Asthma and Allergies Flashcards
chronic inflamartory disease of the airways with:
- episodic or chronic symptoms of airway obstruction
- bronchial hyperresponsiveness to triggers
- evidence of at least partial reversibility of airway obstruction
- alternative dx have been excluded
asthma
what is the etiology of asthma?
specific cause unknown but it is thought to deal with :
- environmental (allergens, infections, microbes…)
- biologic and genetic risks (immune system)
why is asthma important in kids/
- most common chronic medical condition of childhood, causing significant morbidity
- 6.3 million children have asthma (9%)
which gender is more likely to have asthma?
males
- 80% of asthmatics report onset prior to age 5
- leading cause of hospitalizations
type of asthma that is recurrent wheezing in early childhood, primarily triggered by common viral infections of the respiratory tract
type one
type of asthma that is chronic asthma associated with allergy that persists into late childhood and often adulthood
type 2
what is the pathogenesis of asthma?
- airflow obstruction from bronchoconstriction
- inflammation, edema, and mucus
- production of pro-allergic, pro-inflammatory cytokines
- mediation of inflammatory process by chemokines
triggered activation of MAST cells and histamine degranulation following exposure to allergens (dust, pollen)
extrinsic (allergic) asthma
trigger from tobacco smoke, air polution, strong fumes/odors, chemicals in air, respiratory infections, exercise, cold air, anxiety, stress, GI reflux. aspirin or NSAIDS
intrinsic (non-allergic/idiopathic) asthma
how many asthmatics have both types of triggers?
10%
what are the rescue medications for astmatics?
- short-acting beta agonists (albuterol)
- anticholinergics
*always bring to the appt
what are some comorbidities of asthma?
- allergic rhinitis (hay fever)
- chronic sinusitis
- gastroesophageal reflux disease
- food allergies
- atopic dermatitis, eczema
what causes candadiasis in kids?
immature immune system, antibiotics, steroid inhalers, maternal infection, pacifiers
what are some oral disease prevention with asthmatics?
- drink or rinse with water after inhaler use
- recommend inhaler extenders to dec risk of candadiasis
4% of asthmatics are allergic to NSAIDS, so what should you use instead?
acetaminophen
what is the prevalence for food allergies with kids?
2%
what causes food allergies with kids?
- aberrant immune response caused by exposure to specific food protein
- may be IgE mediated, cell mediated, or both
what are the major signs and symptoms of food allergies?
- GI problems: nausea, vomitting, diarrhea
- respiritory problems: sneezing, rhinorrhea, bronchoconstriciton
- oral and cutaneous reactions: hives, eczema, angioedema
well-demarcarted non-pitting oedema that is a reaction deeper in the dermis and subcutaneous tissues that was first described by Quincke in 1882
angioedema
what causes angioedema?
same pathological factors that cause urticaria
where is angioedema most commonly located?
face, tongue, eyelids mostly
what is the big fear with angioedema?
may cause life-threatening respiratory distress if LARYNX is involved
localized IgE mediated allergy, usually to raw fruits and vegitibles that most commonly affect pts who are allergic to pollens
- symptoms are generally short lived
- restriced to oral cavity
- occasionally pruritis
oral allergy syndrome
what are the symptoms of oral allergy syndrome?
-after contact to fruit or vegitible, rapid onset of itching of the lips, tongue, roof of mouth, and throat. WITH OR WITHOUT swelling, and/or tingling of the lips, tongue, roof of mouth, and throat
how would you dx oral allergy syndrome?
- reproducibilty of symptoms on exposure
- skin-prick test or blood test confirmation
multiple red, annular patches with white scalloped border, LOSS OF FILIFORM PAPILLAE, may have burning or fissured tongue
- occurs on the dorsum of the tongue
- pain is persistent but waxe and wanes
benign migratory glossitis
what is the prevalence of benign migratory glossits
up to 3% in all ages (more in kids)
what is the cause of benign migratory glossitis?
unknown, allergy, hormonal
