ENT- allergies

Question 1

what are the common type of allergies in the UK?

Answer 1

asthma 9.4%, allergic rhinitis 5.4%
eczema 1%
food allergies
multiple allergies

Question 2

what is the cost of treating allergies in scotland?

Answer 2

130 million

Question 3

risk factors for allergies?

Answer 3

Host factors are heredity, race, and age.

Environmental factors are alterations in exposure to infectious diseases during early childhood, environmental pollution, allergen levels, and dietary changes
. Occupational – flour, latex, wood dust

Question 4

definitoin of allergy

Answer 4

Skin: Urticaria / angioedema
Upper Respiratory: Rhinitis
Lower Respiratory: Asthma
Systemic: Anaphylaxis

Question 5

risk factors for allergic rhinitis

Answer 5

atopy, family history, 1st born Environmental factors are alterations in exposure to infectious diseases during early childhood, environmental pollution, allergen levels, and dietary changes

Question 6

symptoms of allergic rhinitis

Answer 6

Immediate : sneezing, itch, nasal blockage, rhinorrhoea

Late : chronic obstruction, hyposmia, hyperreactivity

Question 7

definition of allergy

Answer 7

Allergy is a hypersensitive disorder of the immune system.

Question 8

what is an allergen?

Answer 8

antigen that causes allergic reactions

Question 9

pathophysiology of type 1 / immediate hypersensitivity reaction

Answer 9

Sensitization
Plasma cells produce IgE
Bind to mast cells

Re-exposure
Mast cells degranulate
Release Histamine, Leukotrienes, Prostaglandins & chomotactic factors

Question 10

what happens in an acute response?

Answer 10

Ag+ specific IgE –

degranulation with release of histamine, cytokines, interleukins, leukotrienes, and prostaglandins from their granules causing systemic effects, such as vasodilation, mucous secretion, nerve stimulation and smooth muscle contraction.

Question 11

why does a late-phase response occur?

Answer 11

This is due to the migration of other leukocytes such as neutrophils, lymphocytes, eosinophils and macrophages to the initial site.

Question 12

symptoms of an inflammatory response?

Answer 12

sneezing
coughing
wheezing
runny nose
weepy eyes
itchiness

Question 13

where does allergic rhinitis occur?

Answer 13

allergic inflammation of the nasal airway

Question 14

what makes an allergy intermittent?

Answer 14

symptoms less that 4 days per week or less than 4 consecutive weeks

Question 15

what makes an allergy persistent?

Answer 15

symptoms more than 4 days a week and over 4 consecutive weeks

Question 16

what makes an allergy mild?

Answer 16

normal sleep
no impairment of daily activities, sport, leisure
no impairment of work and school
symptoms present but not troublesome

Question 17

what makes an allergy moderate-severe?

Answer 17

sleep disturbance
impairement of daily activities. sport. leaser
impairement of school or work
troublesome symptoms

Question 18

how would you diagnose n allergies

Answer 18

Skin test: responses to known allergens- high NPV, upto 15% false positives

RAST: presence and levels of allergen-specific IgE.

Total Serum IgE
Nasal Allergen Challenge
Nasal Cytology

Question 19

treating allergies

Answer 19

Allergen avoidance- Education

Pharmacotherapy
    Topical Intranasal steroids
    Systemic Steroids
    Antihistamines
    Sodium Cromoglycate
    Allergen Immunotherapy
    Anti-IgE

Immunotherapy.