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Self-Assessment Questions


Food Allergies in Children: Review Questions

Kenneth Paris, MD, MPH , and Ricardo U. Sorensen, MD

Dr. Paris is a fellow, and Dr. Sorensen is a professor and chairman; both are in the Department of Pediatrics, Section of Allergy and Immunology, Louisiana State University Health Sciences Center, New Orleans, LA.

Choose the single best answer for each question.

1. An 8-year-old boy presents to the emergency department in respiratory distress. His symptoms began within 15 minutes after he ate a chocolate chip cookie, and he has had similar reactions after eating foods containing peanuts and other ingredients. Physical examination reveals diffuse urticaria, angioedema, and bilateral wheezing. The patient is treated with epinephrine, antihistamines, and oral corticosteroids, and he recovers. What type of hypersensitivity reaction has this patient experienced?
  1. Type I
  2. Type II
  3. Type III
  4. Type IVa
  5. Type IVb
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2. A 4-year-old boy presents to his primary care physician for a well-child examination and routine immunization. In the time between his first measles-mumps-rubella (MMR) vaccine and now, he has developed severe atopic dermatitis. Evaluation by an allergist/immunologist revealed IgE-mediated allergy to egg, soy, and peanut. He has had anaphylaxis after eating peanut, and eating eggs results in urticaria and worsening of his atopic dermatitis. His mother read that MMR vaccine is produced from eggs and is concerned about a possible reaction. What is the next course of action for this patient?

  1. Proceed with the vaccination
  2. Refer the patient for desensitization to egg protein and then proceed with immunization
  3. Delay vaccination because of the history of documented egg allergy
  4. Repeat skin prick testing and, if negative, proceed with immunization
  5. Use gradually increasing doses of the vaccine to decrease the risk of a reaction
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3. A 10-year-old girl has a history of perennial allergic rhinitis with seasonal exacerbations in April and May. In vitro testing revealed IgE-mediated allergy to several inhalant allergens, including birch tree pollen, Aspergillus fumigatus, and dust mite. She also complains that ingestion of certain foods causes her mouth and lips to itch. Which of the following foods is most likely to cause this patient’s oral symptoms?
  1. Wheat
  2. Apple
  3. Soy
  4. Milk
  5. Tomatoes
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4. Which of the following is a current recommendation of the American Academy of Pediatrics (AAP) for decreasing the incidence of food allergy in at-risk children?

  1. Breast feed exclusively for 12 months
  2. Include peanut in the lactation diet to induce oral tolerance
  3. If unable to breast feed, use soy-based formulas rather than cow’s milk formula
  4. Delay introduction of solid foods
  5. Begin feeding whole cow’s milk at age 4 months, before allergies develop
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Updated 1/04/08 • kkj