Allergy Flashcards
what percentage of the population have food allergies
2-10%
what are the most common food allergies (8)
cow's milk egg peanuts tree nuts fish shell fish wheat soy
who is considered high risk for a food allergy
High risk = personal history of atopy or 1st degree relative with hx of atopy
Introduction at 4-6 months has shown reduction in allergy to these foods
For high-risk infants consider introducing common allergenic solids when?? how many at a time? how often?
6 months of age but not before an infant is 4 months of age
Allergenic foods should be introduced one at a time
Advise parents to offer it a few times a week to maintain tolerance
The texture or size of any complementary food should be age-appropriate to prevent choking
what is large local reaction to insect sting?
systemic reaction?
Large local reactions = swelling 10cm or more
onset 1-2 days, resolves by 3-10 days
Systemic reactions = combo of cutaneous, GI, Resp, CVS signs within 5-30 minutes; may not have previous Hx of reaction to sting
what insect causes most insect reactions
Yellow Jacket stings = most frequent cause of insect reactions
what are 4 stinging insects
wasp
yellow jacket
hornet
honeybee
how do you manage a local insect reaction?
cold compress, oral non-sedating antihistamine, oral analgesics; if severe local reaction can give short course of oral corticosteroids
how do you manage a systemic insect reaction?
Systemic:
IM epinephrine 0.01mg/kg
Max 0.3mg child, 0.5mg adolescent
Observe in ER 4-6 hours
Antihistamines, bronchodilators = adjunct
Prescribe EpiPen 0.15mg up to 25kg, 0.3mg >25kg
if large local reaction will they have anaphylaxis in the future?
risk of anaphylaxis with future stings is still very low!
Avoidance measures
No need for allergy testing, Epipen, or immunotherapy
what are some stinging insect avoidance measures?(4)
TABLE!!!
Do not walk barefoot
Exercise caution when eating and drinking outdoors
Wear gloves and long sleeves for gardening and a long sleeve shirt for play in high risk areas
Remove all insect nests around the home
Evaluation of insect sting reactions causing severe anaphylaxis should include what test?
Evaluation of insect sting reactions causing severe anaphylaxis should include a baseline serum tryptase blood test.
what type of reaction warrants VIT and when is it given?
systemic reaction
Reduce risk of future reaction from 30% to 5%
Given over 3-5 years
SC injection weekly, monthly and then every 2-3 months
Use of one venom covers 2x hornet + yellow jacket due to cross-reactivity
Don’t need to carry EpiPen during maintenance phase (monthly injections) unless previous severe reaction, high baseline Tryptase, underlying conditions, or frequent exposures
what type of formula may help prevent eczema if baby is anyways formula fed
Hydrolyzed cow’s milk formula may help prevent eczema if baby is anyways formula fed
Extensively hydrolyzed casein formula is likely to be more effective than partially hydrolyzed whey formula in preventing atopic dermatitis
Should you do skin test of IgE as screening before introduction of allergenic foods?
NO!! DO NOT do a skin test of IgE as screening before introduction of allergenic foods (false-positives)
