allergy

Question 1

what is the allergic march

Answer 1

infancy - eczema, food allergy

childhood - conjunctivits, rhinitis, asthma

Question 2

Difference in presentation between IgE and non-IgE mediated allergies

Answer 2

IgE - starts 10-15 mins after, allergic symptoms

non-IgE - (way more GI) diarrhoea, vomiting + abdo pain, can get blood in stool too

Question 3

Diagnosis of food allergy

Answer 3

IgE - skin prick testing
delayed hypersensitivity - do Patch testing

gold standard is exclusion of food

Question 4

mx food allergy

Answer 4

exclude offending food

drugs - mild - non-sedating antihistamines, severe - IM adrenaline

Question 5

mx of cow’s milk protein allergy

Answer 5

SUPPLEMENT VIT D
IgE:
allergy testing, exlusion of cow’s milk and replacement with substitute
non IgE mediated: (onset 2-72h hours) same as above
re-evaluate every 6-12 months
consider milk ladder

Question 6

mx allergic rhinitis

Answer 6

assess for asthma and look for deviated nasal septum and nasal polyps

antihistamines PRN if infrequent
for prevention:
avoid allergen, if issue is blockage do intranasal corticosteroid, if sneezing give oral antihistamines

Question 7

what is urticaria/angioedema development dependent on

Answer 7

dependent on mast cell degranulation

Question 8

Mx for urticaria

Answer 8

avoid triggers
urticaria activity score to quantify
cetirizine if moderate
pred if more severe

Question 9

mx for angioedema

Answer 9

if rapidly developing angioedema w/o ananphylaxis - chloramphenamine + hydrocortisone

otherwise give cetirizine and then pred