Pathology EMQ template.

Name: Piriyankan Ananthavarathan

Theme: Allergies

OPTION LIST

A	Adrenaline	I	IgA
B	b-Defensin	J	IgE
C	Complement C3	K	IgG
D	Contrast medium	L	Mast cell (serum) tryptase
E	Corticosteroids	M	Noradrenaline
F	Diluent	N	Peanuts
G	Filaggrin	O	Penicillin
H	Histamine	P

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 30-year-old overweight Asian gentleman presents to his GP several hours after noticing that his skin is becoming increasingly itchy and the appearance of hives after admitting to have consumed a ‘cheeky packet of peanuts’ at work. What is the most likely causative factor in mediating his symptoms?

2. You are a medical student attending an atopy clinic and are observing a doctor administer a skin prick test. The doctor asks you to explain what she is injecting into the patient’s skin as a ‘positive control’. What component makes up the positive control?

3. You are an anaesthetic doctor in surgery and notice that your patient has suddenly developed unexpected widespread rashes and is becoming increasingly hypotensive. You suspect the patient may be having an anaphylactic reaction. What is the best test to determine if the patient is undergoing a systemic allergic reaction in this situation?

4. A miserable-looking child of European descent presents to your clinic with a long, troublesome history of atopic dermatitis. Which component is a potential genetic cause of the child’s atopy that should be considered?

5. A patient with nephrolithiasis is seen by your on-take team at the beginning of a long night shift. You see the patient and refer the patient for appropriate investigations and decide to take a short coffee break. Returning from your break a few hours later, to your dismay, you learn that the patient has developed severe abdominal pain and diarrhoea. The patient also appears to be a little confused. The registrar suggests to you that this may be a non-IgE mediated reaction. What could have happened, and what is the likely cause of the patient’s symptoms?

ANSWERS

1. J

2. H

3. L

4. G

5. D