Immunology Review Corner

Chapter 84 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al.

Prepared by Drs. Karla R. Davis, Landstuhl Regional Medical Center, Germany, and Soo Kim-Delio, Walter Reed Army Medical Center.

Chapter 84: Mastocytosis Syndromes

1. Which of the following cytokines has been associated with bone remodeling in patients with Mastocytosis?
A. IL-3
B. IL-5
C. IL-6
D. TNF-alpha

2. Isolated mastoma of the skin typically occurs before what age?
A. 6 months
B. 3 years
C. 12 years
D. 70 years

3. What is the most common gastrointestinal symptom in patients with mastocytosis?
A. Abdominal pain
B. Diarrhea
C. Nausea
D. Vomiting

4. What is the most common site of pathologic mast cell infiltrates in mastocytosis?
A. Bone marrow
B. Liver
C. Lymph nodes
D. Spleen

5. Bone marrow infiltration with mast cells is associated with radiographically detectable lesions in up to 70 percent of patients. Which bones are most frequently affected?
A. Long bones
B. Pelvis
C. Ribs
D. Skull

6. What is the most common skin manifestation of mastocytosis in both children and adults?
A. Atopic dermatitis
B. Isolated mastocytoma
C. Telangiectasia macularis eruptive perstans
D. Urticaria pigmentosa

7. Dermal mast cells in patients with mastocytosis have been examined by both light and electron microscopy. When mast cells were examined for the presence of tryptase and chymase using specific antibodies, which of the following mast cells were identified?
A. Tryptase-negative, chymase positive
B. Tryptase-negative, chymase negative
C. Tryptase-positive, chymase positive
D. Tryptase-positive, chymase negative

8. What is the most common point mutation of c-kit in patients with mastocytosis?
A. ASP 618 VAL
B. ASP 816 VAL
C. VAL 816 ASP
D. VAL 618 ASP

9. Which mast cell mediator is associated with osteoporosis in patients with mastocytosis?
A. Heparin
B. Histamine
C. Leukotriene C4
D. Tryptase

10. Which of the following clinicopathologic features of mastocytosis is associated with Leukotriene D4?
A. Abdominal pain
B. Bronchoconstriction
C. Pruritis
D. Urticaria

Answers:
1. C, page 1524
2. A, page 1525
3. A, page 1526
4. A, page 1529
5. A, page 1529
6. D, page 1524
7. C, page 1532
8. B, page 1523
9. A, page 1524
10. B, page 1524