/F Most children who are unable to consume nonbaked forms of eggs and milk are able to tolerate baked egg and milk
True
97
which type of Th response is expected for hypersensitivity pneumonitis (Th1, Th2, or Th3?) Which type of cell is expected
note that chronic HP switches to Th2 type
98
review the presentation of acute, subacute, and chronic HP
99
review important HP associations
100
T/F - cigarette smoking is protective for HP
True for acute. somehow the smoking inactivates the macrophages in lungs. However, smoking can worsen chronic disease
101
review lab findings in HP what kind of PFT findings would you expect
restrictive over time, with progressive chronic disease, can become obstructive
102
review differential of HP pay attention especially to organic dust toxic syndrome

ACAAI Review for the Allergy/Immunology Boards (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions