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PHCP2 > Allergic rhinitis > Flashcards

Allergic rhinitis Flashcards

1
Q

Inappropriate or exaggerated response to an antigen or an allergen

A

Hypersensitivity

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2
Q

antigens that enters the body, trapped in antigen presenting cells ( Macrophages/ Dendritic cells)

A

Exogenous

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3
Q

Body’s own cell or sub fragments

A

Endogenous

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4
Q

normal proteins or complexes that is recognized by the immune system of someone with an autoimmune condition

A

Auto antigen

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5
Q

Exogenous examples

A

Microorganisms, allergens

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6
Q

Endogenous examples

A

Blood group antigen, histocompatibility leucocyte antigen

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7
Q

Auto antigen examples

A

Thyroglobulin

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8
Q

IgE mediated release of histamine, mast cells and basophils

A

Type 1: Allergic reaction ( immediate hypersensitivity)

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9
Q

Allergic reaction examples

A

Bee sting, latex allergy, medications (penicillin), urticaria, anaphylaxis, atopy

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10
Q

refers to the genetic tendency to develop allergic diseases such as allergic rhinitis, asthma, and atopic dermatitis (eczema)

A

Atopy

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11
Q

Commonly associated with heightened response of IgE

A

Atopy

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12
Q

Involves IgG and IgM bound cell surface antigens

A

Type 2: Cytotoxic reaction

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13
Q

Type 2: Cytotoxic reaction duration

A

Hours to days

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14
Q

Type 1: Allergic reaction duration

A

Reaction within 1 hour

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15
Q

Involves circulating IgG and IgM immune complex that deposits in post-capillary venules

A

Type 3: Immune complex reaction

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16
Q

Type 3: Immune complex reaction duration

A

1-3 weeks

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17
Q

Type 3: Immune complex reaction examples

A

SLE, Serum sickness

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18
Q

Cell mediated immunity

A

Type 4: Delayed hypersensitivity

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19
Q

Mediated by T-cells rather than antibodies

A

Type 4: Delayed hypersensitivity

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20
Q

Type 4: Delayed hypersensitivity duration

A

Days- weeks

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21
Q

Type 4: Delayed hypersensitivity examples

A

nickel allergy, SJS, poison ivy

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22
Q

involves inflammation of nasal mucous membranes in sensitized individuals when inhaled allergenic particles contact mucous membranes and elicit a response mediated by immunoglobulin E (IgE).

A

Allergic rhinitis

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23
Q

Mediators of immediate hypersensitivity

A

Histamine, leukotrienes, prostaglandin, tryptase, and kinins

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24
Q

late-phase reaction may occur ___ after initial allergen exposure due to cytokine release from mast cells and thymus-derived helper lymphocytes.

A

4 to 8 hours

25
Q

Intermittent

A

Response lasting <4 days/ week or <4 weeks per year

26
Q

Persistent

A

Response lasting >4 days/week or >4 weeks/ year

27
Q

Mild

A

Symptoms that do not interfere with quality of life

28
Q

Moderate to severe

A

Symptoms that interfere with quality of life such as sleep disturbance and work performance

29
Q

Symptoms include

A

clear rhinorrhea
sneezing
nasal congestion
postnasal drip
allergic conjunctivitis
pruritic eyes, ears, or nose.

30
Q

In children, physical examination may reveal

A

dark circles under the eyes (allergic shiners)
a transverse nasal crease caused by repeated rubbing of the nose
adenoidal breathing
edematous nasal turbinates coated with clear secretions
tearing
periorbital swelling.

31
Q

Medical history

A

Careful description of symptoms
Environmental factors and exposures
Results of previous therapy
Use of medications
Previous nasal injury or surgery
Family history

32
Q

Determines whether rhinitis is caused by immune response to allergens

A

Allergy testing

33
Q

commonly used allergy testing

A

Immediate-type hypersensitivity skin tests

34
Q

is safer and more generally accepted than intradermal testing, which is usually reserved for patients requiring confirmation.

A

Percutaneous testing

35
Q

can detect IgE antibodies in the blood that are specific for a given antigen, but it is less sensitive than percutaneous tests

A

radioallergosorbent test (RAST

36
Q

Pharmacologic Therapy

A

Histamine H1-receptor antagonists
Decongestants
Nasal Corticosteroids
Cromolyn Sodium
Ipratropium bromide
Montelukast
Immunotherapy

37
Q

Antihistamines are more effective when taken ___ before anticipated exposure to the offending allergen

A

1 to 2 hours

38
Q

sympathomimetic agents that act on adrenergic receptors in nasal mucosa to produce vasoconstriction, shrink swollen mucosa, and improve ventilation

A

Decongestants

39
Q

(rebound vasodilation with congestion) may occur with prolonged use of topical agents (>3–5 days).

A

Rhinitis medicamentosa

40
Q

____ has replaced ___ in many nonprescription antihistamine–decongestant combination products because of legal restrictions on pseudoephedrine sales

A

Phenylephrine
pseudoephedrine

41
Q

relieve sneezing, rhinorrhea, pruritus, and nasal congestion with minimal side effects

A

Nasal Corticosteroids

42
Q

They reduce inflammation by blocking mediator release, suppressing neutrophil chemotaxis, causing mild vasoconstriction, and inhibiting mast cell–mediated, late-phase reactions.

A

Intranasal corticosteroids

43
Q

Nasal Corticosteroids examples

A

Beclomethasone
Budesonide
Flunisolide
Fluticasone
Mometasone
Triamcinolone

44
Q

a mast cell stabilizer, is available as a nonprescription nasal spray for symptomatic prevention and treatment of allergic rhinitis.

A

Cromolyn Sodium

45
Q

It prevents antigen-triggered mast cell degranulation and release of mediators, including histamine.

A

Cromolyn Sodium

46
Q

an anticholinergic agent that may be useful in persistent allergic rhinitis.

A

Ipratropium bromide

47
Q

It exhibits antisecretory properties when applied locally and provides symptomatic relief of rhinorrhea.

A

Ipratropium bromide

48
Q

a leukotriene receptor antagonist approved for treatment of persistent allergic rhinitis in children as young as 6 months and for seasonal allergic rhinitis in children as young as 2 years.

A

Montelukast

49
Q

The process of administering doses of antigens responsible for eliciting allergic symptoms into a patient with the intent of inducing tolerance to the allergen when natural exposure occurs.

A

Immunotherapy

50
Q

for ___ very dilute solutions are given initially once or twice weekly.

A

subcutaneous immunotherapy

51
Q

is available for ragweed and certain grass allergies

A

Sublingual immunotherapy

52
Q

Adverse reactions with subcutaneous immunotherapy include

A

mild local adverse reactions include induration and swelling at the injection site

53
Q

More severe reactions with subcutaneous immunotherapy

A

generalized urticaria
bronchospasm
laryngospasm
vascular collapse
death from anaphylaxis

54
Q

Severe reactions with subcutaneous immunotherapy are treated with

A

epinephrine
antihistamines
systemic corticosteroids

55
Q

The most common reactions with sublingual immunotherapy are

A

pruritus of the mouth, ears, and tongue
throat irritation
mouth edema.

56
Q

Non-Pharmacologic Treatment

A

Avoiding offending allergens
Removing pets from the home, if feasible.
Reducing exposure to dust mites
Prevent poor air quality in homes

57
Q

An immediate reaction occurs within seconds to minutes, resulting in rapid release of preformed and newly generated mediators from the ___

A

arachidonic acid cascade

58
Q

These mediators of immediate hypersensitivity cause

A

Vasodilation, increased vascular permeability, and production of nasal secretions

59
Q

Histamine produces

A

rhinorrhea, itching, sneezing, and nasal obstruction.

PHCP2 (1 decks)

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