Immunology Review Corner

Immunology Review Corner: Chapter 64 Part B of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al.

Questions prepared by Karla R. Davis, Walter Reed Medical Center, and Anne K. Ellis, McMaster University.

Chapter 64, Part B (pages 1148-1168): Epidemiology of Asthma and Allergic Disease

1. Which of the following statements with regard to airway reactivity in patients with a history of bronchopulmonary dysplasia (BPD) is the most accurate?

A. Airway reactivity in patients with a history of BPD in infancy is strongly associated with a family history of asthma.
B. Airway reactivity in patients with a history of BPD is associated with an increased prevalence of atopy.
C. Most patients with a history of BPD during infancy do not have pulmonary dysfunction as adolescents and young adults.
D. Airway reactivity in patients with a history of BPD in infancy is not associated with a more frequent family history of asthma.

2. Occupational asthma is caused by exposure to a specific agent or conditions in a particular occupational setting. Which of the following groups of agents is correctly paired with the suspected pathogenic mechanism?

A. High-molecular-weight agents: induce occupational asthma by nonimmunologic mechanisms
B. Low-molecular-weight agents: induce specific IgE antibodies
C. Irritant gases, fumes and chemicals: induce specific IgE antibodies
D. High-molecular-weight agents: induce specific IgE antibodies

3. Studies have investigated the possible role of specific air pollutants in the development of asthma. Which of the following, related to road traffic, has been associated with an increased prevalence in physician-diagnosed asthma (after adjusting for potential confounders)?

A. Benzene
B. Sulfur dioxide
C. Nitrogen dioxide
D. Carbon monoxide

4. In 2000, The Institute of Medicine, Committee on the Assessment of Asthma and Indoor Air, published “Clearing the air: asthma and indoor air exposures.” According to data from the Institute of Medicine, for which of the following indoor exposures is there significant evidence of a causal relationship in the development of asthma?

A. Cat
B. Dog
C. House dust mite
D. Cockroach

5. Which of the following statements regarding determinants in childhood asthma is the most accurate?

A. Asthma occurs more frequently in girls than boys.
B. Smoking during adolescence has been associated with decreased risk for the persistence of symptoms.
C. Treatment of asthma in childhood alters the natural history of the disease.
D. Persistence of eczema has been associated with persistence of asthma.

6. The 1996 National Health Interview Survey (NHIS) estimated that about 24 million Americans have allergic rhinitis. In which area of the country was the highest prevalence of seasonal allergic rhinitis reported?

A. South
B. West
C. Midwest
D. Northeast

7. Which of the following risk factors for allergic rhinitis is best supported by current epidemiologic studies?

A. Very young age
B. Air pollution
C. Low socioeconomic status
D. Parental history

8. In 2000, The Institute of Medicine, Committee on the Assessment of Asthma and Indoor Air, published “Clearing the air: asthma and indoor air exposures.” According to data from the Institute of Medicine, for which of the following biological agents is there sufficient evidence of a causal relationship for exacerbation of asthma in sensitive individuals?

A. Chlamydia trachomatis
B. Cow
C. Houseplants
D. Cockroach

9. In 2000, The Institute of Medicine, Committee on the Assessment of Asthma and Indoor Air, published “Clearing the air: asthma and indoor air exposures.” According to data from the Institute of Medicine, for which of the following chemical agents is there sufficient evidence of a causal relationship for exacerbation of asthma in sensitive individuals?

A. Environmental tobacco smoke in preschool children
B. Formaldehyde
C. Environmental tobacco smoke in school-aged children
D. Pesticides

10. Which of the following statements regarding tobacco smoking and asthma is the most accurate?

A. Young smokers have greater lung function and a lesser degree of underlying airway responsiveness than nonsmokers.
B. Smokers report wheezing less frequently than do nonsmokers.
C. Active cigarette smoking has been directly linked to asthma as a cause.
D. Active smoking decreases nonspecific airway responsiveness.

11. The Tucson study by Martinez et al. described the natural history of wheezing beginning before age 3 years. Continued wheezing up to age 6 years was associated with which of the following?

A. Maternal history of asthma
B. Diminished airway function in early life
C. Decreased IgE levels
D. Paternal history of asthma

Answers:
1. D, page 1148
2. D, page 1149
3. A, page 1152
4. C, page 1154
5. D, pages 1159-1160
6. B, page 1162
7. D, page 1163
8. D, page 1155
9. A, page 1155
10. A, pages 1154-55
11. A, page 1156