Immunology Review Corner

Immunology Review Corner: Chapter 65 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al.

Prepared by Karla R. Davis, Walter Reed Medical Center; Anne K. Ellis, McMaster University; and J. Michael Norvell, Vanderbilt University

Chapter 65: Natural History, Development, and Prevention of Allergic Disease in Childhood

1. Which of the following study designs is able to identify risk factors associated either with the new onset of a disease or with the severity of an illness?

A. Cross-sectional
B. Retrospective
C. Quasi-experimental
D. Longitudinal

2. Specific IgE antibodies to food allergens are detectable in up to which percentage of 1-year-old children?

A. 5%
B. 10%
C. 15%
D. 25%

3. Sensitization against inhalant allergens generally develops in children at which of the following ages?

A. The first months of life
B. The first year of life
C. Between 1 and 2 years of life
D. After 3 years of life

4. Atopic eczema is primarily related to IgE responses to which of the following?

A. Dietary allergens
B. House dust mites
C. Pollens
D. Molds

5. Cohort studies of children with asthma in Germany, Australia and the United States have shown that early sensitization is a characteristic feature of childhood asthma. Which of the following has been most closely associated with an increased risk of asthma?

A. Sensitization to inhalant allergens after 8 years of age
B. Paternal history of asthma
C. Elevated concentration of total serum IgE at birth
D. Food sensitization before age 1 to 2 years

6. Different mechanisms may determine allergic sensitization during childhood. Which of the following statements with regard to allergen sensitization and development of asthma is the most accurate?

A. Sensitization related to asthma occurs at low doses, with no dose-response association with the degree of exposure to the corresponding allergen.
B. Sensitization related to asthma occurs at low doses and has a strong dose-response association with the degree of exposure to the corresponding allergen.
C. Sensitization related to asthma occurs at very high doses of allergen exposure.
D. The development of allergic sensitization is not different among specific allergen exposures; such as cat, dog, and house dust mite.

7. Environmental exposure to which of the following, as assessed in mattress dust levels, significantly decreases the risk of hay fever, atopic sensitization, and atopic asthma in childhood?

A. Fungi
B. Mold
C. Endotoxin
D. Gram-positive germs

8. There is evidence of a dose-response relationship between allergen exposure and atopic sensitization to the specific allergen for which of the following allergens?

A. Dog
B. Dust mite
C. Cockroach
D. Ragweed

9. Contact with which of the following is thought to explain the relationship between farming and atopy?

A. Rodents
B. Smog-free air
C. Livestock
D. Silos

10. By the school-age years, which percentage of children in a Western population will be sensitized to one of the following environmental allergens: house dust mites, animal dander, various pollens, and molds?

A. 0-25%
B. 5-15%
C. 15-25%
D. 25-65%

Answers:
1. D, page 1169
2. B, page 1169
3. D, page 1169
4. A, page 1169
5. D, page 1170
6. A, page 1171
7. C, page 1172
8. B, page 1170
9. C, page 1172
10. D, page 1169