ENT: Allergy

Question 1

allergic reaction (general definition)

Answer 1

an exaggerated or inappropriate immune reaction that causes damage to the host

Question 2

allergic reaction of the skin

Answer 2

allergic eczema, urticaria, angioedema

Question 3

upper respiratory allergic reaction

Answer 3

rhinitis

Question 4

lower respiratory allergic reaction

Answer 4

asthma

Question 5

systemic allergic reaction

Answer 5

anaphylaxis

Question 6

allergy is what type of reaction

Answer 6

type I hypersensitivity reaction

Question 7

for an individual to become allergic to something, this must occur

Answer 7

they must already have been exposed to the substance and the body overreacts in its immune response

Question 8

after re-exposure to the allergic substance, this occurs

Answer 8

mast cells degranulate and release histamine, leukotrienes, and prostaglandins

Question 9

late phase response

Answer 9

usually occurs 2-4 hours after allergen exposure; due to migration of other leukocytes (neutrophils, lymphocytes, eosinophils, macrophages) to initial site

Question 10

allergic rhinitis

Answer 10

chronic inflammation of nasal airways

Question 11

risk factors for allergic rhinitis

Answer 11

other atopic disease presence, family history, environmental factors, individual’s alterations to that environment and their exposure

Question 12

symptoms of allergic rhinitis

Answer 12

may present with asthma or dermatitis;
may present clinically with sneezing, itching, blocked nose;
late symptoms: chronic obstruction, hyposomnia, hyperreactivity

Question 13

allergic inflammatory response presentation

Answer 13

sneezing, coughing, wheezing, runny nose, weepy eyes, itchiness

Question 14

classification of symptoms: mild

Answer 14

present with all of the following: 
normal sleep;
no impairment of daily activities, sport, leisure;
no impairment of work and school;
sx present but not troublesome

Question 15

classification of symptoms: intermittent

Answer 15

< 4 days per week OR < 4 consecutive weeks

Question 16

classification of symptoms: moderate-severe

Answer 16

one or more of the following:
sleep disturbance;
impairment of daily activities, sport, leisure;
impairment of school or work;
troublesome symptoms

Question 17

classification of symptoms: persistent

Answer 17

> 4 days a week AND >4 consecutive weeks

Question 18

skin tests

Answer 18

good for assessing allergic responses to known allergens. patient has a few substances placed on their arm and reactions to different substances are assessed

Question 19

RAST tests

Answer 19

analyze presence and levels of allergen-specific IgE. different levels of serum-specific IgE determine how sensitive an individual is to a specific allergen

Question 20

other allergy tests

Answer 20

total serum IgE, nasal allergen challenge, nasal cytology

Question 21

determining sensitivity

Answer 21

Level 0: <0.35 kU/L (negative);
Level 1: 0.35-0.69 kU/L;
Level 2: 0.7-3.4 kU/L;
Level 3: 3.5-17.4 kU/L;
Level 4: 17.5-49.9 kU/L;
Level 5: 50-99 kU/L;
Level 6: 100+ kU/L (very high sensitivity)

Question 22

treatment modalities for allergic reactions

Answer 22

Main = allergen avoidance. 
Pharmacotherapeutic treatments:
topic intranasal steroids,
systemic steroids,
antihistamines,
sodium cromoglycate,
allergen immunotherapy, 
anti-IgE,
immunotherapy