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Child Health > Allergy > Flashcards

Allergy Flashcards

1
Q

Allergy

A

Hypersensitivity of immune system to allergens

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2
Q

Allergen

A

Protein that immune system recognises as foreign and potentially harmful
Leading to allergic immune response
Types of antigen

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3
Q

Antigens

A

Proteins that can be recognised by immune system

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4
Q

Atopy conditions

A 
Eczema
Asthma
Hay fever
Allergic rhinitis
Food allergies
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5
Q

What are the two main contributors to a child developing an allergy to a food?

A

Break in skin (eczema or skin infection), allows allergens from environment to cross skin and react with immune system
Child doesn’t have contact with that allergen from GI tract, absence of GI exposure to allergen

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6
Q

Hypersensitivity conditions

A 
Asthma
Atopic eczema
Allergic rhinitis
Hay fever
Food allergies
Animal allergies
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7
Q

Coombs and Gell classification hypersensitivity

A

TY1: IgE
TY2: IgG and IgM
TY3: immune complex
TY4: T lymphocytes

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8
Q

TY1 hypersensitivity

A

IgE antibodies to a specific allergen
Trigger mast cells and basophils to release histamine and other cytokines
Immediate reaction
Food allergy

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9
Q

TY2 hypersensitivity

A

IgG and IgM antibodies
React to allergen and activate complement system
Direct damage to the local cells
Examples: HDN, transfusion reactions

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10
Q

TY3 hypersensitivity

A

Immune complexes accumulate and causes damage to local tissues
SLE, rheumatoid arthritis, Henoch-Schonlein purpura

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11
Q

TY4 hypersensitivity

A

Cell mediate hypersensitivity
T lymphocytes
T cells inappropriately activated
Causing inflammation and damage to local tissues
Organ transplant rejection and contact dermatitis

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12
Q

History of allergy

A

Timing after exposure to allergen
Previous and subsequent exposure and reaction to allergen
Symptoms of rash, swelling, breathing, difficulty, wheeze and cough
Previous personal and FH of atopic conditions and allergies

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13
Q

Investigations in allergy

A

Skin prick testing: sensitisation
RAST testing: sensitisation
Food challenge testing: gold standard for diagnosing allergy

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14
Q

Skin prick testing

A

Fresh needle, water control, histamine control

After 15 minutes, size of wheals to each allergen are assessed and compared to the controls

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15
Q

Patch testing

A

Used to diagnose allergic contact dermatitis
Not helpful for food allergies
After 2-3 days assess skin reaction to patch

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16
Q

RAST testing

A

Measures total and allergen specific IgE quantities in patients blood sample

17
Q

Allergy management

A

Establish and avoid correct allergen
Avoid foods that trigger reactions
Regular hoovering and changing sheets and pillows if there is a dust mite allergy
Staying indoor where pollen count is high
Prophylactic antihistamines where contact is inevitable
Adrenalin auto-injector for patients at risk of anaphylaxis

Immunotherapy

18
Q

Treatment following exposure of allergen

A

Antihistamines (cetirizine)
Steroids
IM adrenaline

19
Q

Anaphylaxis presentation

A 
History of exposure
Urticaria
Itching
Angio-oedema
Abdominal pain 
SoB
Wheeze
Swelling of larynx, causing stridor
Tachycardia
Lightheadedness
Collapse
20
Q

Anaphylaxis principles of management

A

Airway: secure airway
Breathing: provide oxygen if required, salbutamol can help with wheezing
Circulation: IV fluid bolus
Disability: lie patient flat to improve cerebral perfusion
Exposure: look from flushing, urticaria, angio-oedema

21
Q

Medications to treat anaphylaxis

A

IM adrenaline
Antihistamines: oral chlorphenamine or cetirizine
Steroids, hydrocortisone

22
Q

After anaphylaxis

A

Biphasic reaction
Measure serum mast cell tryptase within 6 hours
Train parents in BLS
Adrenalin auto-injector

23
Q

Adrenalin auto-injector indications

A 
Anaphylaxis reactions
Asthma requiring inhaled steroids
Poor access to medical treatment
Adolescents
Nut/insect sting allergies
Significant co-morbidities
24
Q

How to use adrenalin auto-injection

Epipen

A 
Remove blue cap
Grip device needle end is orange 
Administer injection, hold for 3s
Remove device and massage for 10s
Phone ambulance
Second dose after 5 mins
25
Q

How to use Jext epipen

A 
Remove yellow cap
Grip device needle end is black 
Administer injection, hold for 10s
Remove device and massage for 10s
Phone ambulance
Second dose after 5 mins
26
Q

Types of allergic rhinitis

A

Seasonal, hay fever
Perennial, house dust mite allergy
Occupational

27
Q

Allergic rhinitis presentation

A

Runny, blocked and itchy nose
Sneezing
Itchy, red and swollen eyes

28
Q

Allergic rhinitis triggers

A

Tree pollen or grass

House dust mites and pets

29
Q

Management of allergic rhinitis

A 
Avoid trigger
Hoover
Stay indoors during high pollen counts
Minimise contact with pets 
Oral antihistamines 
Nasal corticosteroid sprays: fluticasone, mometasone 
Nasal antihistamines
30
Q

Non-sedating anti-histamines

A

Cetirizine
Loratadine
Fexofenadine

31
Q

Sedating antihistamines

A

Chlorphenamine (piriton)

Promethazine

32
Q

Cows milk protein allergy

A 
Typically affects <3 years
IgE mediated (reaction occurring within 2 hours) or non-IgE mediated (over several days)

Risk factors: formula-fed babies, personal or FH of other atopic conditions

33
Q

Cows milk protein allergy presentation

A

Presents before 1 year of age
Apparent when weaned from breast milk to formula milk
Bloating and wind
Abdominal pan
D/V
Allergi symptoms in cows milk protein allergy but not cows mill intolerance

34
Q

Management of Cow’s milk protein allergy

A 
Breast feeding mothers should avoid dairy
Hydrolysed formulas: proteins broken down 
Elemental formulas (amino acids)
Every 6 months try infants on milk ladder

Child Health (20 decks)

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