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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
What is the gold standard for a diagnosis of food allergies?
Oral food challenge
26
How does the oral food challenge work?
Patient given gradually increasing amounts of the suspected food allergen over a time period of hours to a day Close medical supervision
27
What are atopy patch tests used for?
Diagnose delayed hypersensitivity T-cell mediated reactions such as contact dermatitis
28
Diagnostics of Food Allergies
Clinical history Oral challenge Skin tests Serum specific IgE
29
Established Cutoff Values for Serum Specific IgE for Eggs
3-17 years: 7 kU/L
30
Established Cutoff Values for Serum Specific IgE for Cow's Milk
3-17 years: 15 kU/L
31
Established Cutoff Value for Serum Specific IgE for Peanuts
14 kU/L
32
Established Cutoff Value for Serum Specific IgE for Fish
20 kU/L
33
Treatment of Food Allergies
Avoidance of food Notify adult when they eat something that may contain the food Epi-pen auto injector
34
Where should Epi-pens be available for the child?
Home Daycare School
35
Define pollen-food allergy syndrome (PFAS)
Occur from cross-reactivity between proteins present in pollens and those expressed by fruits & veggies
36
Another Name for Pollen-Food Allergy Syndrome
Oral Allergy Syndrome (OAS)
37
Symptoms of PFAS and OAS
Tingling & itching of the lips, tongue, and palate when eating certain raw fruits & veggies
38
Do symptoms of PFAS/OAS occur when the fruit or vegetable is cooked?
No
39
Birch Pollen Cross Reactivity is Associated with Which Fruits/Veggies
``` Apples Plums Peaches Nectarines Cherries Almonds ```
40
Ragweed Pollen Cross Reactivity is Associated with Which Fruits/Veggies
Melons Bananas Tomatoes
41
Grass Pollen Cross Reactivity is Associated with Which Fruits/Veggies
Melons | Kiwi fruit
42
Diagnosis of PFAS/OSA
Confirmed through skin prick testing to the fresh foods and pollen Also with oral food challenges
43
Treatment of PFAS/OSA
Controlled with antihistamines Avoid consumption of raw food product Strictly avoid food in all forms if systemic symptoms Epi-pen
44
What advice would you give a peanut/tree nut allergy regarding their risk of fatal anaphylaxis?
Foods may unknowingly contaminated with peanuts/tree nuts and therefore having an Epi-pen is critical at all times
45
Who is at a higher risk for fatal food-induced anaphylaxis?
Teenagers
46
Why are teenagers at a higher risk for fatal food-induced anaphylaxis than younger children?
Decreased dose with increasing age | Poor understanding when reactions are severe and when Epi-pen use is needed
47
Are shellfish, eggs, or peanuts more common in adults than children?
Shellfish
48
What are the most common food allergies in children?
Milk Eggs Peanuts
49
What are the most common food allergies in adults?
Shellfish Peanuts Tree nuts
50
Symptoms of Allergic Rhinitis
``` Sneezing Rhinorrhea Nasal congestion Itching of the eyes, nose, palate, ear canals Postnasal drip, cough Irritability Fatigue ```
51
Allergic Rhinitis Significant Impact on QOL & Cognitive function
Sleep disordered breathing Fatigue General malaise Cognitive & psychiatric issues in children
52
What types of cognitive and psychiatric issues are there in children?
``` ADHD Lower exam scores in peak pollen season Poor concentration Impaired athletic performance Low self esteem ```
53
Diseases Associated with Allergic Rhinitis
``` OM Eustachian tube dysfunction Sinunsitis Asthma Sleep-related breathing disorders ```
54
Physical Findings of Allergic Rhinitis
``` Allergic salute Allergic shiner Dennie Morgan lines Conjunctival chemosis Cobbelstoning ```
55
Diagnosis of Allergic Rhinitis
Suggestive history Supportive exam Identify specific-IgE
56
Define Sensitization
Presence of specific IgE to an allergen
57
Define Allergy
Allergy symptoms | Evidence of sensitization
58
Treatment of Allergic Rhinitis
Environmental control Pharmacotherapy Immunotherapy
59
Pharmacotherapy Options for Allergic Rhinitis
``` Antihistamines Decongestants Nasal steroids Anticholinergics Mast cell stabilizers Ocular meds Leukotriene modifiers ```
60
Treatment in Children
``` Avoidance therapy Cromolyn nasal spray Ceterizine Fexofenadine Intranasal glucocorticoids (severe) ```
61
Treatment for Allergic Rhinitis with Mild or Episodic Symptoms
``` Cetirizine, loratidine, or fexofenidine Azelastine (>5 years) Olopatidine (>12 years) Intranasal glucocorticoid Intranasal cromolyn ```
62
Treatment for Allergic Rhinitis with Persistent or Severe Symptoms
``` Intranasal glucocorticoid Topical nasal antihistamines Oral antihistamine Decongestant Start with 1st and work down ```
63
Intranasal Glucocorticoids for Children
``` Memetasone (Nasonex) >2 years Fluticasone furoate (Veramyst) >2 years Fluticasone propionate (Flonase) >4 years ```
64
Topical Nasal Antihistamines for Children
Azelastine (Asteline) >5 years Olopatidine (Patanase) >12 years Combo azelastine & fluticasone (Dymista) >12 years
65
Treatment of Allergic Rhinitis with Allergic Conjunctivitis
Intranasal glucocorticoid | Topical Ophthalmic antihistamine drops
66
Treatment of Allergic Rhinitis with Asthma
Monteleukast (Singulair) >6 months

Pediatrics (24 decks)

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