Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > Allergic GI diseases, Allergic rhinitis, Conjunctivits > Flashcards

Allergic GI diseases, Allergic rhinitis, Conjunctivits Flashcards

1
Q

How to test for IgE mediated food allergies

A
  • skin prick test

- specific IgE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How to test for non-IgE mediated food allergies

A
  • atopy patch test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Food allergy classification

A

IgE mediated

  • immediate GI hypersensitivity
  • Pollen associated allergy syndrome

non-IgE mediated disorders

  • food protin induced enterocolitis syndrome (FPIES)
  • food protein induced allergic proctolitis (AP)
  • food protein enteropathy

mixed IgE and cell-mediated

  • eosinophilic esophagitis
  • eosinophilic gastritis
  • eosinophilic gastroenteritis
  • Eosinophilic colitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Immediete gastrointestinal hypersensitivity

A
  • igE mediated mast cell degranulation
  • nausea, vomiting, diarrhea, colic or abdominal pain within minutes to 2 hours after ingestions
  • latent allergen exposure: vomiting may be followed by anorexia, poor weight gain, abdominal pain and colic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Immediete gastrointestinal hypersensitivity

- diagnosis and treatment

A
  1. Sensitization to the food
  2. Oral food challenge

Treatment:
- dietary therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Oral allergy syndrome

A

IgE mediated mast cell degranulation

  • itching, burning, erythema or tingling of the lips, tongue, palate or oropharynx wihtin minutes or during raw allergen ingestions
  • resolution shortly afterwards
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Oral allergy syndrome

- diagnosis and treatmetn

A
  1. sensitization to the plant food
  2. Sensitization to pollen
  3. Correlation between the plan food(s) in question and pollens to which the patient is sensitizes
    +/- oral food challenge

Treatment:
avoidance of raw foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Eosinophilic esophagitis

A
  • T-cell and IgE mediated mechanisms

- feeding dysfunction, vomiting, abdominal or chest pain, dysphagia, odynophagia, food impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Eosinophilic esophagitis

- diagnosis and treatment

A
  1. Endoscopic abnormalities
  2. Histopathological abnormalities
    +/- sensitization to food
    +/- oral food challenge

Treatment

  1. Dietary therapy
  2. PPI
  3. Local glucocorticoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Eosinophilic gastritis and Gastroenterocolitis

A
  • T-cell and IgE mediated mechanisms
    1. Mucosal: nausea, vomiting, abdominal pain and diarrhea; ot may be associated with occult blood loss, iron deficiency anemia, protein losing enteropathy, failure to thrive
    2. Muscular: obstructuve symtpoms, mimicking pyloric stenosis or thickening of the gastric outlet
    3. Serosal: asites and abdominal pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Eosinophilic gastritis and Gastroenterocolitis

- diagnosis and treatment

A
  1. Endoscopic abnormalities
  2. Histopathological abnormalities
    +/- sensitization to food
    +/- oral food challenge

Treatment:

  1. Cromolyn
  2. Systemic glucocorticoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Eosinophilic esophagitis endoscopic signs

A
  • edema
  • rings
  • white exudate
  • furrows
  • strictures
  • combination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Eosinophilic gastroenteritis endoscopic signs

A

nodularity and polypoid mucosa of tha antrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Eosinophilic esophagitis histologic signs

A
  • over 15 eosinophis/ HPF
  • over 20 eosinophils/ HPF
  • fibrosis
  • eosinophil degranulation
  • basal layer hyperplasia
  • microabscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Eosinophilic gastroenteritis histologic signs

A
  • over 30 eosinophils/ HPF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Food protein-induced enterocilitis syndrome (FPIES)

A
  • t-cell mediated mechanisms

ACUTE
- repetitive vomiting and lethargy 1-3 hours, ill appearing, hypotensive, diarrhea within 2 to 10 hours, dehydration, pallor, hypothermia

CHRONIC
- diarrhea, occasional mucus, abdominal distention, intermittent comiting, dehydration and lethary, failure to rhive and poor weight gain, weight loss, enamia, hypoproteinemia and hypoalbuminemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Food protein-induced enterocilitis syndrome (FPIES)

- diagnosis and treatment

A

Diagnosis:
- elimination diet
+/- sensitization to the food (SPT, APT)
+/- oral food challenge

treatment

  1. dietary therapy
  2. emergency plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Food protein induced allergic proctolitis (AP)

A
  • t-cell mediated
  • multiple daily stools with visible blood, mucous-streaked stools that are hemoccult positive, infrequent stools with occasional bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Food protein induced allergic proctolitis (AP)

- diagnosis and treatment

A 
diagnosis
- elimination diet
- reintroduction at home
\+/- microscopic stool exam
\+/- CBC

treatment
- dietary therapy

20
Q

Foor protein- induced enterophaty (FPE)

A
  • t- cell mediated

- diarrhea, failure to thrive , emesis and abdominal distention, malabsorption with steatorrhea, lack of acute symtpoms

21
Q

Foor protein- induced enterophaty (FPE)

- diagnosis and treatment

A

diagnosis:

  • laboratory studies to confirm malabsorption
  • moderate anemia
  • hypoproteinemia
  • prolonged coagulation time
  • jejunal biopsies with villous atrophy and crypt hyperplasia

treatment:
- dietary therapy

22
Q

FPIES emergency treatment plan

A

MILD (1-2 epidoses of emesis and no or mild lethargy)
- oral rehydration and treating with antiemetic if patient is over 6 months old

MODERATE (> 3 episodes of emesis with or without moderate lethargy)

  • ondansetron (antiemetic) if patient is > 6 mo
  • peripheral iv line with saline

SEVERE (> 3 episodes of emesis, severe lethargy, hypotonia and/or cyanotic appearance)

  • peripheral iv line with saline
  • methylprednisolone
  • epihenphrine i.m.
  • correct electrolyte abnormalities
  • noninvasive monitoring of BP and HR
23
Q

Which formula to choose?

A

AAF: anaphylaxis, FPIES, cow’s milk protein induced enteropathy

eHF: urticaria, eczema, immediate GI allergy, eosinophilic esophagitis, GERD, cow milk protein induced gastroenteritis and proctolitis, colic, constipation/diarrhea

24
Q

Allergic rhinoconjunctivitis symptoms

A

two or more symptoms that last > 1 hours

  • rhinorrhea
  • sneezing (often paroxysmal)
  • stuffy nose
  • itching of nose
  • dennie-morgan lines
  • allergic shinners
  • conjunctival erythema
  • +/- conjunctivitis
  • +/- itching og palate/ inner ear
25
Q

Symtpoms of allergic rhintitis

A
  • nasal crease
  • allergic salute
  • cobblestoning on the back of the pharynx –> hypertrophied lymphoid tissue
  • postnasal drip
  • nasal discharge
  • edemic/ hypertrophied lower nasan conchae
  • serous otitis
  • allergic shinners
  • recesses lower jaw
26
Q

Indications for nasal provocation challange

A
  • local allergic rhinitis
  • occupational rhinitis
  • unclear cases
  • to monitor the effectiveness of immunotherapy
27
Q

Classification of rhinitis (duration)

A
  • intermittent: symptoms < 4 days per week or < 4 consecutive weeks
  • persistent: symptoms > 4 days of week and > 4 consecutive weeks
28
Q

Classification of rhinitis (severity)

A

MILD (all of the following)

  • normal sleep
  • no impairment of daily activities
  • no impairment of work/ school
  • symptoms present but not troublesome

MODERATE/ SEVERE (one or more)

  • distrubed sleep
  • impairment of daily activitities
  • impairment of work/school
  • troublesome symptoms
29
Q

Allergic rhinitis treatment optione

A
  1. allergen avoidane
  2. pharmaceutical treatment - symptomatic treatmnt
  3. immunotherapy - etiological treatment
30
Q

Assessment of control in untreated symptomatic patient

A 
VAS < 5
--> initiate treatment (anti H1, INCS, INCS + AZE)
VAS > 5
--> intermittent: (like above)
--> persistnet (INCS or INCS+ AZA)

reassess VAS daily up to D3
VAS < 5
–> if symtpomatic: continue treatment
–> if no symtpoms: consider step down treatment
VAS > 5
–> step up and re-assess VAS daily up to D7
– > if VAs is then still over 5, consider SIT

31
Q

Allergen-specific immunotherpay (ASIT)

A
  • only etiological treatment
  • desensitization of the immune system by introducing an allergen in very small doses
  • main types: sublingual and subcutaneous
  • duration of treatment: 3-5 years
  • treatment targets: children from 5 years old
32
Q

ASIT indications

A
  • symptoms strongly suggestive or AR with or without conjunctivitis
  • there is evidence of IgE sensitization
  • experience moderate-to-severe symptoms which interfere with suual activities
33
Q

ASIT contraindications

A
  • uncontrolled or severe asthma
  • systemic autoimmune disorders
  • active malignant neoplasia
  • initiation udring pregnancy
34
Q

Complications of allergic rhinitis

A
  • recurrent sinusitis, nasal polyps, chronic nasal discharge
  • persistent or chronic cough
  • eustachian tube dysfunction
  • secondary serous otitis
  • overbite
  • sleep disorders and apnea
  • reduction in quality of life
35
Q

Ocular allergy classification

A

OCULAR NON ALLERGIC HYPERSENSITIVITY
- irritative conjunctivitis

OCLAR ALLERGY

  • -> IgE mediated
  • seasonal and perennial allergic conjunctivitis
  • vernal keratoconjunctivitis
  • atopic keratoconjunctivitis
  • -> non IgE mediated
  • contact blepharoconjunctivitis
  • vernal keratoconjunctivitis
  • atopic keratoconjunctivitis
36
Q

Seasonal allergic conjunctivitis symptoms

A
  • intermittent itching
  • tearing
  • conjunctivan redness
  • eyelid swelling
  • small papillary hpyertrophy of tarsal conjunctiva
37
Q

Perennial allergic conjunctivitis symptoms

A
  • all.year rounds similar to seasonal
38
Q

Vernal keratoconjunctivitis symptoms

A
  • intense itching
  • tearing
  • photophobia
  • corneal involvement may resolve with different leels of scarring
39
Q

Atopic keratoconjunctivitis symptoms

A
  • eczematous lesions of the eyelids
  • conjunctival redness
  • limbus and cornea can be involved
40
Q

Contact Blepharoconjunctivitis symptoms

A
  • itching and burning of the eyelid
  • edema
  • eyelid skin redness
  • eczema or lichenification
  • conjunctival redness
  • papillae
41
Q

Ocular allergy classification according to duration

A
  • intermittent (< 4 days pr week or < 4 weeks)

- persistent (> 4 days per week and > 4 weeks)

42
Q

Ocular allergy classification according to severity

A
  • vision distrubance
  • impairment of daily activities
  • impairment of school or work
  • troublesome symtpoms

mild: 0
Moderade: 1
Severe: 2 and more

43
Q

IgE mediated ocular allergy treatment

A
  • avoidance
  • topical antihistamines, mast cell stabilizers, double-action durgs
  • intranasal corticosteroids (should not be used if only ocular symptoms)
  • topical vasoconstrictors
  • systemic antihistamines in acute forms
  • consider SIT
44
Q

Persistent/ chronic (IgE- and non-IgE-mediated) ocular allergy treatment

A
  • avoidance
  • cold compresses, good eyelid hygiene and lubricants
  • topical antihistamines, mast cell stabilizers, double-action durgs
  • topical corticosteroids in acut4e exacerbations when cornea is involved
  • topical cancineurin inhibitors
  • systemic immunosuppressive treatment in refractory cases of AKC with visual treat –> cyclosporine
45
Q

Non-IgE-mediated ocular allergy treatment

A
  • avoidance
  • eyelid hygiene
  • emollients
  • oral antihistamines
  • topical antihistamiens
  • topical calcineurin inhibitors

Pediatrics (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions