UP-PGH IN-SERVICE REVIEWER

ALLERGOLOGY

MULTIPLE TRUE OR FALSE.
5. Correct about the manifestations and diagnosis of allergic
There are 5 statements after each question. Determine whether
rhinitis (HPIM p 2068-2070)
each statement is true or false. On the answer sheet, place an x in
a. Episodic rhinorrhea, sneezing, obstruction of the nasal
the box corresponding to your answer.
passages with lacrimation, and pruritus of the

conjunctiva, nasal mucosa, and oropharynx are the
1. Correct regarding treatment of allergic rhinitis? (HPIM p 2069-
hallmarks of allergic rhinitis.*
2070)
b. Nasal polyps may occur independent of allergic rhinitis
a. Phenylephrine or oximetazoline are effective for
in patients with aspirin-intolerant triad of rhinosinusitis
nasopharyngeal itching, tearing, and erythema.
and asthma.*
b. Intranasal high-potency glucocorticoids are the most
c. Vasomotor rhinitis resembles perennial allergic rhinitis
potent drugs for the relief of seasonal and perennial
occurring with specific stimuli.
rhinitis, and are effective in relieving nasal
d. A positive intradermal test has a high positive
congestion.*
predictive value.
c. The duration of the efficacy of alpha-adrenergic agents
e. ELISA employing anti-IgE provides rapid and cost-
is limited because of rebound rhinitis and
effective determinations.*
hypertension*

d. Immunotherapy is contraindicated in patients with

significant cardiovascular disease or stable and

unstable asthma.
e. Topical ipatropium can be efficacious when combined MULTIPLE CHOICE.
with intranasal steroids.* Choose the best answer.

2. Correct statement/s regarding the manifestations and 1. Key effector cell in the biologic response in allergic rhinitis,
pathology in anaphylaxis (HPIM p 2063-2065) urticaria and anaphylaxis (HPIM p2061)
a. Atopy predisposes individuals to anaphylaxis from a. Mast cell *
penicillin therapy or venom of a stinging insect. b. Eosinophil
b. The hallmark of the anaphylactic reaction is the onset c. Macrophage
of some manifestation within minutes to hours after d. Neutrophil
introduction of the antigen.
c. Elevations of tryptase levels in serum implicate mast 2. Polycythemia vera is associated with what kind of urticarial
cell activation in an adverse systemic reaction and are (HPIM p2065)
particularly informative with episodes of hypotension a. Cholinergic urticaria
during general anesthesia. * b. Contact urticaria
d. Skin testing is of no value for non-IgE-mediated c. Aquagenic urticaria
eruptions.* d. Pressure urticaria
e. Patients dying of vascular collapse without antecedent
hypoxia from respiratory insufficiency have visceral
congestion with presumptive loss of intravascular
blood volume. *

3. True regarding the management of anaphylaxis (HPIM p2064)
a. Early identification of the offending stimulus is
necessary before treatment can be initiated.
b. Mild symptoms such as pruritus and urticaria can be
controlled by administration of 0.3 to 0.5 ml of 1:1000
epinephrine SC or IM.*
c. Replacement of intravascular volume due to
postcapillary venular leakage may require several liters
of saline.*
d. Antihistamines such as diphenhydramine may also be
used to control urticarial/angioedema.
e. Intravenous glucocorticoids (e.g. 0.5-1.0mg/kg Medrol)
are employed to control the acute events in
anaphylaxis.

4. IgE-dependent cause/s of urticaria and/or angioedema (HPIM
p 2065, Table 311-1)
a. Autoimmunity*
b. Food allergy*
c. NSAIDs
d. Radiocontrast media
e. Serum sickness

1 TMC Internal Medicine