Stinging Insects Quiz

Hymenoptera is the name for the order of insects that are stinging insects. This includes bees, fire ants, hornets, wasps and yellow jackets.

It is estimated that potentially life-threatening systemic reactions (called anaphylaxis) to insect stings occur in 0.4% to 0.8% of children and 3% of adults. In the United States, at least 40 deaths are attributed to Hymenoptera stings each year (Stinging insect hypersensitivity: A practice parameter update 2011. The Journal of Allergy and Clinical Immunology. Volume 127, Issue 4, Pages 852-854.e23).

This quiz will test your knowledge of stinging insect allergy and what to do in the event of a severe allergic reaction.

Question 1
All of the following are ways to avoid insect stings except:
a. Not wearing clothes with flower patterns
b. Having wasp nests removed from the around the house
c. Wearing shoes, socks and work gloves when working outdoors
d. Keeping food and drink containers closed when outdoors

Answer a: Insects do not see the same spectrum of light that we do and so what we see as a flower pattern on clothing does not look like a flower to them.

Question 2
The first medicine to use for a severe allergic reaction to an insect sting is:
a. Diphenhydramine (Benadryl®)
b. Epinephrine auto-injector
c. Albuterol inhaler
d. Acetaminophen (Tylenol®)

Answer b: While all of the medicines listed may be used in someone having a severe allergic reaction to an insect sting, the only medicine that treats all the symptoms potentially associated with an allergic reaction to insects is epinephrine.

Question 3
After using an epinephrine auto-injector, you should seek emergency medical care.
True
False

True: A severe allergic reaction may sometimes last hours. Epinephrine works quickly but may only last for 15 to 20 minutes. Therefore additional medical care may be required.

Question 4
After receiving emergency care for a severe allergic reaction to an insect sting, which of the following therapeutic interventions should be accomplished:
a. A discussion of how best to avoid future stings
b. A prescription for an epinephrine auto-injector
c. A referral to an allergist/immunologist
d. All of the above
e. None of the above

Answer d: All of these are recommended by national guidelines after experiencing a severe allergic reaction to an insect sting.

Question 5
The technical name for a severe allergic reaction is:
a. Bronchospasm
b. Urticaria
c. Anaphylaxis
d. Hypotension

Answer c: Anaphylaxis means severe allergic reaction. The other terms are technical words for some of the symptoms associated with anaphylaxis. Bronchospasm means wheezing. Urticaria means hives. Hypotension means low blood pressure.

Question 6
There is no treatment to prevent recurrence of a severe allergic reaction to an insect.
True
False

False: Your allergist/immunologist can test you for your insect sting reaction. If your tests are positive, venom immunotherapy (allergy shots) may be started. Venom immunotherapy has have been shown to almost completely eliminate the chance of a severe reaction with future stings.

Question 7
Anaphylaxis occurs when the immune system gets involved and overreacts to the insect venom, causing symptoms in more than one part of the body such as:
a. Swelling of the face, throat or tongue
b. Difficulty breathing
c. Dizziness
d. Stomach cramps
e. Nausea or diarrhea
f. Itchiness and hives over large areas of the body
g. All of the above.

Answer g: If you have these symptoms after an insect sting, inject epinephrine immediately and get emergency medical treatment. After receiving this medical treatment, make an appointment with an allergist / immunologist. With proper testing, your allergist can diagnose your condition and help you learn how to stay safe in the future.

Question 8
Allergic reactions to insect stings:
a. Usually get worse with every future sting
b. Occur unpredictably and can vary from sting to sting
c. Are a “fluke” and very unlikely to happen from a future sting

Answer b: Most people do not get worse with each sting. It is important to note that people can get stung many times in their lives with no reaction and then have a severe allergic reaction to a sting. Once the person is allergic, there is a high chance of a severe reaction happening again. A reaction could happen one time and not another because of differences in the insects or differences within our bodies.

Question 9
Allergy tests for insect stings:
a. Should be done only in people who have had severe allergic reactions
b. Should be done in everyone to screen for possible severe reactions to stings
c. Can predict how severe a reaction will be

Answer a: Allergy tests show when a person has allergic antibodies to insect venoms, but cannot predict how bad a reaction will be. Also, allergy tests can show positive in people who do not react to stings and so cannot be used as a screening test. So allergy tests for insect stings should be done only in people who have had severe allergic reactions. The tests are used to confirm the allergy when someone has a severe reaction, and to identify which insects someone is allergic to.

Question 10
Which of the following may increase the risk of fatal anaphylaxis from a Hymenoptera sting in someone with a stinging insect allergy:
a. Delay in administering epinephrine
b. Delay in taking Benadryl
c. Not applying ice to the sting site
d. Calling 911, after administering epinephrine

Answer a: Delay in administering epinephrine. Prompt use of epinephrine in the upper outer thigh is the only therapy that is effective in reducing the risk of fatal anaphylaxis. Delaying the administration of epinephrine increases the risk of death.

Question 11
Epinephrine is most rapidly active when administered:
a. Just beneath the skin in the upper arm
b. Within the muscle in the upper arm
c. Just beneath the skin in the thigh
d. Within the muscle in the upper, outer thigh

Answer d: Blood levels of epinephrine are much higher and achieved much faster when administered within the muscle in the upper, outer thigh.

You answered   questions correctly.

 

Learn more about stinging insect allergy symptoms, diagnosis, treatment and management.

AAAAI - American Academy of Allergy Asthma & Immunology