Allergy FIT Board Review Middleton 8th with Questions and Answers

Allergy FIT Board Review Middleton 8th with Questions and Answers Bronchial challenges are useful tests for the evaluation of asthma. Tests can be performed with direct acting constrictors or indirect-acting constrictors. Which of the following is an example of an indirect-acting constrictor? a. Histamine b. Methacholine c. Albuterol d. Mannitol ANSWER 1. D, pg.757 Both methacholine and histamine are considered direct-acting constrictors in bronchial challenges. Indirect acting constrictors include mannitol, adenosine, exercise, and cold air. There is little difference between the use of histamine and methacholine; however, methacholine is used more widely due to fewer side effects. One disadvantage of the direct acting constrictors is that they produce positive tests for patients with asthma and COPD. This has led to the use of alternative agents that act indirectly by releasing mediators from mast cells in the airway. However, the indirect acting constrictors have not been studied as extensively as methacholine and histamine. Currently there is no validated questionnaire for the diagnosis of food allergy. What is considered the gold-standard for the diagnosis of food allergy? a. Open food challenge b. Double-blinded placebo controlled food challenge c. Specific IgE testing d. Blinded food challenge ANSWER 2. B, pg. 758 The gold standard for diagnosing food allergy is the double-blinded placebo controlled food challenge. Currently there are no validated questionnaires for the diagnosis for food allergy, unlike other allergic conditions. This has complicated the epidemiologic study of food allergy. Many reported food allergy symptoms are unable to be confirmed when a full diagnostic evaluation is completed. As such, estimates from invalidated questionnaires are