Allergy

Question 1

Presentations of allergy

Answer 1

1. Atopy
2. Asthma
3. Food intolerance
4. Allergic conjunctivitis
5. Hay fever
6. Anaphylaxis
7. Eczema
8. Contact dermatitis

Question 2

Typical age of presentation of atopy

Answer 2

1. Eczema in infant, preschooler
2. Food allergy in toddler, preschooler
3. Asthma in young children
4. Hay fever in adolescents

Question 3

Management of allergic conjunctivitis

Answer 3

1. Sodium cromoglicate drops

2. Topical antihistamines

Question 4

History

Answer 4

1. Family history of atopy
2. Eczema in infancy
3. Obvious trigger
4. Full dietary history
5. Allergen avoidance thus far
6. History of drug allergies
7. Treatments needed in the past? Adrenalin?
8. How much of life affected by allergies

Question 5

Examinations

Answer 5

1. Airway
Swollen lips
Stridor
Swollen tongue
Nasal congestion
2. Breathing
Respiratory distress
Status asthmaticus
3. Circulation
CRT
Evidence of shock
BO
4. Skin
Urticaria
Vesicles
Angioedema

Question 6

Investigations

Answer 6

1. RAST
2. IgE testing
3. PEFR, Lung FTs in asthma, reversibility
4. Controlled allergen challenge

Question 7

How common is atopy

Answer 7

1. Affects one in 4 children

Question 8

Mechanism of sodium cromoglycate

Answer 8

1. Mast cell stabiliser

Question 9

Most common food allergies in infants/small children

Answer 9

1. Cows milk protein
2. Eggs
3. Peanut

Question 10

Management of a food allergy

Answer 10

1. Exclude foo allergen, usually for 2 years
2. Consider controlled challenge
3. Dietician review
4. Anaphylaxis plan if required
5. Medic alert bracelet
6. Annual review
7. Epipen

Question 11

Basic overview management of anaphylaxis

Answer 11

1. Remove allergen
2. ABC
3. IM adrenalin
4. Oral antihistamines
5. IV Hydrocortisone