A 28 year old female presents with a 2 week history of nasal congestion and drainage. Associated symptoms include some eye itching without redness. She most likely has:
Upper respiratory infection
Allergic rhinosinusitis
Bacterial sinus infection
Non allergic rhinitis with eosinophilia (NARES)
Unilateral nasal drainage is often associated with:
Foreign body or tumor
Hormonal changes such as pregnancy
Medications
Non allergic rhinitis
The treatment of choice for allergic rhinosinusitis is which of the following:
Oral an:histamine
Intra nasal decongestant
Intranasal steroid
Oral steroid
In Vitro testing for allergies:
Can only be used in select patients
Is less expensive than in vivo testing
Is more sensitive than in vivo testing
Tests for allergen-specific IgE
Which of the following is the BEST indication for immunotherapy?
Able to avoid allergens
Failure of pharmacotherapy
More cost effective than oral medications
Quick relief of symptoms
Patients best suited for immunotherapy are:
Pregnant
Controlled on intranasal steroids
Patients with uncontrolled asthma
Adherent patients
Pathophysiology of asthma includes:
Interstitial fibrosis
Irreversible airflow obstruction
Decreased mucous production
Involvement of eosinophils
An asthma patient who experiences daily symptoms requiring the daily use of a short acting beta-2 agonist would be classified as:
Moderate persistent
Mild intermediate
Mild persistent
Severe persistent
Which of the following is true in regard to making the diagnosis of asthma?
A reduction in the FEV1 and normal FEV1/FVC with an increase >12% after inhalation of a short acting bronchodilator
A reduction of FEV1 and FEV1/FVC with an increase >12% after inhalation of a short acting bronchodilator
A reduction of FEV1 and FEV1/FVC with an increase of >20% after inhalation of a short acting bronchodilator
Spirometry testing is not recommended
Which of the following is true regarding oral steroid use in asthma:
It is commonly used as a rescue medication for quick relief in asthmatics
Should never be used except by a specialist
Should never be used for long term treatment of asthma
May be first line medication for severe persistent asthma
Which of the following medications may commonly cause a drug fever?
Ibuprofen
Acetaminophen
Nitrofurantoin
Diphenhydramine
Which of the following is the best reason to try to categorize the symptoms of asthma:
Assists in determining treatment
Establishes the diagnosis of asthma
Classifies those patients that will have to be referred to the pulmonologist
None of the above
Which of the following increases the risk for asthma-related death:
High intensity exercise program
Uncontrolled bipolar disorder
Recent asthma exacerbation treated with oral corticosteroids
Concurrent allergy symptoms
Ben is a 6 year old boy with asthma. In the past 6 months he has awakened once/week with nighttime coughing attacks and has needed oral corticosteroids to control exacerbations twice. Ben’s parents note that he has used his rescue inhaler 3-4 times per week during the same time period. Ben’s current severity classification is:
Intermittent
Mild Persistent
Moderate Persistent
Severe Persistent
Based on his severity classification, the next step in treatment could include:
Leukotriene receptor antagonist
Low dose inhaled corticosteroid
Subcutaneous allergen immunotherapy
All of the above
Children will often outgrow a sensitivity to:
Peanuts
Shell fish
Soybeans
Tree nuts
Anaphylactic reactions in adults:
Are usually treated in an inpatient setting with vasopressors, antihistamines, and corticosteroids
Should be followed by skin testing for allergies within 2 weeks
Are usually IgG mediated reactions
Are uncommonly caused by food products
Which of the following is a true statement regarding food allergies:
Food allergies are more common in adults than children
Asthma is the most common manifestation of food allergies
Cooked foods are less likely than raw foods to cause a contact allergy reaction
Peanuts are the most common cause of food dependent exercise-induced anaphylaxis
Which of the following is an IgE Mediated Clinical Disease:
Celiac Disease
Food dependent exercise-induced anaphylaxis
Food protein-induced enterocolitis
Food induced anaphylactoid reaction
The preferred agent for long term control of asthma is:
Inhaled long acting beta agonist
Oral corticosteroid
Inhaled corticosteroid
