Download 2023 AAAAI-ACAAI Online Joint Board Certification Review Questions and Answers and more Exams Nursing in PDF only on Docsity!
Review questions and answers
2023 AAAAI-ACAAI Online Joint Board Certification Review Q&As
- Which of the following statements is true. A.) Signaling through the TCR is sufficient to activate naïve T cells B.) CD28 is a costimulatory molecule that is needed to activate naïve T cells C.) CD80 and CD86 interact with CD4 to inhibit TCR signaling D.) Costimulatory molecules activate phosphatases that inhibit Zap70 - Correct Answer B.) CD28 is a costimulatory molecule that is needed to activate naïve T cells
- Which of the following statements is true? A.) ITIMs recruit phosphatases such as SHP-1 and SHP- B.) ITAMs have intrinsic kinase activity C.) Phosphatases always mediate inhibitory signals D.) Adaptor proteins phosphorylate ITAMs - Correct Answer A.) ITIMs recruit phosphatases such as SHP-1 and SHP-
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Which one of the statements regarding function of adaptor proteins is true? A.) Recruitment of other signaling molecules via specialized domains. B.) Phosphorylate other proteins via kinase domain. C.) Inhibit downstream signaling by dephosphorylation. D.) Are only expressed on the surface of cells. - Correct Answer A. Recruitment of other signaling molecules via specialized domains. B-1 B cells: A.) Are localized in the spleen at the junction between the white pulp and the red pulps B.) Are dependent on 'help' from CD4+ T cells C.) Constitutively secrete antibody D.) Require replenishment from the bone marrow to maintain their population - Correct Answer C.) Constitutively secrete antibody Isotype Class Switching:
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C.) Production by eosinophils is important for cellular expansion in the draining lymph node D.) Is expressed as a type II membrane protein dimer in macrophages - Correct Answer A.) Is secreted from cells by the action of TACE A middle-aged female patient presents with episodic shortness of breath, fever, hypoalbuminemia, hypergammaglobulinemia, and elevated C-reactive protein. On cardiac exam, you detect a 'tumor plop.' Why cytokine produced by this tumor is responsible for the abnormal lab tests in this patient? A.) TSLP B.) IL- C.) IL- D.) IL-15 - Correct Answer C.) IL- IL-15: A.) Transduces its signal through a receptor that shares its a-chain with the receptor for IL- B.) Is a member of the common cytokine receptor b-chain gene family
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C.) Is expressed at high levels in the spleen germinal centers D.) Supports the differentiation of NK cells - Correct Answer D.) Supports the differentiation of NK cells T cells require two signals for activation. The second signal has which of the following features: A.) It is induced on antigen presenting cells by microbial products B.) It is induced on B cells by IgM C.) It is induced by IL-2 from the activated T cell D.) Coordinate interactions with NK cells recognizing stress molecules drive expression of the second signal - Correct Answer A.) It is induced on antigen presenting cells by microbial products The T cell repertoire is shaped by selection in the thymus. Which of these has a correct order of events? A.) Double positive before double negative T cells B.) Medullary selection before cortical selection C.) Selection before VDJ recombination
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He has been previously treated with increasing strength of topical corticosteroids (compliance confirmed with pharmacy and family) without improvement. Similarly, he has also used topical calcineurin inhibitors without success. He maintains a good skin care regimen with moisturizing and bathing. Lichenified lesions are noted on the flexor surfaces of his extremities. You have decided to administer a monoclonal antibody therapy directed against the IL-4Rα subunit. In addition to injection site reactions, you must counsel the family on this particular side effect: A.) Increased risk for oral thrush B.) Self-limited conjunctivitis C.) Worsening skin pruritis during first 12 weeks of therapy D.) Nausea and liver enzyme increases - Correct Answer B. Self-limited conjunctivitis Epithelial skin dysfunction in atopic dermatitis can be due to decreased expression of filaggrin, transglutaminases, keratins, loricrin, involucrin, and intercellular proteins. Which of the following is not seen as an effect of such abnormalities?
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A.) Increased penetration of allergens and microbes B.) Increased proinflammatory cytokines C.) Decreased skin pH D.) Decreased skin hydration - Correct Answer C.) Decreased skin pH What form of inducible urticaria is most commonly associated with wheezing? A.) Cholinergic urticaria B.) Dermographism C.) Solar urticaria D.) Vibratory angioedema - Correct Answer A.) Cholinergic urticaria When compared to HAE-C1INH, patients with HAE-FXII have: A.) Earlier onset B.) More abdominal attacks C.) More facial swelling D.) Higher disease penetrance - Correct Answer C.) More facial swelling
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Based on evidence from randomized, placebo-controlled, double blind studies, which of the following "controller" options is preferred for Mary? A.) Low dose inhaled steroid monotherapy B.) Medium dose inhaled steroid monotherapy C.) Combination low dose inhaled steroid and long acting beta agonist D.) Leukotriene modifier monotherapy - Correct Answer A.) Low dose inhaled steroid monotherapy Which of the following co-administered agents may be associated with an increase in serum theophylline level? A.) Carbamazepine B.) Phenytoin C.) Rifampin D.) Zileuton - Correct Answer D.) Zileuton A 55 year old woman with severe refractory asthma and chronic rhinosinusitis, had severe bronchospasm in association with taking two tablets of aspirin 2 years
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ago, and has since avoided aspirin and aspirin-like drugs. She has been referred to you by an Orthopedic surgeon to determine which analgesic medication she should take for osteoarthritis. Which of the following would be associated with no risk for cross-reaction? A.) Acetaminophen 1000 mg TID B.) Celecoxib 100 mg BID. C.) Ibuprofen 600 mg TID. D.) Sodium Salicylate 1500 mg BID - Correct Answer B.) Celecoxib 100 mg BID. Serum Specific IgE to chemical allergens is often detected in workers with occupational asthma caused by: A.) Hexamethylene diisocyanate B.) Trimellitic anhydride C.) Plicatic acid D.) Methyl methacrylate - Correct Answer B.) Trimellitic anhydride Which of the following is an essential feature for establishing a diagnosis of Allergic Bronchopulmonary Aspergillosis?
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He presents to the Emergency Department 15 minutes later with HR= 100, RR = 30, BP = 100/50. IM epinephrine & IV saline are administered. Forty minutes later: HR= 70, RR = 18, BP = 132/70. The most likely diagnosis for this event is: A.) Carcinoid syndrome B.) Systemic anaphylaxis C.) Systemic mastocytosis D.) Vasovagal reaction - Correct Answer B.) Systemic anaphylaxis A 68 year old man receiving venom immunotherapy and taking metoprolol for secondary cardioprotection has systemic anaphylaxis after administration of a routine immunotherapy injection. He is placed in supine position, with HR= 70, RR = 32, BP = 90/40. He receives IM epinephrine and IV saline, and then a 2nd IM epinephrine 10 minutes later. He remains hypotensive with BP = 86/42. The most appropriate next step in his management would be administration of which of the following? A.) Diphenhydramine
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B.) Glucagon C.) Methylprednisolone D.) Montelukast - Correct Answer B.) Glucagon Which of the following is the most frequently identified risk factor for poor outcome after a systemic reaction to allergen immunotherapy? A.) Delay in administration of epinephrine B.) Lack of dose adjustment during a pollen season. C.) Polysensitization. D.) Reaction that begins within minutes of injection. - Correct Answer A.) Delay in administration of epinephrine A blood sample is obtained 2 hours after onset of anaphylaxis. Which of the following anaphylactogenic exposures is least likely to be associated with an elevation of serum tryptase? A.) Consuming a cookie containing tree nuts. B.) Intravenous cefazolin.
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Which beta-lactam pair has the highest rate of cross-reactivity? A.) Penicillin and imipenem B.) Penicillin and ceftriaxone C.) Cefazolin and cefepime D.) Aztreonam and ceftazidime - Correct Answer D.) Aztreonam and ceftazidime A patient with which type of hypersensitivity reactions following ingestion of ibuprofen is most likely to tolerate aspirin? A.) Bronchospasm in a patient with nasal polyps B.) Urticaria in a patient with chronic spontaneous urticaria C.) Urticaria in a patient with urticaria to diclofenac D.) Angioedema in a patient with no prior history of angioedema - Correct Answer D.) Angioedema in a patient with no prior history of angioedema Which of the following symptom constellation in a 6 month old is consistent with acute food protein enterocolitis syndrome based on the consensus diagnostic criteria?
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A.) Emesis with a concurrent rash 2 hours after drinking cow's milk B.) Emesis 4 hours after eating rice with hypotension and fever C.) Emesis 3 hours after drinking soy milk with lethargy and hypothermia D.) Cough with subsequent diarrhea and need for intravenous fluids - Correct Answer C.) Emesis 3 hours after drinking soy milk with lethargy and hypothermia Parents of a 5 month old with eczema and egg allergy with a peanut skin prick wheal size of 2 mm asks if they can introduce peanut to their child. What are appropriate recommendations based on the NIAID Guidelines? A.) Introduce thinned peanut butter at home B.) Introduce peanut at 1 year of age C.) Avoid peanut until re-evaluation with testing in 1 year D.) Admit to the hospital for a graded challenge to peanut - Correct Answer A.) Introduce thinned peanut butter at home A man eats a meal with beef and has wheezing, angioedema and urticaria 6 hours afterwards on three separate occasions. What is the cause of his disease? A.) Milk allergy cross-reactivity
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B.) 0.1 mcg/ml C.) 1 mcg/ml D.) 10 mcg/ml - Correct Answer C.) 1 mcg/ml Life-long or indefinite venom immunotherapy is recommended if the patient: A.) is greater than 60 years of age. B.) is currently treated with an angiotensin converting enzyme inhibitor. C.) required IM epinephrine for an historical sting reaction. D.) has a baseline tryptase of 12 ng/ml. - Correct Answer D.) has a baseline tryptase of 12 ng/ml. A 45-year-old male who lives Phoenix, Arizona experiences the sudden onset of generalized urticaria, emesis and lightheadedness during the middle of the night. He was awakened from sleep by the symptoms. The symptoms spontaneously resolved over 45-60 minutes. He is currently on a fishing trip with friends and staying in a mountain cabin. He and his friends had several beers and fresh trout for dinner. An erythematous papule was noted on his neck by one of his friends, but the man did not report any localized itching or pain. The most likely explanation of his reaction is:
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A.) Galactose-alpha-1,3-galactose sensitivity due to Ixodes pacificus bite B.) Salivary protein sensitivity due to Triatoma rubida bite C.) Hyaluronidase sensitivity due to Ctenocephalides felis bite. D.) Salivary protein sensitivity due to Cimex lectularius. - Correct Answer B.) Salivary protein sensitivity due to Triatoma rubida bite Which of the following environmental US extracts is standardized? A.) Dog B.) D. farinae C.) Cockroach D.) Penicillium - Correct Answer B.) D. farinae A 25 year old male presents with a 5 year history of perennial allergic rhinoconjunctivitis with seasonal worsening in the spring and winter. Which of the following immunologic responses would be expected with allergen specific immunotherapy? A.) Initial decrease in allergen specific IgE
