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Sarah Paeds > Allergy > Flashcards

Allergy Flashcards

1
Q

What is an allergy?

A

Geneti susceptibility resulting in an abnoral reaction to an environmental allergen

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2
Q

What is the commonest chronic disease in children?

A

Allergy

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3
Q

What percentage of children in the UK suffer fro allergy?

A

40%

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4
Q

What is specific allergen immunotherapy?

A

Solutions of allergen are injected SC or sublingually on reg basis for 3-5 years with the aim of developing immune tolerance

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5
Q

Are most allergies in children primary or secondary?

A

Primary - failed to ever build tolerance

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6
Q

Hypersensitivity

A

Reproducible signs/symptoms following exposure to a defined stimulus at a dose tolerated by normal people

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7
Q

Allergy

A

Hypersensitivity reaction IgE or non-IgE

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8
Q

Given an example of a non-IgE mediated allergy

A

Coeliac

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9
Q

Atopy

A

Personal/familial tendency to produce IgE antibodies to normal stimuli

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10
Q

Categories of allergic rhinitis

A

Atopic vs Non-atopic
Intermitten vs persistent
Mild vs severe
Seasonal vs perennial

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11
Q

What percentage of children suffer from allergic rhinitis?

A

20%

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12
Q

Signs/symptoms allergic rhinitis

A

Conjunctivitis
Coryza
Coughing (+/- post nasal drip)
Mouth breathing, halitosis (chronic nasal congestion)

Sleep disturbance
Impaired behaviour
Reduced concentration
–> Affecting school performance

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13
Q

Sepcifics to look out for allergic rhinitis

A

Monitor closely for asthma/other atopy
Check for nasal polyps/narrowing/deviated nasal septum
Identify most likely causative agent(s)

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14
Q

Mouth breathing

A

Dry mouth

Halitosis

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15
Q

Allergic rhinitis management (intermittent mild)

A

Allergen avoidance
Oral/intranasal antihistamine

LTRA

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16
Q

Allergic rhinitis management (persistent mild)

A

Allergen avoidance
Oral/intranasal antihistamine
Intranasal corticosteroids
SL/SC immunotherapy

+Intranasal decongestant
+Nasal saline irrigation

17
Q

Allergic rhinitis management (persistent moderate to severe)

A

Allergen avoidance
Intranasal corticosteroids
Intranasal antihistamine

+Intranasal decongestant
+Nasal saline irrigation
+ INTRANASAL IPRATROPRIUM

18
Q

What percentage of infants may have cow’s milk protein allergy?

A

15%

19
Q

Signs/symptoms cow’s milk protein allergy

A

Resp - wheeze, coryza, cough, dribble
Gastro - vom, diarrhoea, constipation, wind
Skin - eczema, hives, angiodema, dermatitis

(Starting when using starting formula with cow’s milk protein, or in infants exclusively breastfed by mothers drinking cow’s milk)

20
Q

Management for CMPA in breastfed infants

A

Mother should avoid drinking cow’s milk
(Consider calcium and vitD)

Paediatric dietician
Monitor for growth
Regular ax for allergy (many children grow out)

MILK LADDER beginning at 1 year

21
Q

Management for CMPA in formula fed infants

A

Change formula to hypoallergenic:

  • Hydrolysed - Aptamil pepti 1
  • Amino acid if severe

Paediatric dietician
Monitor for growth
Regular ax for allergy (many children grow out)

MILK LADDER beginning at 1 year

22
Q

Management of CMPA in children

A

Remove cow’s milk from diet
Dietician input for nutritional counselling

Paediatric dietician
Monitor for growth
Regular ax for allergy (many children grow out)

MILK LADDER beginning at 1 year

23
Q

What is a milk ladder?

A

If tolerance to CMP is established, gradual exposure of less processed milk

24
Q

What is the most common pathophysiology of food allergy?

A

(Usually) IgE mediated reaction to environmental allergen. Most are primary, meaning the individual failed to ever develop tolerance to allergen

25
Q

Wht is food intolerance?

A

Non-immunological hypersensitivity to allergen

26
Q

Commonest food allergens in infants?

A

CMP, egg, peanut

27
Q

Commonest food allergens in children?

A

Peanut, tree nut, (Shell)fish

28
Q

Symptoms of IgE mediated food allergy

A

Acute onset (10-15 mins)
- Resp symptoms: wheeze, stridor
Angiodema
Urticaria

–> SHOCK

29
Q

Symptoms of non-IgE mediated food allergy

A 
Insidous onset (over hours)
- GI symptoms: abdo pain, DNV,  FTT
30
Q

Which food allergies have a positive skin prick test? Which have negative?

A

+ve: IgE

-ve: non-IgE

31
Q

How are IgE mediated food allergies diagnosed?

A

Skin prick testing or specific IgE Abs in blood

Food challenge

32
Q

How ae non-IgE mediated food allergies diagnosed?

A

Endoscopy and intestinal biopsy (eosinophilic infiltrates)

Food challenge

33
Q

Management of mild food allergies (no cardioresp symptoms)

A

Educate child and parents. Allergy action pain

AVOID TRIGGERS 
Anti histamines (non sedating)
34
Q

Management of severe food allergies (cardioresp symptoms)

A

Educate child and parents
Allergy action plan

IM ADRENALINE (epipen) - <30kg = 0.15mg, >30kg = 0.3mg
Salbutamol if bronchospasm
35
Q

Dosages for epipens

A 
<30kg = 0.15mg 
>30kg = 0.30mg
36
Q

How is severity of urticaria assessed?

A

Urticaria activity score

37
Q

Management for symptomatic urticaria

A

Non-sedating antihistamine (e.g. cetirizine)
Oral pred

Daily antihistamines if persistent

Refractory: LTRA, or anti-IgE antibody

38
Q

Name a non-sedating antihistamine

A

Cetirizine

39
Q

What is omalizumab?

A

Anti-IgE antibody

Sarah Paeds (20 decks)

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