ENT allergy

Question 1

Why are allergies on the increase?

Answer 1

better hygiene

Question 2

Are IgE specific or general?

Answer 2

specific antibodies against specific allergens

Question 3

host risk factors

Answer 3

age, hereditary, race

Question 4

Environmental risk factors

Answer 4

infectious diseases, pollution, diet

Question 5

occupational risk factors

Answer 5

flour, latex, wood dust

Question 6

urticaria

Answer 6

hives

Question 7

What is allergic rhinitis associated with?

Answer 7

asthma, atopic dermatitis

Question 8

immediate symptoms of allergic rhinitis

Answer 8

sneeze, itch, rhinorrhoea, blockage

Question 9

Late symptoms of allergic rhinitis

Answer 9

chronic obstruction, hyposmia, hypereactivity

Question 10

hyposmia

Answer 10

reduced sense of smell

Question 11

Are you born with allergies or are they acquired?

Answer 11

acquired

Question 12

Allergen

Answer 12

usually protein

antigen that causes allergic reactions

Question 13

Why is the mode of transmission of the allergen important?

Answer 13

symptoms

Question 14

Is allergy a type 1 or type 2 hypersensitivity reaction?

Answer 14

1

Question 15

Explain the sensitisation and re-exposure of allergies

Answer 15

plasma cells produce IgE which binds to mast cells

mast cells degranulate and release histamine, leukotrienes, prostaglandins, chemotactic factors

Question 16

What do the mast cell contents promote?

Answer 16

vasodilation, vascular permeability, smooth muscle contraction, leukocyte infiltration

Question 17

What causes the late phase response of the hypersensitivity reaction?

Answer 17

infiltration of other leukocytes eg macrophages, lymphocytes, neutrophils, eosiniphils

Question 18

Allergic rhinitis

Answer 18

allergic inflammation of the nasal airways

Question 19

What route of administration must the allergen pass to cause allergic rhinitis?

Answer 19

inhaled

Question 20

Classification - ARIA

Answer 20

persistent - >4 days a week or >4 consecutive weeks
intermittent less than this
can be mild, moderate severe depending on affects on sleep, work, school, activities

Question 21

Diagnosis of allergies

Answer 21

skin test

RAST - blood test

Question 22

Investigations of allergies

Answer 22

IV serum specific IgE
total serum IgE
nasal allergen challenge
nasal cytology

Question 23

Important values in RAST

Answer 23

<0.35 = -ve 
>100 = severe

Question 24

Treatment of allergies

Answer 24

education - avoidance
pharmacotherapy - antihistamine, steroids, immunotherapy
surgery eg nasal septum deviation correction