Common Allergic Diseases

Question 1

What causes angioedema in general?

Answer 1

Increased levels of bradykinin

Question 2

Is allergic rhinitis allergic or non-allergic?

Answer 2

Classified as both; Symptom-wise, it is hard to distinguish which is allergic and non-allergic

Question 3

What are the pre-disposing factors of non-allergic allergic rhinitis?

Answer 3

Climate change

Strong odors

Question 4

What is the diagnosis requirement for allergic rhinitis?

Answer 4

> Clinical hx of rhinitis sx
Allergen exposure (temporal relationship)
Documentation of sensitization to an environmental allergen

Question 5

Up to 50% of patients with allergic rhinitis manifest what?

Answer 5

Asthma

Question 6

Major effector cell in urticaria?

Answer 6

Mast cell

Question 7

Urticaria due to ingestion of allergens is more common compared to that due to inhalation of airborne allergens. T or F?

Answer 7

True

Question 8

27 year old male, noticed some rashes whenever he jogs. But this goes away after he takes a shower. Which of the following may be caused by a rise in body core temperature?

Answer 8

Cholinergic urticaria

Question 9

A 16 year old male came in because of recurrent bouts of angioedema of the lips and eyelids since 3 months ago. He also has abdominal cramps and throat swelling but no rashes. One relative has similar symptoms. What is the possible cause of this condition?

Answer 9

deficiency of inhibitor of the activated first component of the complement system

Question 10

How can you differentiate between cholinergic urticaria and exercise-induced anaphylaxis?

Answer 10

Exercise-Induced anaphylaxis is precipitated by exertion alone or can be dependent on prior food ingestion and it is NOT RELATED to rise in core body temperature, unlike in cholinergic urticaria which is attributed to a rise in core body temperature

Question 11

Which of the following causes urticaria via non-immunologic mechanisms?
A. ACE inhibitors
B. penicillin
C. dermographism
D. radiocontrast media

Answer 11

D. radiocontrast media

Question 12

Which of the following most common sites for urticaria?
A. Chest and neck area
B. Trunk and back area
C. Face and extremities
D. mucosal surfaces

Answer 12

C. Face and extremities

Question 13

Which of the most frequent site angioedema?
A. GI tract
B. Periorbital area
C. Respiratory tract
D. Neck

Answer 13

B. Periorbital area

Question 14

Which of the following best describes the pathology of urticaria?
A. edema of the superficial dermis
B. inflammation of the blood vessels
C. inflammation of dermatocytes
D. edema of the subcutaneous tissue and deep dermis

Answer 14

A. edema of the superficial dermis

Question 15

A 50 year old male with chronic urticaria came to you for consult. You wanted to prescribe a nonsedating drug to address the pruritus. Which of the following can be given?
A. second generation antihistamine
B. first generation antihistamine
C. steroid tablet
D. H2 blocker

Answer 15

A. second generation antihistamine

Question 16

Which of the following DOESN’T refer to symptom/findings in urticarias?
A. lesions leave no residual hyperpigmentation
B. will blanch diascopy
C. lesions more pruritic than painful
D. lesions persist longer than 36 hours

Answer 16

D. lesions persist longer than 36 hours

Question 17

A 25 year old male noted swelling of lips for 3 days. Which of the following symptoms will make you suspect hereditary angioedema?
A. nonpitting edema
B. nonpruritic urticarial lesions
C. hypotension
D. nonblanching wheals

Answer 17

B. nonpruritic urticarial lesions

Question 18

A 43 y/o male underwent CT Scan with contrast. She noted pruritic wheals over the trunk and angioedema of the lips. What is the possible mechanism for this reaction?
A. IgE-mediated reaction
B. complement activation
C. direct mast cell activation
D. immune complex-mediated reaction

Answer 18

C. direct mast cell activation

Question 19

Which of the following causes angioedema via bradykinin mediated mechanisms?
A. Hereditary angioedema
B. ACE inhibitors
C. Serum sickness

Answer 19

B. ACE inhibitors

Question 20

The dark circles around the eyes of patients with chronic rhinitis are due to which of the following?
A. effect of histamine on conjunctival mucosa
B. venous stasis due to pressure on the veins from edema of nasal cavity
C. inflammatory reaction in the nasal cavity
D. skin discoloration due to allergenic inflammation

Answer 20

B. venous stasis due to pressure on the veins from edema of nasal cavityd

Question 21

patient has been experiencing rhinitis symptoms since he started living with relatives 1 week ago. The house has been poorly maintained and household members do not clean the house regularly. What advice will give initially for this patient?
A. short course steroids therapy
B. intake of antihistamines
C. avoidance of exposure to the offending agents
D. allergen immunotherapy

Answer 21

C. avoidance of exposure to the offending agents

Question 22

A 20 year old male came in because of small, punctate urticarial lesions, surrounded by a large area of erythema, mostly over the neck, face and extremities, which would appear weekly after ROTC training. It would resolve after he takes a cold shower. What is the most likely cause?

Answer 22

Cholinergic urticaria

Question 23

A 32 year old female, developed difficulty of breathing right after taking her antibiotic. What else should you check in order to diagnose Anaphylaxis?

Answer 23

check the blood pressure if there is hypotension

Question 24

A patient in the ward developed sudden hypotension. To confirm the diagnosis of anaphylaxis, what test can you request?

Answer 24

serum tryptase

Question 25

``` Which of the following cause anaphylaxis? A. B cells B. T cells C. Complements D. IgE antibodies ```

Answer 25

D. IgE antibodies

Question 26

A 40 year old male came to the ER with hypotension. When will you suspect anaphylaxis?

Answer 26

If the patient has other systemic symptoms like dyspnea or generalized rashes

Question 27

Which of the following induces anaphylaxis via immunologic mechanisms? A. Aspirinskin discoloration due to allergenic inflammation B. Shrimp allergen C. Opiates D. Food additives

Answer 27

B. Shrimp allergen

Question 28

Which of the following causes or explains the multisystemic symptoms of anaphylaxis? A. circulation of histamine in the bloodstream because of injection of allergen B. widespread, systemic degranulation of mast cells in the body C. entrance of the allergen into the bloodstream D. mast cell stabilization

Answer 28

B. widespread, systemic degranulation of mast cells in the body

Question 29

A 22 y/o male had sudden onset of dyspnea, diffuse erythema and loss of consciousness while hosting a children’s birthday party in a restaurant. What could be the possible cause of the anaphylaxis?

Answer 29

latex

Question 30

A 30 year old male, experienced generalized rashes an hour after eating in a seafood restaurant. There was associated difficulty of swallowing. What is the cause of his symptoms?

Answer 30

anaphylaxis

Question 31

Anaphylaxis is a sudden life-threatening condition requiring urgent attention and management. Which of the following explains the severity of symptoms and reasons why it could lead to death? A. There is widespread systemic antibody release in all major areas of the body B. The allergens which cause it are deadly C. All the cells in the body become hypersensitive D. There is widespread, systemic degranulation of mast cells in the body releasing a lot of chemical mediators

Answer 31

D. There is widespread, systemic degranulation of mast cells in the body releasing a lot of chemical mediators