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47 Cards in this Set
- Front
- Back
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What 2 subfamilies are in the Apidae family?
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1) Apis Mellifera (honeybee)
2) Bombus Spp (bumblebee) |
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What 3 subfamilies are in the Vespidae Vespinae family?
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1) Vespula (yellow jacket)
2) Dolichovespula arenaria and maculata (yellow/white faced hornet) 3) Vespa |
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Where do you find Apidae nests?
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(Honeybee/bumblebee)
Nests hang from trees, contain numerous vertical combs with beeswax. |
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Where are Vespula nests often found?
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(Yellow Jacket)
Nests in concealed locations-- underground, in wall cavities, or in decaying logs. |
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Where are Dolichovespula arenaria and maculata nests found?
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(Yellow/White faced hornet)
Aerial nests in North America (not Europe). |
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What are Vespa nets like?
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(True hornets)
Nests are built in tree hollows or wall cavities |
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What are the two subfamilies of the Vespidae family?
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1. Vespinae
-Vespula, Dolichovespula aerinata and maculata, Vespa 2. Polistinae |
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What are polistes' nests like?
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(Paper wasp)
Nests are found on eaves or window sills of homes. Single level. |
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What is the subfamily in the Formicidae family?
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Solenopsis invicta (imported fire ant)
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List unique characteristics of the Solenopsis Invicta (fire ant).
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1. Widespread in southeast US
2. Aggressive 3. Characteristic sterile pustule within 24hrs of sting. |
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List unique characteristics of the polistes family.
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1. narrow waist
2. less aggressive 3. can sting repeatedly |
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List unique characteristics of the Vespa family.
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1. fly at night
2. attracted to light |
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List unique characteristics of the Vespula family.
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1. aggressive
2. found around garbage cans and food |
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How frequently are systemic reactions reported in adults vs. kids?
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Adults- 3%
Kids- 1% |
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How many fatal stings are there per year in the US?
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30-50
(50% have prior history of allergy to insect sting) |
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What is the concentration of venom extract used in epicutaneous skin testing?
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0.01ug/ml
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How long do you have to wait after venom provoked systemic anaphylaxis to skin prick test?
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6 weeks
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What is the next step in a patient with a convincing clinical history of venom anaphylaxis when the SPT Is negative?
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serologic testing.
If serologies are negative, reskin test to hymenoptera. |
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What is the gold standard in assessing efficacy of venom immunotherapy?
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sting challenge
**still have a 30-60% chance of anaphylaxis to subsequent stings even with negative sting challenge |
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What is the risk of systemic reaction in any age person with a history of a large local reaction to venom?
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<10yr= 10%
>10yr=10% |
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What is the risk of a future systemic reaction in a child with hives and angioedema s/p venom exposure--@<10yr, @>10yr? In an adult?
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Child @ <10yr: 10%
Child @ >10yr: 5% Adult @ <10yr: 20% Adult @ >10yr: 10% |
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What is the risk of a future systemic reaction in a child with anaphylaxis s/p venom exposure--@<10yr, @>10yr? In an adult?
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Child @ <10yr: 40%
Child @ >10yr: 30% Adult @ <10yr: 60% Adult @ >10yr: 40% |
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What is the goal standard maitenance dose for single antigen venom vs. mixed vespids?
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Single antigen venom- 100ug
(increase to 200ug if treatment failure occurs) Mixed vespid- 300ug of venom |
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Is venom IT indicated for <16yr olds with systemic cutaneous only symptoms?
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No
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What can you do to help prevent local and systemic reactions to IT?
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premedicate with antihistamines
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What is the efficacy rate for venom IT?
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75-95% efficacy rate with maintenance dose of 100ug (single antigen) or 300ug (multiple antigen/mixed vespids)
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What is unique about imported fire ant IT extract? What dose do you use?
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whole body extract
maintenance dose is 0.5ml of a 1:10 to 1:200 wt/vol |
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When should IT be discontinued?
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Minimum of 3-5 years
Consider continuation if pts have a very severe initial reaction, systemics while on IT, or honeybee allergy. |
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What is the most common cause of systemic reactions to venoms?
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Kissing bug (triatoma)
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What is unique about Triatoma insect bites?
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Occurs at night
Western US Painless Insect BITES (not sting) |
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What is skeeter syndrome?
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Large local reactions to mosquito bites; sensitization to mosquito salivary secretions
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Name a few insects that cause inhalent allergies?
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butterfly
cochroach Dust mite lady bug midges moth silver fish |
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What component of Honey Bee venom is unique to this group?
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Mellitin (50% of venom protein), Phospholipase A2
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How is honey bee venom standardized?
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Phospholipase A2 content
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What component of Vespid venom is unique to this group?
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Antigen 5
Phospholipase |
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How is vespid venom standardized?
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Hyaluronidase
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What is unique about imported fire ant venom?
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primarily composed of alkaloids
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What physical finding is characteristic of IFA stings?
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sterile pustule
-Neutrophils at 24hrs -Eosinophils/ plasma cells at 72hrs |
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Do the vespids and Polistes wasp cross react?
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yes-- hyaluronidase shows some cross reactivity
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T or F:
A common source for venom proteins in IFA is the venom sac. |
False- use whole body extracts for IT
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Which venom is the least effective and has the highest risk of systemic IT reactions?
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honey bee
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Are old world hornet (ariel yellow jacket) venoms used for SPT or IT?
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No
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T or F:
Tryptase is always elevated in anaphylaxis to venom. |
False (elevated about 50% of the time)
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Is IT indicated for atopic dermatitis?
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Yes
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How long does cat allergen remain after the cat is removed from the home?
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6 months
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Is IT indicated for atopic dermatitis?
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Yes
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How long does cat allergen remain after the cat is removed from the home?
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6 months
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