Allergic disease and clinical immunology topics for the outpatient internist, as tested on USMLE Step 2 CK.
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- What is the first-line treatment for anaphylaxis?
- Intramuscular epinephrine
- What is the preferred injection site for epinephrine in anaphylaxis?
- Anterolateral thigh (vastus lateralis muscle)
- Which antibody class mediates anaphylaxis?
- IgE
- What type of hypersensitivity reaction is anaphylaxis?
- Type I (immediate, IgE-mediated)
- What is a Type II hypersensitivity reaction?
- Antibody-mediated cytotoxic reaction against cell surface antigens
- What is a Type III hypersensitivity reaction?
- Immune complex-mediated reaction
- What is a Type IV hypersensitivity reaction?
- Delayed, T-cell mediated reaction
- What is the classic symptom triad of serum sickness?
- Fever, rash, and arthralgia
- How long after antigen exposure do serum sickness symptoms typically appear?
- 1 to 2 weeks
- What molecule accumulates to cause ACE inhibitor-induced angioedema?
- Bradykinin
- Which protein is deficient or dysfunctional in hereditary angioedema?
- C1 esterase inhibitor
- What is the inheritance pattern of hereditary angioedema?
- Autosomal dominant
- What complement level is characteristically low during a hereditary angioedema attack?
- C4
- What is used to treat an acute hereditary angioedema attack?
- C1 inhibitor concentrate
- Hereditary angioedema attacks are typically unresponsive to ____.
- epinephrine, antihistamines, and corticosteroids