PDC Test - Hives

You can earn 0.25 PDC by passing the exam following this article with a score of 85% or better, which has been approved for publication by NCRA's Council of the Academy of Professional Reporters.

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Hives, also called urticaria, are itchy, raised welts, often red in color on the surface of the skin that appear in varying shapes and sizes. Hives are usually red, but they are sometimes skin-colored swellings, and hives have clearly defined edges. The welts may expand, spread, and cluster together, creating larger hives. The welts can also change shape and sometimes will disappear and then reappear almost at will. A breakout of hives can last minutes, hours, or weeks and can occur anywhere on the body. They are classified as acute or chronic, depending on the length of the episode. Most often hives occur as a result of a food allergy or a reaction to medicine. Twenty percent of the population will get hives at least once in their lives. The swelling that accompanies hives is called angioedema.

When you have an allergic reaction, histamine and other compounds are released into your bloodstream from white blood cells called mast cells. This can cause severe itching and swelling. In acute hives many substances can trigger an outbreak such as pollen, insect bites, medicines, shellfish, and nuts. Alcoholic beverages have been known to worsen the condition. You can also get hives as a result of animal dander, especially cats.  Many people break out from hives as a result of emotional stress. Extreme cold or sun exposure, even exercise, can also cause a breakout of hives. Medications such as antibiotics, penicillin, and aspirin are common causes of hives.
There are different kinds of hives.  Because hives can take hours to surface after contact, they are very difficult to diagnose.  Pressure urticaria are hives that present after applying pressure to the skin. Certain illnesses have also been known to cause people to break out in hives. Infections that can cause hives are strep throat, hepatitis, infectious mononucleosis, and the common cold. Often your doctor will give you a blood test to determine if you are having an allergic reaction. A visit to an allergist-immunologist may be necessary if there is a suspicion of food allergies. Generally the specialist will take your history and ask you to keep a food diary. Other tests can help narrow down what is causing your allergic reaction. Unfortunately by the time you get to the doctor, most signs of the hives have faded. Pictures will help capture the condition to show to your physician.

A mild case of hives will probably go away on its own without any treatment. However, on some occasions if you have a severe attack, you may require a shot of epinephrine on an emergency basis. Hives that appear in the throat can cause anaphylaxis, swelling of the airway, making it hard to breathe. 

A chronic episode of hives is called idiopathic urticaria and usually lasts more than six weeks.

Idiopathic is a medical term meaning there is no discernible cause. Chronic urticaria may be associated with thyroid disease or other hormonal problems. Rarely is chronic urticaria associated with cancer.

Hereditary angioedema  is an uncommon, inherited disorder, which can causes sudden swelling. This condition affects one in 6,000 people in the United States.

Although hives are annoying and very uncomfortable, they generally disappear on their own. Sometimes it is very difficult to narrow down the cause of the outbreak. Changing your diet, soap, or detergent will often resolve the problem.

Different treatments you can try to reduce the itching and swelling are cool compresses, calamine lotion, and antihistamines like Benadryl. Benadryl can be bought over the counter but will cause drowsiness. Other antihistamines that work just as well without making you tired.  Topical therapies which help numb nerve endings will reduce the itching. Hot showers, tight clothing, and harsh soaps will aggravate an outbreak of hives.
 Remember, if you break out in hives, scratching will only worsen the itching!
1.  www.acaai.org/public/advice/urtic.htm
2.  www.medicinenet.com/hives/article.htm
3.  http://dermnetnz.org/reactions/urticaria.html
4.  www.mayoclinic.com/health/hives-and-angioedema/DS00313

Test for Hives

1. What causes hives?
 a. Inoculations.
 b. Poison ivy.
 c. Chocolate.
 d. An allergic reaction

2. What is a symptom of having hives?
 a. Itchiness
 b. Nausea.
 c. Dry skin.
 d. Insomnia.

3. What is a common food allergy which can cause hives?
 a. Rice.
 b. Ice cream.
 c. Peanuts
 d. Bread.

4. Urticaria is also known as

 a. Pink rash.
 b. Nettle rash
 c. Poison oak.
 d. Allergitis.

5. What causes hives to be itchy?
 a. Histamine in the body
 b. The shape of the hive.
 c. The treatment.
 d. Medication.

6. How are hives treated?
 a. Physical therapy.
 b. Vitamins.
 c. Antihistamines.
 d. Aspirin.

7. What is angioedema?
 a. A rare form of hives.
 b. A treatment for hives.
 c. Inflammation of the skin.
 d. Swelling that accompanies hives

8. How long can chronic urticaria last for?
 a. Over six weeks
 b. Hours.
 c. Minutes.
 d.  Days.

9. What is anaphylaxis?
 a. A medicine to treat hives.
 b. When the skin has a red tint.
 c. Severe allergic reaction making it difficult to breathe 
 d. Fear of hives.

10. What is pressure urticaria?
 a. Hives caused when you are under stress or tension.
 b. A welt that shows up  in an area of prolonged pressure.
 c. A genetic type of hive.
 d. Fever-induced hives.

11. What type of drugs are Zyrtec, Claritin, and Allegra
 a. Antihistamines
 b. Antibiotics.
 c. Antidepressants.
 d. Blood thinners.

12. Hives are never considered a serious medical problem.
 a. True.
 b. False.

13. Hives are contagious.
 a. True.
 b. False

14. Once you get hives, you can never get them again.
 a. True.
 b. False.

15. What percentage of the population will probably get hives in their lifetime?
 a. 50 percent.
 b. 10 percent.
 c. 5 percent.
 d. 20 percent.

16. What is dermatographia?
 a. When scratching of the skin causes raised red lines where you’ve scratched
 b. An inflammation of the dermis.
 c. Dry skin.
 d. Allergic reaction to cosmetics.

17. Which of these conditions can bring on hives?
 a. Heat.
 b. Cold.
 c. Soap.
 d. All of the above.

18. In what season are hives more likely to appear?
 a. Winter.
 b. Spring.
 c. Any season
 d. Summer.

19. Hives are rarely seen on what parts of the body?
 a. Palms and soles of your feet.
 b. Tongue.
 c. Arms.
 d. Legs.

20. What is Cholinergic Urticaria
 a. Hives caused by high cholesterol.
 b. Hives produced shortly after exercise
 c. Hives produced by chlorine.
 d. Hives produced by an infection