Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
62 Cards in this Set
- Front
- Back
|
What 2 subfamilies are in the Apidae family?
|
1) Apis Mellifera (honeybee)
2) Bombus Spp (bumblebee) |
|
|
What 3 subfamilies are in the Vespidae Vespinae family?
|
1) Vespula (yellow jacket)
2) Dolichovespula arenaria and maculata (yellow/white faced hornet) 3) Vespa |
|
|
Where do you find Apidae nests?
|
(Honeybee/bumblebee)
Nests hang from trees, contain numerous vertical combs with beeswax. |
|
|
Where are Vespula (Yellow Jackets) nests often found?
|
(Yellow Jacket)
Nests in concealed locations-- underground, in wall cavities, or in decaying logs. |
|
|
Where are Dolichovespula arenaria and maculata (Yellow/White faced hornet) nests found?
|
(Yellow/White faced hornet)
Aerial nests in North America (not Europe). |
|
|
What are Vespa (true hornets) nets like?
|
(True hornets)
Nests are built in tree hollows or wall cavities |
|
|
What are the two subfamilies of the Vespidae family?
|
1. Vespinae
-Vespula, Dolichovespula aerinata and maculata, Vespa 2. Polistinae |
|
|
What are polistes' nests like?
|
(Paper wasp)
Nests are found on eaves or window sills of homes. Single level. |
|
|
What is the subfamily in the Formicidae family?
|
Solenopsis invicta (imported fire ant)
|
|
|
List unique characteristics of the Solenopsis Invicta (fire ant).
|
1. Widespread in southeast US
2. Aggressive 3. Characteristic sterile pustule within 24hrs of sting. (venom high pH) |
|
|
List unique characteristics of the polistes family.
|
1. narrow waist
2. less aggressive 3. can sting repeatedly |
|
|
List unique characteristics of the Vespa (true hornet) family.
|
1. fly at night
2. attracted to light |
|
|
List unique characteristics of the Vespula (yellow jacket) family.
|
1. aggressive
2. found around garbage cans and food |
|
|
How frequently are systemic reactions reported in adults vs. kids?
|
Adults- 3%
Kids- 1% |
|
|
How many fatal stings are there per year in the US?
|
30-50
(50% have prior history of allergy to insect sting) |
|
|
What is the concentration of venom extract used in epicutaneous skin testing?
|
0.01ug/ml
|
|
|
How long do you have to wait after venom provoked systemic anaphylaxis to skin prick test?
|
6 weeks
|
|
|
What is the next step in a patient with a convincing clinical history of venom anaphylaxis when the SPT/IDST Is negative?
|
serologic testing.
If serologies are negative, reskin test to hymenoptera. |
|
|
What is the gold standard in assessing efficacy of venom immunotherapy?
|
sting challenge
**still have a 30-60% chance of anaphylaxis to subsequent stings even with negative sting challenge |
|
|
What is the risk of systemic reaction in any age person with a history of a large local reaction to venom?
|
<10yr= 10%
>10yr=10% |
|
|
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?
|
Child @ <10yr: 10%
Child @ >10yr: 5% Adult @ <10yr: 20% Adult @ >10yr: 10% |
|
|
What is the risk of a future systemic reaction in a child with anaphylaxis s/p venom exposure--@<10yr, @>10yr? In an adult?
|
Child @ <10yr: 40%
Child @ >10yr: 30% Adult @ <10yr: 60% Adult @ >10yr: 40% |
|
|
What is the goal standard maintenance dose for single antigen venom vs. mixed vespids?
|
Single antigen venom- 100ug
(increase to 200ug if treatment failure occurs) Mixed vespid- 300ug of venom |
|
|
Is venom IT indicated for <16yr olds with systemic cutaneous only symptoms?
|
No
|
|
|
What can you do to help prevent local and systemic reactions to IT?
|
premedicate with antihistamines
|
|
|
What is the efficacy rate for venom IT?
|
75-95% efficacy rate with maintenance dose of 100ug (single antigen) or 300ug (multiple antigen/mixed vespids)
|
|
|
What is unique about imported fire ant IT extract? What dose do you use?
|
whole body extract
maintenance dose is 0.5ml of a 1:10 to 1:200 wt/vol |
|
|
When should IT be discontinued?
|
Minimum of 3-5 years
Consider continuation if pts have a very severe initial reaction, systemics while on IT, or honeybee allergy. |
|
|
What is the most common cause of systemic reactions to venoms?
|
Kissing bug (triatoma)
|
|
|
What is unique about Triatoma insect bites?
|
Occurs at night
Western US Painless Insect BITES (not sting) |
|
|
What is skeeter syndrome?
|
Large local reactions to mosquito bites; sensitization to mosquito salivary secretions
|
|
|
Name a few insects that cause inhalent allergies?
|
Autralian jumper ant (Myrmecia) - related to fire ant, but does not cross react with fire ant
butterfly cockroach Dust mite lady bug midges moth silver fish |
|
|
What protein in unique to Honey Bee venom?
|
Mellitin (50% of venom protein)
|
|
|
How is honey bee venom standardized?
|
Phospholipase A2 content
|
|
|
What protein is unique to Vespid venom?
|
Antigen 5
|
|
|
How is vespid venom standardized?
|
Hyaluronidase
|
|
|
What is unique about imported fire ant venom?
|
primarily composed of alkaloids
|
|
|
What physical finding is characteristic of IFA stings?
|
sterile pustule
-Neutrophils at 24hrs -Eosinophils/ plasma cells at 72hrs |
|
|
Do the vespids and Polistes wasp cross react?
|
yes-- hyaluronidase shows some cross reactivity
|
|
|
T or F:
A common source for venom proteins in IFA is the venom sac. |
False- use whole body extracts for IT
|
|
|
Which venom is the least effective and has the highest risk of systemic IT reactions?
|
honey bee
|
|
|
Are old world hornet (ariel yellow jacket) venoms used for SPT or IT?
|
No
|
|
|
T or F:
Tryptase is always elevated in anaphylaxis to venom. |
False (elevated about 50% of the time)
|
|
|
Is IT indicated for atopic dermatitis?
|
Yes
|
|
|
How long does cat allergen remain after the cat is removed from the home?
|
6 months
|
|
|
Which stinging insect if responsible for most human stings?
|
yellow jacket
|
|
|
Why not screen the population for specific IgE testing?
|
20% of population has spedicific IgE and will eventually lose it
|
|
|
Why do SPT vs specific IgE for stinging insect allergy?
|
specific IgE testing may miss up to 20% of allergic patients
SPT will miss 10% (more sensitive and specific) |
|
|
What's the risk of systemic reaction in the general population?
|
16-17%
|
|
|
What is the rate of systmic reactions in IT build up for stinging insects? What is the rate of need for epi?
|
build up - 5-15%
need epi - <5% |
|
|
Which stinging insect if responsible for most human stings?
|
yellow jacket
|
|
|
Why not screen the population for specific IgE testing?
|
20% of population has spedicific IgE and will eventually lose it
|
|
|
Why do SPT vs specific IgE for stinging insect allergy?
|
specific IgE testing may miss up to 20% of allergic patients
SPT will miss 10% (more sensitive and specific) |
|
|
What's the risk of systemic reaction in the general population?
|
16-17%
|
|
|
What is the rate of systmic reactions in IT build up for stinging insects? What is the rate of need for epi?
|
build up - 5-15%
need epi - <5% |
|
|
What are risk factors for venom IT reactions?
|
mastocytosis
MMAS elevated tryptase honeybee ACEI beta blockers rush/cluster IT (may be controversial, may not be true in venom cluster) female atopy |
|
|
When does pollen peak?
|
late night to early morning
"don't sleep with your windows open" |
|
|
If you significantly decrease dust mite in home, what improvements could be seen in patients?
|
improved AD
decreased bronchial hyperreactivity |
|
|
For decreasing dust mites, what temperature should you wash your sheets?
What humidity should the house be set at? |
130 degress
<50% humidity |
|
|
What is the size of the pore to prevent dust mite?
|
<10 um
|
|
|
What is the time for cockroach (Bla G1-4) to decrease after removal?
|
6 months
|
|
|
For decreasing fungus what humidity do you want to keep the house at?
|
<40%
|
