Allergic Disorders

Question 1

This is the strongest predictive factor for having an allergic disorder

Answer 1

Family history

Question 2

There are two types of adverse food reactions

Answer 2

• Immune mediated
• Non-immune mediated

Question 3

There are 3 types of immune mediated adverse food reactions

Answer 3

• IgE: anaphylaxis
• Non-IgE: food protein induced enterocolitis syndrome
• Mixed: eosinophilic esophagitis

Question 4

There are 3 types of non-immune adverse food reactions

Answer 4

• Metabolic: lactose intolerance
• Pharmacological: caffeine
• Toxic: food poisoning

Question 5

This group of adverse food reactions are delayed

Answer 5

Non-IgE mediated reactions

Question 6

This group of adverse food reactions are immediate

Answer 6

IgE mediated reactions

Question 7

What are the steps of an allergic reaction?

Answer 7

• Allergen encounter –> IgE production
• IgE binds mast or basophil surface
• Re-exposure –> 2 IgE cross linking via antigen –> degranulation and release of inflammatory mediators

Question 8

What history should be taken for determining food reactions?

Answer 8

• Suspected food
• Exposure details (route, previous exposure)
• Specific symptoms (cutaneous, resp, GI, cardiovasc)
• Timing of symptoms
• Reproducibility of reaction

Question 9

What are the criteria that make anaphylaxis likely?

Answer 9

At least one of the following:
- Sudden onset with skin or musoca involvement AND sudden resp or decreased BP
- Two or more of the following happen after exposure:
- Skin/mucosal changes
- Sudden resp symptoms
- Sudden BP decrease
- Sudden GI symptoms
- Decreased BP after exposure

Question 10

Symptoms of this type of food allergy are typically isolated to the GI tract

Answer 10

Non-IgE mediated
- rxn likely T-cell mediated

Question 11

Skin testing and serum specific IgE is not helpful in identifying this type of food allergy

Answer 11

Non-IgE mediated
- This is because IgE isn’t made
- No IgE means no rxn to small amount of antigen via skin prick
- No IgE means nothing for 2nd (fluorescent) ab to bind to in serum specific IgE test

Question 12

Presentation of IgE mediated food reactions

Answer 12

• cutaneous, resp, GI, or CV symptoms within min to hours

Question 13

Presentation of non-IgE mediated food reactions

Answer 13

• mainly GI symptoms
• symptom onset takes at least 1 hr after exposure