ENT: Allergy

Question 1

Give examples of some Allergies seen in ENT

Answer 1

Asthma
Allergic rhinitis
Eczema
Food allergies

Question 2

Risk factors for allergies (3)

Answer 2

1. Host factors are heredity, race, and age.
2. Environmental factors are alterations in exposure to infectious diseases during early childhood, environmental pollution, allergen levels, and dietary changes
3. Occupational – flour, latex, wood dust

Question 3

Allergies of the upper respiratory tract are called?

Answer 3

Rhinitis

Question 4

Allergies of the lower respiratory tract

Answer 4

asthma

Question 5

Systematic allergy

Answer 5

anaphylaxis

Question 6

Allergy: skin

Answer 6

urticaria/angioedema

Question 7

Risk factors of allergic rhinitis

Answer 7

Atopy - your genetic tendency to develop an allergy

Family history

1st born environmental factors - alterations in exposure to infectious diseases during childhood, environmental pollution, allergen levels and dietary changes

Question 8

What is allergic Rhinitis and what are some of its symptoms: immediate and late

Answer 8

Allergic inflammation of the nasal airways - occurs when allergen is inhaled by an individual with a sensitised immune system.

Immediate : sneezing, itch, nasal blockage, rhinorrhoea

Late : chronic obstruction, hyposmia, hyperreactivity

Question 9

Define the term ‘allergy’

Answer 9

Allergy is a hypersensitive disorder of the immune system.

Allergic reactions occur to normally harmless environmental substances known as allergens; these reactions are acquired.

Question 10

Type 1/ immediate Hypersensitivity reaction: immunology

Answer 10

Sensitization
Plasma cells produce IgE
Bind to mast cells

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

Question 11

What does the release of Histamine, Leukotrienes, Prostaglandins & chomotactic factors do in the body?

Answer 11

Vasodilation
Vascular permeability
Smooth muscle contraction
leukocyte infiltration
esp eosinophils

Question 12

Describe the acute response to an allergen

Answer 12

Exposure of allergen-

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 13

How long does the late-phase response take to kick in?

Answer 13

2-4 hours

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

Question 14

Give examples of some inflammatory responses by the body?

Answer 14

Sneezing
Coughing
Wheezing
Runny nose
Weepy eyes
Itchiness

Question 15

What is an allergy skin test?

Answer 15

A skin prick test, also called a puncture or scratch test, checks for immediate allergic reactions to as many as 40 different substances at once.

Up to 15% false positive

Question 16

What is a RAST test?

Answer 16

A radioallergosorbent is a blood test to see the presence and levels of allergen-specific IgE in an individual’s blood. Used to detect foods or inhalant allergies

Question 17

What are some other Allergy investigations other than the skin test and RAST?

Answer 17

Total Serum IgE
Nasal Allergen Challenge
Nasal Cytology

Question 18

Treatment options for allergies

Answer 18

Allergen avoidance (+ education)

Pharmacotherapy - topical/systemic steroids, antihistamines, Anti-IgE, allergen immunotherapy or sodium cromoglycate

Immunotherapy - involves giving gradually increasing doses of the substance, or allergen, to which the person is allergic