What and Why
Etiology
H&P
Diff Dx
Treatment
100
these are characteristic diagnostic Hx and PE findings of urticaria
1. ___
2. ___
3. ___
4. ___ (this one is one word not used in the article)
what is...
pruritic
well-circumscribed
erythematous
edematous
evanescent
100
The article lists six ways allergens and/or non-allergens can cause IgE mediated reaction, name three
what are...
air-dust mites, animal dander, mold spores, pollen, cockroach
contact-rubber latex, chemicals (preservatives/dyes/fragrances/detergents/topical), plant products, metal (cobalt and nickel)
food-banana, kiwi, apple, carrot, tomato, potato, shrimp/shell fish
insect venom
meds-benzocaine, camphor, witch hazel
parasites-helminths and protozoa
100
the article lists 8 historical line of questions, name four
what is
onset, possible triggers, timing, duration, location on body, appearance, exacerbating and relieving factors
100
characteristic distribution of maculopapular scaling pruritic rash
what is atopic dermatitis
100
this is step1 treatment for urticaria
what are 2nd generation H1-antihistamines
200
Urticaria plus THIS are two commonly referred to conditions related to histamine release from mast cell activation
what is angioedema
200
this is the percentage of chronic urticaria that is considered idiopathic
what is 80%-90%
200
Listed are seven possible signs or symptoms that may indicate a more severe problem or alternate diagnosis. name at least three
what are:
angioedema, bronchospasm, hypotension,
emesis or diarrhea
abdominal pain or burning pain of lesions
200
weeks long rash, herald patch, Christmas tree pattern on trunk
what is Pityriasis rosea
200
step 2 treatment of urticaria includes this
what is higher doses of H1 2nd get antihistamines, up to 4x the dose
300
these are characteristic diagnostic Hx and PE findings of angioedema
-what is
non-pitting
non-pruritic
interstitial tissue edema
-also, many areas of angioedema >24hrs
300
these are the two medications listed that typically trigger non-IgE related mast cell activation
what are NSAIDS and vancomycin that directly trigger the MRGPRX2 receptor
also includes opioids & RCM
300
key components of an exam include vitals signs and heart and lung exam and examination of current lesions. Additionally, this is one specific skin exam finding
300
pruritic lesions lasting several days, known or likely exposure to insects
what are arthropod bites
300
step 3 for urticaria
add 1st gen H1 blockade
switch to different 2nd generation H1
add montelukast LTRA
400
As a cause of urticaria, this is the BEST understood mechanism for mast cell activation
what is type 1 IgE hypersensitivity reaction
400
these are the physical stimuli that can trigger chronic urticaria, of the six listed, name three
what are...
cold, heat, water, light, vibration and pressure (friction)
400
initial lab testing to consider in chronic urticaria include these, name three of the six listed
what is CBCD, TSH, LFT's, ESR, CRP, total IgE, and IgG TPO
400
this maculopapular rash often includes a word that means "little plague" that can many potential causes, Table 2 lists two common causes
what is a Morbilliform rash two common causes include viral exanthem and drug reaction
400
in pregnancy and breast feeding, these are the recommended antihistamines
what are loratadine and cetirizine
500
urticaria is considered benign when it only is noted at these skin layers
what is the dermis/epidermis skin layers
500
angioedema, which often co-occurs with urticaria, can be mediated by these two compounds-histamine and ________
what is bradykinin
500
Bonus: Although not always definitive, this can be these features may help to differentiate histamine induced reaction from bradykinin
What are hives, speed of onset and response to usual anti-histamines or steroids
500
Bonus: two reasons, (not mentioned in the article) to be cautious to start Xolair in primary care
What is cost ($3000-5000/month) and risk of anaphylactic reaction and always 1st admin in office