Allergy & Asthma Flashcards

A child with asthma has an FEV1 of 65% predicted on spirometry during a flare. According to NAEPP, this exacerbation severity is classified as:

Answer: Moderate

An FEV1 of 40–69% predicted indicates a moderate asthma exacerbation according to NAEPP guidelines.

Which environmental control measure has the strongest evidence for reducing house dust mite allergen exposure?

Answer: Allergen-impermeable mattress and pillow covers

Allergen-impermeable encasements for mattresses and pillows have the strongest evidence for reducing dust mite allergen concentrations in bedding.

Which finding on methacholine challenge testing is considered a positive result indicating bronchial hyperresponsiveness?

Answer: ≥20% fall in FEV1 at ≤16 mg/mL (PC20 ≤16 mg/mL)

A PC20 of ≤16 mg/mL (≥20% fall in FEV1 at ≤16 mg/mL methacholine) is considered a positive methacholine challenge indicating bronchial hyperresponsiveness.

A patient on subcutaneous allergen immunotherapy (SCIT) develops generalized urticaria and hypotension 15 minutes post-injection. After epinephrine administration, what is the next critical step?

Answer: Observe for at least 4 hours for biphasic reaction

After treating anaphylaxis from SCIT, patients must be observed for at least 4 hours due to the risk of a biphasic anaphylactic reaction.

Which biologic agent targets IL-5 to reduce eosinophil counts and is approved for severe eosinophilic asthma?

Answer: Mepolizumab

Mepolizumab is an anti-IL-5 monoclonal antibody that reduces eosinophil production and is approved for severe eosinophilic asthma.

A patient with allergic rhinitis reports that antihistamines are not adequately controlling nasal congestion. Which mechanism explains why antihistamines poorly control congestion?

Answer: Nasal congestion is primarily mediated by leukotrienes and bradykinin, not histamine

Nasal congestion is primarily driven by leukotrienes, bradykinin, and vascular engorgement rather than histamine, explaining the limited effect of antihistamines.

In exercise-induced bronchoconstriction (EIB), when does peak bronchoconstriction typically occur?

Answer: 5–10 minutes after stopping exercise

EIB typically peaks 5–10 minutes after cessation of exercise as the airways cool and dry, triggering mast cell degranulation and bronchoconstriction.