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ICC3 > allergy and hypersenitivity > Flashcards

allergy and hypersenitivity Flashcards

1
Q

what is the clinical presentation of allergic reactions?

A

severe symptoms include
urticaria
angioedema
anaphylaxis

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2
Q

how quickly does an allergic reaction happen ?

A

usually occurs within a few minutes of exposure to the antigen but can be occasionally delayed

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3
Q

how do you approach an allergic reaction ?

A 
establish the time lag between the exposure to the antigen and onset of symptoms 
drug intake 
allergens at home 
family history 
occupation
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4
Q

what is urticaria ?

A

urticaria is characterized by mucosal swelling due to plasma leakage

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5
Q

what is the difference between urticaria and angioedema ?

A

urticaria is superficial dermal swelling, which is often pruritic and is pink or pale in the centre
angioedema is deep dermal swelling, which is often painful and is not accompanied by any colour changes

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6
Q

what are the characteristics of urticaria ?

A

the hallmark of wheals is that individual lesions come and goo rapidly, by definition within 24 hours , all urticarias are initially acute

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7
Q

what is the main cause of urticaria ?

A

idiopathic

upper respiratory tract infection

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8
Q

what is a life threatening complication of angioedema ?

A

laryngeal edema causing airway compromise

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9
Q

what is the other name for hereditary angioedema ?

A

C1 esterase inhibitor deficiency

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10
Q

what is C1 esterase inhibitor deficiency characterized by?

A

recurrent episodes of angioedema without urticaria or pruritus

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11
Q

what are the investigations for allergic reactions ?

A 
full CBC ( eosinophilia)
Serum IgE
skin prick test 
challenge test 
C1 esterase inhibitor deficiency
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12
Q

what is the treatment of allergic reactions ?

A 
allergens avoidance 
antihistamines 
corticosteroids 
leukotrienes receptor agonists
monoclonal antibodies 
desensitization
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13
Q

what is always the first line treatment in allergic reactions ?

A

anti histamine

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14
Q

anaphylaxis ?

A

life threatening emergency
usually requires priming ( pre exposure to the antigen)
antigen must be systematically absorbed
rapid onset

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15
Q

what are the clinical features of anaphylaxis ?

A 
bronchospasm 
facial and laryngeal edema 
hypotension 
nausea and vomiting 
death can occur within minutes
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16
Q

what is the treatment of anaphylaxis ?

A 
ABCDE approach 
make sure patient is lying flat with feet raised 
open the airways 
o2 
establish a venous access
give subcutaneous adrenaline 0.5mg
IV hydrocortisone
17
Q

what is the non emergency treatment of anaphylaxis ?

A

prevention
epipen
desensitization

18
Q

SJS vs TEN

A

steven johnson syndrome and toxic epidermal necrolysis

19
Q

what is the percentage of skin detachment in SJS ?

A

less than 10%

20
Q

what is the percentage of skin detachment in TEN ?

A

more than 30%

21
Q

what is the percentage of skin detachment in SJS-TEN overlap ?

A

10-30%

22
Q

what is the pathogenesis of SJS-TEN ?

A

type 4 hypersensitivity

23
Q

how would you confirm a diagnosis of SJS-TEN ?

A

skin biopsy

24
Q

what are the DDX with SJS-TEN?

A

staphylococcal scalded skin syndrome

other bullous disease of the skin

25
Q

what is the management and treatment of SJS-TEN ?

A 
hospital admission 
stop the offending drug 
fluid replacement 
wound care 
eye+mouth care 
IV cyclosporine , predinsolone
26
Q

what is erythema multiforme ?

A

a self limited but potentially recurring disease and has two types one major and the other minor

27
Q

what is the clinical presentation of erythema multiforme ?

A

abrupt onset of papular target lesions

28
Q

what are the two types of lesions in erythema multiforme ?

A

typical- with at least three different zones

atypical - with only two different zones with poorly defined birders

29
Q

relation between EM and TEN ?

A

EM doesn’t carry the risk of becoming TEN

30
Q

what is the most common form of cutaneous drug eruption ?

A

exanthematous eruption also called

morbilliform or maculopapular eruptions

31
Q

what is the clinical picture of exanthematous eruptions?

A

erythema, macules and papules

prominent pruritus

32
Q

what is the treatment of exanthematous eruptions ?

A

topical steroids
antihistamines
supportive treatment

33
Q

what is the prognosis of exanthalmous drug eruption ?

A

good prognosis , clears within two weeks when offending drug is removed

34
Q

how do we test for a specific allergen ?

A

RAST test

35
Q

what are the precipitating factors for EM ?

A

HSV

ICC3 (66 decks)

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