Makeup, Maseratis, and Mites: Allergies are Everywhere

Question 1:

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A pruritic, edematous eruption involving upper and lower lids, bilaterally, appeared several days after this 53-year-old man borrowed his wife’s eye drops. The presentation suggests that the patient might be allergic to some component of the ophthalmic suspension. The product in question contained neomycin, polymyxin-B, and hydrocortisone.

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The correct answer is B. Neomycin

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Question 2:

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The correct answer is E. A, B, and C
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Question 3:

Sam is an active 9-year old whose mother brings him in for evaluation because he “looks tired all the time” even though he sleeps well. He has also been sneezing a lot after playing outside with friends or helping his father with spring clean up in the yard. You notice slight bluish discoloration under his eyes and that he rubs the side of his nose several times during the visit. The remainder of the exam is unremarkable. Your initial impression is allergic rhinitis and you discuss with the mother the possibility of starting medication. She is hesitant because she is concerned about side effects.

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The correct answer is A. Nasal saline spray
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Question 4:

A 43-year-old woman had erythematous plaques on the cheeks that were more prominent on the right side. She had no pruritus but reported occasional facial burning. The rash had overlying scale and minimal papules. The diagnosis was demodicidosis, caused by the Demodex mite.

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The correct answer is C. The presence of the mite is always pathological
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Question 5:

A 55-year-old man comes to you as a new patient complaining of new-onset cough, wheezing, chest tightness, shortness of breath, and breathing difficulty. He denies having asthma or other respiratory illness. He describes a mild burning sensation in his eyes and nasal passages as well. He and his wife have recently moved to the area where he began work about 3 weeks ago as a foreman at a new high-end automobile parts manufacturing plant. His arrival in early May has allowed him to join the plant’s Frisbee team so he is outside after work several days a week “working up a sweat” and wonders if he may be developing seasonal allergies in his new hometown or if the mold in the basement of the old house they are renovating is bothering him.

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The correct answer is C. Isocyonates
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Question 6:

A 72-year-old woman noted the recent appearance of swelling and itching every time she used her favorite lipstick. She is allergic to an ingredient in the cosmetic. Patch testing should be performed to determine the specific allergen responsible.

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The correct answer is D. A, B, and C
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Question 7:

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The correct answer is A. False positives are less common
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