I also have a 1990 D150. she had the same exact problem. There's a ( what the dealer calls ) throttle kicker solenoid that controls the idle. if your looking at the truck its on the right of the throttle body with a 4 pin connector and a bolt looking thing making contact to where your throttle cable hooks up too. unplug it and take it off. if your idle drops down like mine did that's your problem. its not retracting all the way. the part number at the dealer is 04288256 and its number 16 on their diagrams. the problem is that it costs 236 bucks for a new one since its now a vintage part, and if it gets cold where you live you need it. hope this helped you out.
Idle air control needs cleanin or replacin-the motor wears out--inspec whole area and get a haynes manual at parts place for troublshootn
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