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5 Written questions

5 Matching questions

  1. Hereditary angioedema
  2. Disorders of immunoglobulins
  3. Dosing for epinephrine for shock but w/ pressure
  4. Anaphylaxis secondary exposure
  5. Platelet activating factor effects
  1. a Massive degranulation of mast cells & basophils
  2. b Airway emergency
    C1 esterase inhibitor->poorly regulated compliment activation->release of vasoactive mediators (bradykinin)->episodic airway edema
  3. c Deficiencies:
    X-linked agammaglobulinemia
    Acquired hypoimmunoglobulinemia
    Selective immunoglobulin A deficiency
    Cold autoimmune diseases
    Multiple myeloma
    Waldenstrom's macroglobulinemia
  4. d 0.01 mg - 0.1 mg IV. Do not give 1 mg!
  5. e Release of vasoactive amines

5 Multiple choice questions

  1. 1-600 adults, sinus & pulm infections, risk during blood transfusion (anti-IgA antibodies)
  2. Vanco‐ life threatening anaphylactic &
    anaphylactoid (red man syndrome) reactions
    PCN‐ most common cause of fatal anaphylaxis (structurally r/t cephalosporins-> theoretical ↑d risk of allergy
  3. Life threatening manifestation of antigen‐antibody reaction
  4. O2, IV fluids, epinephrine, H1 antagonists, steroids
  5. Degranulations & release of vasoactive mediators->hypotension & CV collapse

5 True/False questions

  1. Drug allergy: protamineDerived from salmon semen
    ↑d incidence in pts allergic to seafood, diabetics, vasectomized males)
    Protamine induced compliment activation->thromboxane->bronchoconstriction & pulm HTN (↑d PAP)
    Peripheral vasodilation


  2. X‐linked agammaglobulinemia‐Inability to form any class of antibodies (absent mature B‐lymphocytes)->recurrent bacterial infections


  3. AmyloidosisMast cells, Anaphylaxis and allergy


  4. Type 2 hypersensitivity reaction cytotoxic hypersensitivityAntigens are normally endogenous, although exogenous chemicals (haptens) which can attach to cell membranes
    Drug-induced hemolytic anemia, granulocytopenia & thrombocytopenia
    IgM & IgG mediated
    Phagocytes & K cells play a role


  5. Drug allergy: Muscle relaxantsRare, accounts for 1% of adverse reactions to locals
    Ester based->PABA
    Preservatives (methylparaben, propylparaben) similar to PABA
    No proven cross-reactivity between ester & amides


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