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Pediatrics > Allergies > Flashcards

Allergies Flashcards

1
Q

What types of reactions are allergic reactions?

A

IgE mediated

Non-IgE mediated

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2
Q

IgE Mediated Reactions

A 
Rapid in onset
Skin
GI Tract
Respiratory tract
Anaphylaxis
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3
Q

What are the top 8 sources of IgE mediated responses?

A 
Cow's milk
Eggs
Soybeans
Wheat
Peanuts
Tree nuts
Fish
Shellfish
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4
Q

Which of the top 8 sources of IgE mediated responses resolve by age 5?

A

Cow’s milk
Eggs
Soybeans
Wheat

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5
Q

Which of the top 8 sources of IgE mediated responses are lifelong?

A

Peanuts
Tree nuts
Fish
Shellfish

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6
Q

Non-IgE Mediated Reactions

A

Hours to days after exposure
Presents in infants
Present as chronic skin conditions or GI symptoms

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7
Q

Common GI Symptoms for Non-IgE Mediated Reactions

A

Proctitis/Proctocolitis
Enteropathy
Enterocolitis

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8
Q

Cutaneous Symptoms of Food Induced Allergic Reactions

A

Erythema
Pruritus
Urticaria
Angioedema

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9
Q

Ocular Symptoms of Food Induced Allergic Reactions

A

Pruritis
Conjunctival erythema
Tearing
Periorbital edema

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10
Q

Upper Respiratory Symptoms of Food Induced Allergic Reactions

A 
Nasal congestion
Pruritis
Rhinorrhea
Sneezing
Laryngeal edema
Hoarseness
Dry cough
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11
Q

Lower Respiratory Symptoms of Food Induced Allergic Reactions

A 
Cough
Chest tightness
Dyspnea
Wheezing
Intercostal retractions
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12
Q

GI Oral Symptoms of Food Induced Allergic Reactions

A

Angioedema of the lips
Tongue or palate
Oral pruritis
Tongue swelling

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13
Q

Lower GI Symptoms of Food Induced Allergic Reactions

A 
Nausea
Colicky abdominal pain
Reflux
Vomiting
Diarrhea
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14
Q

CV Symptoms of Food Induced Allergic Reactions

A 
Tachycardia
Hypotension
Dizziness
Fainting
LOC
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15
Q

Diagnostic Tests for Food Induced Allergic Reactions

A

Skin prick test (SPT)
Allergen specific serum IgE
Oral food challenge

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16
Q

Treatment of Food Induced Allergic Reactions

A

Avoidance

Eli-Pen for anaphylacis

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17
Q

Is/are atopic dermatitis, chronic nasal congestion, or acute urticaria associated with food allergies?

A

Atopic dermatitis

Acute urticaria

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18
Q

What happens to atopic dermatitis after the elimination of the allergen?

A

Often improves

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19
Q

When do you want to consider evaluation of atopic dermatitis in infants & children?

A

When there is moderate to severe atopic dermatitis

History of exacerbation with eating specific foods

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20
Q

Causes of Acute Urticaria

A

Infection
Drug reaction
Food allergy

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21
Q

Is acute or chronic urticaria present with a food allergy?

A

Acute

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22
Q

Nasopharyngeal Symptoms with Food Allergies

A

Acute rhinitis
Pruritis of the throat
Angioedema

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23
Q

What must be continued in order to do skin prick testing?

A

Antihistamines

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24
Q

Which serum specific IgE tests need to be correlated with the patient’s clinical history?

A

Positive tests

Negative tests

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25
Q

What is the gold standard for a diagnosis of food allergies?

A

Oral food challenge

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26
Q

How does the oral food challenge work?

A

Patient given gradually increasing amounts of the suspected food allergen over a time period of hours to a day
Close medical supervision

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27
Q

What are atopy patch tests used for?

A

Diagnose delayed hypersensitivity T-cell mediated reactions such as contact dermatitis

28
Q

Diagnostics of Food Allergies

A

Clinical history
Oral challenge
Skin tests
Serum specific IgE

29
Q

Established Cutoff Values for Serum Specific IgE for Eggs

A

3-17 years: 7 kU/L

30
Q

Established Cutoff Values for Serum Specific IgE for Cow’s Milk

A

3-17 years: 15 kU/L

31
Q

Established Cutoff Value for Serum Specific IgE for Peanuts

A

14 kU/L

32
Q

Established Cutoff Value for Serum Specific IgE for Fish

A

20 kU/L

33
Q

Treatment of Food Allergies

A

Avoidance of food
Notify adult when they eat something that may contain the food
Epi-pen auto injector

34
Q

Where should Epi-pens be available for the child?

A

Home
Daycare
School

35
Q

Define pollen-food allergy syndrome (PFAS)

A

Occur from cross-reactivity between proteins present in pollens and those expressed by fruits & veggies

36
Q

Another Name for Pollen-Food Allergy Syndrome

A

Oral Allergy Syndrome (OAS)

37
Q

Symptoms of PFAS and OAS

A

Tingling & itching of the lips, tongue, and palate when eating certain raw fruits & veggies

38
Q

Do symptoms of PFAS/OAS occur when the fruit or vegetable is cooked?

A

No

39
Q

Birch Pollen Cross Reactivity is Associated with Which Fruits/Veggies

A 
Apples
Plums
Peaches
Nectarines
Cherries
Almonds
40
Q

Ragweed Pollen Cross Reactivity is Associated with Which Fruits/Veggies

A

Melons
Bananas
Tomatoes

41
Q

Grass Pollen Cross Reactivity is Associated with Which Fruits/Veggies

A

Melons

Kiwi fruit

42
Q

Diagnosis of PFAS/OSA

A

Confirmed through skin prick testing to the fresh foods and pollen
Also with oral food challenges

43
Q

Treatment of PFAS/OSA

A

Controlled with antihistamines
Avoid consumption of raw food product
Strictly avoid food in all forms if systemic symptoms
Epi-pen

44
Q

What advice would you give a peanut/tree nut allergy regarding their risk of fatal anaphylaxis?

A

Foods may unknowingly contaminated with peanuts/tree nuts and therefore having an Epi-pen is critical at all times

45
Q

Who is at a higher risk for fatal food-induced anaphylaxis?

A

Teenagers

46
Q

Why are teenagers at a higher risk for fatal food-induced anaphylaxis than younger children?

A

Decreased dose with increasing age

Poor understanding when reactions are severe and when Epi-pen use is needed

47
Q

Are shellfish, eggs, or peanuts more common in adults than children?

A

Shellfish

48
Q

What are the most common food allergies in children?

A

Milk
Eggs
Peanuts

49
Q

What are the most common food allergies in adults?

A

Shellfish
Peanuts
Tree nuts

50
Q

Symptoms of Allergic Rhinitis

A 
Sneezing
Rhinorrhea
Nasal congestion
Itching of the eyes, nose, palate, ear canals
Postnasal drip, cough
Irritability
Fatigue
51
Q

Allergic Rhinitis Significant Impact on QOL & Cognitive function

A

Sleep disordered breathing
Fatigue
General malaise
Cognitive & psychiatric issues in children

52
Q

What types of cognitive and psychiatric issues are there in children?

A 
ADHD
Lower exam scores in peak pollen season
Poor concentration
Impaired athletic performance
Low self esteem
53
Q

Diseases Associated with Allergic Rhinitis

A 
OM
Eustachian tube dysfunction
Sinunsitis
Asthma
Sleep-related breathing disorders
54
Q

Physical Findings of Allergic Rhinitis

A 
Allergic salute
Allergic shiner
Dennie Morgan lines
Conjunctival chemosis
Cobbelstoning
55
Q

Diagnosis of Allergic Rhinitis

A

Suggestive history
Supportive exam
Identify specific-IgE

56
Q

Define Sensitization

A

Presence of specific IgE to an allergen

57
Q

Define Allergy

A

Allergy symptoms

Evidence of sensitization

58
Q

Treatment of Allergic Rhinitis

A

Environmental control
Pharmacotherapy
Immunotherapy

59
Q

Pharmacotherapy Options for Allergic Rhinitis

A 
Antihistamines
Decongestants
Nasal steroids
Anticholinergics
Mast cell stabilizers
Ocular meds
Leukotriene modifiers
60
Q

Treatment in Children

A 
Avoidance therapy
Cromolyn nasal spray
Ceterizine
Fexofenadine
Intranasal glucocorticoids (severe)
61
Q

Treatment for Allergic Rhinitis with Mild or Episodic Symptoms

A 
Cetirizine, loratidine, or fexofenidine
Azelastine (>5 years)
Olopatidine (>12 years)
Intranasal glucocorticoid
Intranasal cromolyn
62
Q

Treatment for Allergic Rhinitis with Persistent or Severe Symptoms

A 
Intranasal glucocorticoid
Topical nasal antihistamines
Oral antihistamine
Decongestant
Start with 1st and work down
63
Q

Intranasal Glucocorticoids for Children

A 
Memetasone (Nasonex) >2 years
Fluticasone furoate (Veramyst) >2 years
Fluticasone propionate (Flonase) >4 years
64
Q

Topical Nasal Antihistamines for Children

A

Azelastine (Asteline) >5 years
Olopatidine (Patanase) >12 years
Combo azelastine & fluticasone (Dymista) >12 years

65
Q

Treatment of Allergic Rhinitis with Allergic Conjunctivitis

A

Intranasal glucocorticoid

Topical Ophthalmic antihistamine drops

66
Q

Treatment of Allergic Rhinitis with Asthma

A

Monteleukast (Singulair) >6 months

Pediatrics (23 decks)

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