ENT - allergy

Question 1

what are risk factors for ENT allergy

Answer 1

host factors:
hereidtary, race, age

environmental factors:
exposure to infectious disease, pollution, allergen levels, diet changes

occupational:
flour, latex, wood dust

Question 2

how does skin allergy present

Answer 2

urticaria, angioedema

Question 3

how does upper respiratory allergy present

Answer 3

rhinitis

Question 4

how does lower respiratory allergy present

Answer 4

asthma

Question 5

how does systemic allergy present

Answer 5

anaphylaxis

Question 6

what are the symptoms of immediate rhinitis

Answer 6

sneezing, itch, nasal blockage, rhinorrhoea, coughing, weepy eyes

Question 7

what are the symptoms of late rhinitis

Answer 7

chronic obstruction, hyposmia, hyperreactivity

Question 8

what is the definition of an allergy

Answer 8

a hypersensitive disorder of the immune system

reactions occur to normally harmless environmental substances (allergens)

reactions are acquired

Question 9

what is allergen

Answer 9

an antigen that causes an allergic reaction - usually proteins

Question 10

what is the pathology behind TYPE 1 immediate hypersensitivity reactions

Answer 10

SENSITIZATION:

• plasma cells produce IgE
• bind to mast cells

RE-EXPOSURE

• mast cells degranulate
• release histamine, leukotrienes, prostaglandins and chemotactic factors
• lead to inflammatory response symptoms

Question 11

what does mast cell degranulation cause

Answer 11

vasodilation, increased vascular permeability, mucous secretion smooth muscle contraction, leukocyte infiltration (esp eosinophils)

Question 12

how does a late-phase response occur in type 1 hypersensitivity

Answer 12

occurs 2-4 hours later

due to migration of other leukocytes e.g. neutrophils, lymphocytes, eosinophils and macrophages to the initial site

Question 13

what is the definition of allergic rhinitis and how does it occur

Answer 13

allergic inflammation of the nasal airways - occurs when there an allergen is inhaled by an individual with a sensitized immune system

Question 14

what classifies AR as intermittent

Answer 14

symptoms:
<4 days per week
OR
< 4 consecutive weeks

Question 15

what classifies AR as persistent

Answer 15

symptoms:
>4 days per week
AND
>4 consecutive weeks

Question 16

what classifies AR as mild

Answer 16

ALL OF:

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

Question 17

what classifies AR as moderate-severe

Answer 17

ONE OR MORE OF:

• sleep disturbance
• impairment of delay activities, school or work
• troublesome symptoms

Question 18

what are the 2 main test to diagnose AR

Answer 18

skin test - responses to known allergens BUT can have many false positive readings

RAST - blood test used to detect presence and levels of allergen specific IgE antibodies

Question 19

what other tests can be used to diagnose allergies

Answer 19

total serum IgE
nasal allergen challenge
nasal cytology

Question 20

what are the three types treatment for allergies

Answer 20

allergen avoidance

pharmacotherapy

immunotherapy

Question 21

give examples of pharmacotherapy for allergies

Answer 21

topical intranasal steroids
systemic steroids
antihistamines
sodium cromoglycate
allergen immunotherapy
anti-IgE