American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the first-line treatment for patients with systemic reactions to egg exposure receiving influenza vaccines?

1. Inactivated influenza vaccine

2. Live-attenuated influenza vaccine

3. Awaiting further studies

4. Referral for allergy evaluation

The correct answer is: Referral for allergy evaluation

The first-line treatment for patients who have experienced systemic reactions to egg exposure when receiving influenza vaccines is indeed referral for allergy evaluation. This process is important because it allows a thorough assessment of the patient's specific allergies and any potential risks associated with receiving the influenza vaccine. Patients with a history of anaphylaxis or severe allergic reactions to eggs may have concerns regarding the safety of receiving the influenza vaccine, especially since some formulations may contain trace amounts of egg protein. An allergy evaluation can help determine the severity of the patient's egg allergy, provide guidance on the appropriate vaccine formulation, and may lead to identifying alternative vaccination strategies. In some cases, individuals with egg allergies may safely receive the inactivated influenza vaccine under medical supervision, if evaluated as safe by an allergist. For patients with severe egg allergies, specialized formulations or the use of the flu vaccine in a controlled setting can also be considered, but these considerations highlight the need for a proper evaluation to make an informed decision regarding vaccination. The options related to the vaccine formulations, such as the inactivated influenza vaccine or the live-attenuated influenza vaccine, do not address the immediate concern of safely managing patients with severe allergies; hence, a referral for allergy evaluation serves as the best initial step in ensuring patient safety and appropriate care