Multiple Choice Questions (MCQ)

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Category: Medicine--->Allergy and Immunology
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Question 1# Print Question

A 20-year-old woman develops urticaria that lasts for 6 weeks and then resolves spontaneously. She gives no history of weight loss, fever, rash, or tremulousness. She denies any use of medication or drugs; the hives are not related in time to the ingestion of fresh fruits, shellfish, peanuts, or dairy products. Physical examination shows no abnormalities except for a few residual hives in the antecubital fossae.

Which of the following is the most likely cause of the urticaria? 

A. Connective tissue disease
B. Hyperthyroidism
C. Chronic infection
D. Food allergy
E. Not likely to be determined

Question 2# Print Question

A 20-year-old man is found to have weight loss and generalized lymphadenopathy. He has hypogammaglobulinemia with a normal distribution of immunoglobulin isotypes. Histologic examination of lymphoid tissue shows germinal center hyperplasia. A diagnosis of common variable immunodeficiency is made.

Which of the following statements is correct?

A. The patient likely had symptoms in childhood
B. At least one parent is also afflicted with the disease
C. The patient may develop recurrent bronchitis and chronic idiopathic diarrhea
D. The patient should receive the standard vaccine protocol.
E. The patient should receive trimethoprim-sulfamethoxazole as prophylaxis against Pneumocystis infections

Question 3# Print Question

A 25-year-old woman complains of watery rhinorrhea and pruritus of the eyes and nose. She had mild asthma as an adolescent, but her lower respiratory symptoms have resolved. The nasal symptoms occur throughout the year but are worse in spring and fall. She has no pets in the home and avoids exposure to pollens and grass as much as possible. She has had inadequate symptom relief with month-long trials of daily oral loratadine and cetirizine. She does not use OTC decongestants. On physical examination, VS are normal. Nasal mucosa is pale and boggy, and she has an “allergic crease” on her nose. There is no sinus tenderness or lymphadenopathy.

What is the best next step in management of her symptoms? 

A. Referral to allergist for immunotherapy
B. Addition of montelukast 10 mg daily to the oral antihistamine
C. Addition of prednisone 10 mg daily until symptoms are controlled, then taper to lowest dose that controls her symptoms
D. Addition of daily intranasal glucocorticoid
E. Addition of daily intranasal cromolyn

Question 4# Print Question

A 20-year-old nursing student complains of asthma while on her surgical rotation. She has developed dermatitis of her hands. Symptoms are worse when she is in the operating room.

Which of the following statements is correct? 

A. This is a benign contact reaction
B. The patient should be evaluated for latex allergy by skin testing
C. This syndrome is less common now than 10 years ago
D. Oral corticosteroid is indicated.
E. She will have to change her career since there is no substitute for latex gloves

Question 5# Print Question

A 59-year-old man develops skin rash, pruritus, and mild wheezing 20 minutes after a coronary arteriogram. The symptoms respond to a single dose of epinephrine and diphenhydramine. The angiogram, however, reveals 95% stenosis of the right coronary artery. The cardiologist recommends repeat study with percutaneous angioplasty.

What is the best recommendation for this patient’s management?

A. The patient cannot receive intravenous contrast agents. Medical management of his coronary stenosis should be pursued
B. Premedicate the patient with oral N-acetylcysteine and intravenous normal saline and proceed with contrast study
C. Make sure that a non-ionic contrast agent is used, premedicate the patient with corticosteroids, and proceed with the procedure
D. Premedicate the patient with subcutaneous epinephrine and inhaled albuterol and proceed with the procedure
E. Proceed with the procedure, having epinephrine and endotracheal tube readily available in the heart catheterization suite

Category: Medicine--->Allergy and Immunology
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