Chapter 11: Allergic Conditions in Otolaryngology Patients Flashcards

1
Q

Common conditions involving the nose and sinuses

Adverse immune reactions

A

Allergies

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2
Q

Type of allergy which is mediated by reagin-type antibodies

A

Atopy

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3
Q

Main immunoglobulin involved in the production of atopic conditions

A

IgE

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4
Q

Involve and antibody, usually IgE, attached by the Fc portion to a cell containing mediators or their precursor

A

Antibody cell-associated reactions (reagin, cytophilic, anaphylactic antibodies)

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5
Q

Asthma
Anaphylaxis
Urticaria
Seasonal rhinitis

A

Antibody cell-associated reactions

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6
Q

Involve an antibody, usually of the IgG and IgM variety, interacting with an antigen that is part of or associated with the cell wall
Complement-dependent can cause damage, stimulation or blockade

A

Antigen cell-associated reactions (cytotoxic, blocking and stimulation antibodies)

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7
Q

Damage to cell

A

Rh-positive
Penicillin hemolytic anemia
Autoimmune thrombocytopenia

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8
Q

Stimulation

A

Thyrotoxicosis

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9
Q

Blocking

A

Myasthenia gravis
Insulin dependent diabetes
Bronchial asthma
Rhinitis

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10
Q

Involve interaction of the antigen and antibody independent of the cell, activating the complement and other amplifying systems–>adverse reaction
Eg. Serum sickness, PSGN,

A

Antigen-Antibody reactions and cell-independent reactions (arthus reaction, immune complex)

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11
Q

Antigen interacting with T lymphocytes leads to the release of various mediators
Eg. Dermatitis, transplantation reactions

A

Cell-mediated reactions

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12
Q

Main in vivo method to identify IgE or reaginic antibody

Occurs within minutes after introduction of the allergen

A

Skin testing

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13
Q

More sensitive but more likely to produce systemic reactions in highly sensitive individuals

A

Intradermal testing

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14
Q

Most popular way to quantify IgE

A

Radioallergosorbent test (RAST)

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15
Q

Indications for performing the RAST and the histamine release assay

A
  1. Situations in which the patient cannot be skin rested such as the presence of dermatographism, dependence on medication that interferes with skin testing, extreme youth and age when skin testing is difficult to perform and interpret, previous extreme sensitivity to the test allergen
  2. Need to confirm the significance of a positive skin test
  3. Strong history of allergen sensitivity but a negative skin test
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16
Q

Increased in subjects with allergic rhinitis

A

Nasal polyp and sinusitis

17
Q

Symptoms of allergic rhinitis

A
  1. Nasal congestion or obstruction
  2. Sneezing
  3. Watering and itching of the eyes
  4. Postnasal drip
18
Q

Most common complaints associated with nasal polyps

A
  1. Nasal obstruction

2. Rhinorrhea

19
Q

Physical exam in subjects with allergic rhinitis

A
  1. Excessive lacrimation
  2. Reddening of the sclera and conjunctiva
  3. Periorbital darkness (allergic shiners)
  4. Moderate to marked swelling of nasal turbinates
  5. Clear thin nasal secretions
  6. Lateral crease of the ridge of the nose
20
Q

Most common location of nasal polyp

A

Upper part of the lateral nasal wall around the middle turbinate

21
Q

Laboratory findings compatible with immunologic reactions

A
  1. Increased eosinophils in the nasal secretion and peripheral blood
  2. Elevated serum IgE level
22
Q

5 major areas in treatment of allergic rhinitis, nasal polyps and sinusitis

A
  1. Avoidance of the causative allergen
  2. Symptomatic treatment with drugs
  3. Allergen injection, immunotherapy or hyposensitization
  4. Management of complications or aggravating factors
  5. Surgical treatment