Immunotherapy Safety for the Primary Care ... - U.S. Coast Guard

15. A 12 yo male presents for his allergy injection. He has asthma and is on several medications.
His mother stated that after his last injection, he had an increase in coughing, but no wheezing or
other chest complaints. The coughing continued through the night but resolved the next day.
What dose of his immunotherapy would you administer next?
a. Repeat the last dose given since this may be the patient’s baseline
b. Advance as per protocol since this may be the patient’s baseline
c. Decrease or hold the dose per allergist’s dose adjusting instructions as if the patient had a
systemic allergic reaction from the last injection
d. Decrease by 25% after pretreating with albuterol and Benadryl before today’s shot
16. A patient comes in for her shot. She has asthma; therefore pulmonary function testing is
done prior to her shot. Her Peak Flow is 24% lower than her normal baseline. It is permissible to
give her allergy shot today.
a. Yes
b. No
17. You DO NOT reduce the first dose when administering venom from a refill vial.
a. True
b. False
18. You have received a set of new vials for a patient. The vials have red tops and previously the
vials had blue tops. The accompanying schedule directs that the vial progression is from green to
blue to yellow to red tops. What should you do?
a. Notify the prescribing allergist’s office of a possible error and do not give any further
injections until clarified
b. Give the recommended starting dose of 0.05 cc SQ per protocol
c. Give ½ of the recommended starting dose
d. Start over in the previous vials (blue tops)
19. Your patient is 6 weeks late for his allergy shot and his Allergist has asked that you “reduce
this shot by 75%”. His last shot was 0.50 cc from his yellow (1:10 v/v) vial. Today's dose would
be?
a. 0.1 cc from his yellow (1:10) vial
b. 0.4 cc from his blue (1:100) vial
c. 0.25 cc from his blue (1:100) vial
d. 0.05 cc from his yellow (1:10) vial
20. You decide in question #19 to give your patient a dose from his blue vial, but find his blue
vial has expired. To make a blue vial from his yellow vial, you would…
a. Add 1.0 cc of yellow vial to 10.0 cc of sterile albumin/saline diluent
b. Add 0.05 cc of yellow vial to 4.5 cc of sterile albumin/saline diluent
c. Add 0.2 cc of yellow vial to 1.8 cc of sterile albumin/saline diluent
d. Add 3.0 cc of yellow vial to 9.0 cc of sterile albumin/saline diluent