allergy Flashcards
Breast feeding reduces the risk for what diseases?
Nothing!!! It only delays onset of allergies
What is the most important risk factor for development of allergic disease ?
One parent with atopy = 50% risk
Two parents with atopy = 70% risk
What 2 environmental exposures increase asthma risk?
Dust mites and smoking
You suspect allergic rhinitis, How can you confirm the diagnosis?
Nasal smear shows eosinophils
What condition presents with eosinophils on nasal smear but negative skin test?
Non allergic rhinitis with eosinophilia syndrome (NARES)
What is the first step in treating allergic rhinitis and the first line treatment?
Eliminate offending agent
Nasal steroid
What is the diagnosis in a patient with nasal congestion, rhinorrhea and post nasal drainage triggered by emotions or weather?
Vasomotor rhinitis
What is rhinitis medicamentosa?
Rebound nasal congestion after adrenergic nose drops
What is required for the diagnosis of hay fever?
Repeated exposure to pollen , child usually > 3 y/o
Which childhood allergies are typically NOT outgrown?
Peanuts
Tree nuts
Seafood
What type of oils are okay for patients with peanut allergy?
Hot pressed peanut oil
Sunflower oil
What is the dose for epinephrine in anaphylaxis?
If >30 kg, 0.3 mg
If <30 kg, 0.15 mg
How do you treat a child with hx milk allergy who complains of stomach ache after lunch?
Epinephrine
When is urticaria considered chronic?
6 weeks
How should you manage chronic urticaria?
2nd/3rd generation antihistamines
Benadryl for breakthrough
No allergy testing or steroids
A patient with chronic urticaria has positive skin test for dogs , what should you do?
Nothing. Skin test does not predict cause of chronic urticaria
What should you do in a patient with shrimp allergy who needs IV contrast ?
Nothing. There is no correlation between shellfish allergy and contrast
What is the mechanism of an allergic reaction to contrast media?
Osmolality hypertonicity triggers de granulation of mast cells (not IgE mediated)
What do you do for a patient with radio contrast allergy who needs contrast?
Premedicate with antihistamines and prednisone
What should you do for a child with a mild systemic reaction to bee sting?
Referral to allergist
What should you do for a child with life threatening reaction to a bee sting and why?
Venom immunotherapy is 98% effective in preventing future reactions
What type of allergic reaction is antibody mediated ?(type 1-4)
Type 2
What type of allergic reaction is immune complex mediated ?
Type 3
How should penicillin allergy be tested for?
skin igE testing which must show reaction within 24 hours
In what situations is skin testing falsely negative?
Antihistamines
Antidepressants
What is the difference between management of a milk allergy that develops urticaria vs eczema rash?
Urticarial rash needs referral to allergist but eczema rash is T cell related and does not require referral
What is RAST testing and what is te benefit ?
In vitro and not impacted by antihistamines
What disease may be the diagnosis in a patient with awkward gait and frequent sinus infections?
Ataxia telangiectasia
What should you consider in a child with a new infection every month?
Reassure the mother - unless recurrent infections are coupled with poor growth
What type of immunodeficiency is being presented in a patient with recurrent Pyogenic infections?
B cell dysfunction
What type of immunodeficiency presents with recurrent candida infection?
T cell dysfunction