CLINICAL CARE OF THE IMMUNE SYSTEM

Question 1

_____ is an immunologically mediated hypersensitivity reaction to a foreign antigen manifested by tissue inflammation and organ dysfunction.

Answer 1

Allergy

Question 2

True/False
The clinical expression of allergic disease depends on prior immunologic responsiveness, antigen exposure, and genetically influenced host factors.

Answer 2

True

Question 3

An allergic reaction generally occurring within 60

minutes after initial exposure is considered what?

Answer 3

immediate

Question 4

______ is the most serious and potentially life-threatening manifestation of mast cell and basophil mediator release.

Answer 4

Anaphylaxis

Question 5

What is defined clinically by these circumstances?
1) Allergen exposure followed by the acute onset of illness involving skin or
mucosal tissue and either respiratory compromise or hypotension (systolic blood pressure less than 90 mm Hg or 30% less than known baseline).
2) Likely allergen exposure followed by the acute onset of two or more of the following conditions: Skin or mucosal tissue involvement, respiratory compromise, hypotension, and persistent gastrointestinal symptoms.
3) Known allergen exposure followed by hypotension.

Answer 5

Anaphylaxis

Question 6

Most acute systemic food allergy is caused by

Answer 6

proteins in milk, 
egg, 
wheat,
 soy,
fish, 
shellfish, 
peanuts,
tree nuts.

Question 7

True/False

Milk and egg allergies in atopic children are often never outgrown by adulthood.

Answer 7

False

they are usually outgrown

Question 8

most common causes of food anaphylaxis in adults.

Answer 8

Shellfish, peanuts, and tree nuts

Question 9

Food Allergy:

Immediate allergic reactions within _______ of ingestion of foods are much less common among adults than children.

Answer 9

2 hours

Question 10

Early administration of _____________ at the onset of suspected anaphylaxis is the cornerstone of therapy.

Answer 10

intramuscular epinephrine

Question 11

_________ is the formation of allergen mediated rash

(a) Eruptions of evanescent wheals or hives.
(b) Itching is intense but, rarely, may be absent.

Answer 11

Urticaria

Question 12

Special forms of urticaria have special features such as

Answer 12

dermatographism, cholinergic

urticaria, solar urticaria, or cold urticaria

Question 13

True/False

Most incidents of urticaria are acute and self-limited (1-2 weeks)

Question 14

Chronic urticaria (episodes lasting longer than 6 weeks) may have an ______

Answer 14

autoimmune basis.

Question 15

Most common immunologic mechanism is mediated by ______, as seen in the majority of patients with acute urticaria; another involves activation of the complement cascade.

Answer 15

IgE

Question 16

Symptoms/Physical Exam Findings of what
(1) Lesions are itchy, red swellings of a few millimeters to many centimeters
(Figure 6- 24).
(2) The morphology of the lesions may vary over a period of minutes to hours,
resulting in geographic or bizarre patterns.
(3) Individual lesions in true Redacted last less than 24 hours, and often only 2-4 hours.

Answer 16

urticaria

Question 17

What is acquired or inherited and triggered by exposure to cold and wind.

Answer 17

Cold urticaria

Question 18

What is triggered by a rise in core body temperature

(hot showers, exercise), wheals are 2-3 mm in diameter with a large surrounding red flare.

Answer 18

cholinergic urticaria

Question 19

The mainstay urticaria of treatment initially includes

Answer 19

Antihistamines

Question 20

These thins are the chief causes of what?
(a) Medications-eg, aspirin, NSAIDs, ACE inhibitor, angiotensin receptor blocker,
morphine, and codeine.
(b) Arthropod bites-eg, insect bites and bee stings (though the latter may cause anaphylaxis as well as angioedema).
(c) Physical factors, such as heat, cold, sunlight, and pressure.
(d) Neurogenic factors, as in cholinergic urticaria induced by exercise, excitement, hot showers, etc.
(e) Other causes may include penicillin and other medications.
(f) Inhalants such as feathers and animal danders.
(g) Ingestion of shellfish, tomatoes, or strawberries.
(h) Infections, such as viral hepatitis (causing urticarial vasculitis).
(i) Tartrazine dyes.

Answer 20

urticaria

Question 21

is swelling of vascular tissue involving deeper subcutaneous tissue with
swelling of the lips, eyelids, palms, soles, and genitalia.

Answer 21

Angioedema