Allergy Flashcards
The Allergic March
Eczema andfood allergy in infancy
Allergic rhinitis, conjuctivitis and asthma in preschool
Eczema or food allergy in infancy is predictive of asthma in later life
Factors contributing to hygiene hypothesis
Small family size Low parasite exposure Few infections High Abx exposure Low farming exposure Low microbiology exposure
Signs of allergy on exam
Mouth breathing -obstructed airway from rhinitis -hx of snoring or sleep apnoea Allergic salute: nose rubbing Pale and swollen inferior turbinates hyperinflated chest or harrisons sulci Eczema in limb flexures Blue discolouration below eye lids prominent creases (dennie-Morgan folds)
Immunotherapy in allergy
children aged 3-5y
Regular allergen injection
Subcut/sublingual
Under specialist supervision
Features pollen food allergy syndrome
secondary food allergy due to cross reaction Typically birch pollen and apples Mild allergic reaction Itchy mouth No systemic symptoms
Presentation IgE mediated food allergy
Urticaria Facial swelling Wheeze Stridor Abdominal pain Vomiting Diarrhoea Shock/collapse Onset 10m-2h after ingestion
Presentation non-IgE mediated food allergy
Diarrhoea Vomiting abdominal pain Faltering growth Colic Eczema Blood in stool
Ix Allergy
Skin-prick testing
Specific IgE antibodies in blood
Non-IgE mediates: endoscopy and eosinopillic biopsy
Food exclusion and placebo controlled challenge
Mx Allergy
Avoidance of relevant food
Self management plans and training for anaphylaxis
non-sedating antihistamines
Im autoinjector adrenaline
Gradual reintroduction in early childhood milk and egg allegry
Classificaiton of allergic rhinitis
Intermittent Persistent Mild Moderate Severe Seasonal
Mx allergic rhinitis
2nd gen non sedating antihistamines Topical corticosteroid nasal or eye preparatios cromoglycate eye drops leukotriene receptor antagonists nasal decongestants (max 7-10 days use) Allergen immunotherapy
Classification urticaria
Acute: resolves within 6w Chronic: intermittent >6w Physical: cold, pressure, heat, solar, vibratory Water Sweating/exercise induced Aspirin and NSAIDs C1 esterase inhibitor deficiency
