Allergies

Question 1

what is ARF?

Answer 1

adverse reactions to food

Question 2

___% of population alters diet cuz ARF

Answer 2

20

Question 3

what are immunological reactions to food and reactions to food:

Answer 3

production of IgE, inflam. mediators released from eosinophils in GI, food protein enteropathies in milk or soy, associated diseases which has an immune component (celiac disease)

Question 4

adverse rxn where body unable digest, absorb, or metabolize food or component of food (non immunological)

Answer 4

food intolerance

Question 5

troublesome rxn after ingestion of food, unclear whether immunological or physiologic effect

Answer 5

food sensitivity

Question 6

examples of cell mediated food allergies?

Answer 6

celiac, FPIES

Question 7

etiology?

Answer 7

heredity, antigen exposure, maternal diet, early infant feeding, GI microbiota, , skin and gut, dysbiosis in microbiome, increased intestine permeability

Question 8

most important cells in initiation of recognition process:

Answer 8

dendritic cells (intestinal mucosa)

Question 9

70% of immune cells located in gut-associated ___ tissue

Answer 9

lymphoid

Question 10

risk factors for allergy?

Answer 10

hygiene hypothesis, increased pollution, family hx, time of food intro

Question 11

sensitization on first exposure involves ___ antibodies, in subsequent exposure involves ____ + ____

Answer 11

IgE; IgE, mast cells

Question 12

what does IgE and mast cells cause release of?

Answer 12

histamine, prostaglandins, interleukin (mediators)

Question 13

____ cells responsible for humoral and cell mediated immunity

Answer 13

B + (type 2 helper) T

Question 14

b and t cells are types of ____

Answer 14

lymphocytes

Question 15

what do Th1 do?

Answer 15

regulate B cells to produce antibodies and destroy antigens; triggers protective response to a pathogen; produce IgM, IgG, IgA

Question 16

what do Th2 do?

Answer 16

mediate allergic response by regulating production of B cells of IgE-sensitized to food or other allergens, produce IgE

Question 17

B cells become _____ which attach to ___ cells

Answer 17

plasma cells which produce antibodies; mast

Question 18

IgE binds to mast cell, causing ____

Answer 18

degranulation (release inflammatory mediators)

Question 19

allergy skin and mucous symptoms:

Answer 19

eczema, uticaria (hives), inflammation, itching

Question 20

allergy digestive symptoms:

Answer 20

ab pain/bloating, nausea/vomiting, diarrhea, constipation

Question 21

allergy resp symptoms:

Answer 21

itchy watery eyes, cough, rhinitis, throat tightening

Question 22

allergy systemic symptoms:

Answer 22

anaphylaxis, hypotension, dysrhythmias

Question 23

common pediatric allergens:

Answer 23

cow’s milk, egg, wheat, soy, peanut/treenuts

Question 24

common adult allergens

Answer 24

peanut/treenuts, fish/shellfish, sesame

Question 25

reliability/validity of skin tests depends on:

Answer 25

quality of testing material, experience of technician and interpretor

Question 26

skin tests measure ____

Answer 26

wheal and flare

Question 27

size of wheal and flare measured positive ____ to ___+

Answer 27

1; 3

Question 28

diameter > ____mms to diagnose allergy

Answer 28

3

Question 29

why false positives?

Answer 29

skin mast cells by stimuli don't degranulate the mast cells in the digestive tract, gastric acid and digestive enzymes can degrade antigens, raw form in extract may be degraded during cooking

Question 30

blood test for allergies:

Answer 30

RAST, an enzyme-linked immunosorbent assay with broader range sensitivity

Question 31

example of unproven test:

Answer 31

allergen specific IgG measurement (cytotoxicity assays, applied kinesiology, hair analysis)

Question 32

oral allergy syndrome is:

Answer 32

pollen-food allergy syndrome, rapid onset, confined to mouth, itchy/irritation, coexists with seasonal allergy, caused by raw fruit/nuts

Question 33

____ means shared between foods and pollens

Answer 33

conserved homologous proteins

Question 34

foods with birch pollinosis?

Answer 34

apples, carrots, celery, potatoes, hazelnuts

Question 35

foods with ragweed pollinosis:

Answer 35

melons, bananas

Question 36

brazil nut allergy:

Answer 36

cherries, apricots, plums, peaches

Question 37

what is food elimination?

Answer 37

eliminate all forms of suspected food, gradually introduce foods back to diet

Question 38

what is food challenge?

Answer 38

one food at a time on diff days; be prepared for emergency treatment of rxns

Question 39

repeated exposure to latex can cause ______

Answer 39

cross-reactivity between latex and some foods (chestnut, kiwi, fig, apple, apricot, cherry, banana, avocado, pear)

Question 40

human milk is protective against ____ disease

Answer 40

atopic

Question 41

if allergic to cows milk protein , need use _____ formulas

Answer 41

protein hydrosylate

Question 42

rare and characterized by food-related rxn (GI symptoms), treatment is with prednisone

Answer 42

eosinophilic gastroenteritis (diff from food allergy cuz lack of specific offending food)

Question 43

acute, systemic, severe, potentially fatal allergic rxn

Answer 43

anaphylaxis

Question 44

in anaphylaxis, the inflammatory mediators cause:

Answer 44

systemic vasodilations of BV, causing sudden severe dip of BP; lungs have edema of mucosa and constriction of bronchioles, obstructing airways

Question 45

anaphylaxis is ____ rxn

Answer 45

biphasic

Question 46

treatment of anaphylaxis:

Answer 46

self injectable epinephrine, antihistamines, hospital O2 and IV fluids to stabilize

Question 47

exercise induced anaphylaxis has these symptoms:

Answer 47

hives, itching, SOB, low BP

Question 48

why does exercise induced anaphylaxis occur?

Answer 48

cuz exercise triggers the potential for release of histamine and other mediators from mast cells

Question 49

foods involved in exercise-induced anaphylaxis:

Answer 49

wheat, celery, shellfish, chicken, peaches, nuts

Question 50

presents with severe vomiting, lethargy, possible hypotension or cyanosis, triggered by milk, soy, rice, oats

Answer 50

food protein-induced enterocolitis

Question 51

presents with bloody stools in otherwise healthy infant, occurs in breastfed infants, related to mom ingesting cow's milk

Answer 51

food protein-induced proctocolitis

Question 52

allergen immunotherapy with limited evidence:

Answer 52

oral immunotherapy (developing tolerance, desensitization)