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Allergy Quiz

Check your AQ (Allergy Quotient)

Edited by Glenis Scadding, MD

Allergen Immunotherapy
Quiz Which level of atopic dermatitis is currently an indication for allergen immunotherapy with house dust mite extract?
Quiz A 45 year-old patient presents with symptoms of flushing, peri-oral numbness, lip swelling, abdominal discomfort and diarrhea. These occurred within half an hour after consuming home cooked mackerel which he had caught recreationally. He had previously consumed mackerel with no reaction in the past. There was no recent febrile illness or consumption of new medication. An avid runner, he had also gone for a thirty-minute brisk jog before his meal. What is the most likely diagnosis?
Quiz MS, male 34 years, was brought to the Emergency department. Fifteen minutes before, while walking in the street, he received a bee-sting. Very quickly he had palmo-plantar pruritus with ongoing skin red eruptions with intense pruritus, a dry cough with aphonia, stuffy nose and pruritus in nose and throat. He was taken to a nearby hospital where a diagnosis of anaphylaxis was made in ED. Pulse rate was 110/minute, blood pressure 90/50, O2 saturation was 92%. No other abnormalities were found.

Patient immediately was laid down in recumbent position; epinephrine via auto injector was administered on the external surface of the left thigh, and followed with a serum intravenous infusion with diphenhydramine ("Benadryl") 10 mgs and metilprednisolone 500 mgs. Blood was obtained for tryptase levels and specific IgE to bee venom.

A favorable response is promptly registered, the urticaria began to fad, the patient became able to speak, and 45 minutes later his blood pressure was 120/70, O2 saturation 98%, pulse rate 85/minute with no other abnormalities noted. One hour later the patient is feeling well. His urticaria has disappeared and the lip angioedema was clearly much smaller. The blood pressure was stable and the rest of the clinical examination is normal. Fifteen minutes later, after 2 hours in the ED, the patient was discharged with instructions to see a specialist for treatment of bee-venom allergy.

Which of the procedures made in this clinical case, (a real one), was wrong or absent?
Quiz Perioperative anaphylaxis is probably an underestimated problem due to a high number of undiscovered or unreported cases. According to the study of the Danish Anaesthetist Allergy network, which drug/compound/device is the most common cause of perioperative anaphylaxis?

Which of the following are minor characteristics of difficult to control asthma? (Several questions)

Quiz Asthma is a chronic inflammatory respiratory disease characterized by airways inflammation, hyperresponsiveness, obstruction, and remodeling. It affects 300 million people worldwide, generating significant morbidity, reduced quality of life, substantial mortality (250,000 deaths/year), and high costs.

Conventional therapy of asthma includes allergen avoidance, inhaled glucocorticoids (IGCs), ß2-adrenergic receptor agonists, antileukotrienes and immunotherapy.

10% of asthma patients do not benefit with conventional therapy (refractory asthma). Therefore, it is important to develop new therapies based on asthma pathogenesis. Biologic therapies, including monoclonal anti bodies, are emerging therapeutic alternatives for refractory asthma.

Mark the incorrect relation between a monoclonal antibody and its corresponding target molecule:
Quiz A patient with severe asthma has nasal polyposis that recurs rapidly after surgery. Which of the following tests would you perform?
Quiz In virus-induced asthma eosinophils have a . . .
Quiz Which of the following are minor characteristics of difficult to control asthma?
Quiz Which of the following wheezing phenotypes seems to be more likely to persist into childhood?
Atopic Dermatitis
Quiz Which of the following statements about atopic dermatitis is FALSE?
Chronic Cough
Quiz Which is the best approach for a male patient with dry cough and occasional dyspnea for 6 months?
Drug Allergy
Quiz Which following statements regarding oral aspirin desensitization in AERD are true?
Food Allergy
Quiz A 17 year-old atopic boy with recurrent urticaria and dizziness during or shortly after physical activity correlates the symptoms to the consumption of pizza with tomatoes, cheese, ham and (button) mushrooms. Usually he tolerates pizzas of the same brand without any symptoms. Which is the most likely allergen for this patient?
Quiz A 30 year-old female from the United Kingdom reports immediate lip and mouth irritation on eating a hazelnut. Which of the following might aid diagnosis?
Quiz Which of the following statements regarding cow's milk protein allergy is true?
Gastrointestinal Allergy
Quiz A two-year old patient is presenting with failure to thrive, vomiting and irritability. What is your presumptive diagnosis? And what complementary evaluations would you ask for?
Immune Deficiency  
Quiz Which is the defective gene in the classic NK cell deficiency subtype 1?
Lung Diseases
Quiz Which of the following statements are incorrect in Cystic Fibrosis (CF)?
Quiz What has been shown to reduce examination performance in teenagers?
Quiz Which of the following statements about rhinitis is false?
Urticaria/ Angiodema
Quiz A 32-year-old woman came to the Emergency Department complaining of chronic persistent urticaria and periorbital angioedema, which had been occurring daily for the past four weeks. She was diagnosed with thyrotoxicosis six weeks ago, and she had been started on carbimazole 20 mg bd and propranolol 10 mg tds. Her sister also had a history of urticaria and agioedema.
Quiz A thirteen year old female patient presents with daily urticaria of 7 months duration. The weals are 3-5 cm in diameter, itchy and each lesion persists for 1-2 hours. She also gives history of photosensitivity. Her urine analysis shows proteinuria 700 mg/day and red blood cell casts. What is the most probable cause of the urticaria?
Quiz Which of the following statements about the influenza vaccine are true?
Quiz Which of the following vaccines are contra-indicated in patients anaphylactic to egg?