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H and N > ENT - allergy > Flashcards

ENT - allergy Flashcards

1
Q

Define allergy

A

Chronic condition involving abnormal hypersensitive reaction produced by the immune system to an ordinarily harmless antigen called anallergen

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2
Q

What are the 2 types of rhinitis

A

ALLERGIC RHINITIS & NON-ALLERGIC RHINITIS

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3
Q

Allergic rhinitis is also known as

A

Hayfever

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4
Q

Define rhinitis

A

Nasal mucosa inflammation

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5
Q

Define allergic rhinitis

A

Nasal mucosa inflammation due to an allergen - e.g. pollen, cat hair, dust

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6
Q

Immediate symptoms of allergic rhinitis (4)

A

Itchy nose
Sneezing
Blocked nose
Rhinorrhoea (nasal discharge)

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7
Q

Late symptoms of allergic rhinitis (3)

A

Chronic obstruction
Hyposmia (Reduced smell)
Hyper-reactivity

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8
Q

Pathophysiology of allergic rhinitis (type 1 hypersensitivity reaction) (2)

A

Sensitisation to the allergen
-plasma cells produce specific IgE in response to allergen and IgE binds to mast cells

Re-exposure to the allergen

  • stimulates that specific IgE to act against the allergen
  • mast cell degranulation
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9
Q

What do mast cells contain (4)

A

Histamine, leukotrienes, prostaglandins, chemotactic factors

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10
Q

Effect of histamine release in allergic rhinitis

A

Vasodilation –> increasing vascular permeability

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11
Q

Effect of leukotriene release in allergic rhinitis

A

promotes inflammation by activating neutrophil production and recruiting them to the area

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12
Q

Effect of prostagrandin release in allergic rhinitis (2)

A

Smooth muscle contraction

Vasodilation

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13
Q

Effect of chemotactic factor release in allergic rhinitis

A

Leukocyte infiltration (esp eosinophils)

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14
Q

2 stages of type 1 hypersensitivity reaction

A

Acute (immediate response)
-minutes after exposure

Late phase response
-2-4hrs after exposure

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15
Q

What occurs in the acute immediate response of type 1 hypersensitivity reactions

A

Mast cell degranulation –> vasodilation, mucous secretion, nerve stimulation & smooth muscle contraction

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16
Q

What occurs in the late phase response of type 1 hypersensitivity reactions

A

Migration of other leukocytes (e.g. neutrophils, lymphocytes, eosinophils and macrophages) to the initial site

17
Q

Name 3 factors that produce allergic reactions, e.g. eczema, asthma, food allergies

A

Host factors
Environmental factors
Occupational factors

18
Q

List some host factors that contribute to allergic reactions (3)

A

Inherited
Race
Age

19
Q

List some environmental factors that contribute to allergic reactions (3)

A

Exposure to infectious diseases during early childhood
Pollution
Dietary changes

20
Q

List some occupational factors that contribute to allergic reactions (3)

A

Flour - bakers
Latex - health workers
Wood dust

21
Q

Define intermittent allergic rhinitis

A

Symptoms <4 days per week OR <4 consecutive weeks

22
Q

Define persistent allergic rhinitis

A

Symptoms >4 days per week AND >4 consecutive weeks

23
Q

Investigations of allergic reactions (5)

A 
Skin test
RAST (radioallergosorben test)
Total serum IgE
Nasal allergen challenge
Nasal cytology
24
Q

How does the skin test work

A

Checks for immediate allergic reactions to as many as 40 different substances at once.

Small amounts of different allergens are placed on an individual’s skin, usually with a pinprick.

If allergic to these substances, will develop itchyhivesat these sites

25
Q

How does the RAST (radioallergosorben test) work

A

Is a blood test so takes longer than skin test so skin test preferred
Looking for presence and levels of IgE against specific allergens in the blood

26
Q

Negative RAST test = what concentration of IgE

A

Level 0: IgE <0.35kU/L

27
Q

Treatment of allergic reactions (3)

A

Avoid allergen
Pharmacotherapy
Immunotherapy

28
Q

Pharmacotherapy of allergic reactions (7)

A

Topical intranasal steroids
Systemic Steroids
Antihistamines - prevent vasoconstriction etc
LTRA
Sodium cromoglycate - inhibits degranulation of mast cells
Allergen Immunotherapy
Anti-IgE

29
Q

How is immunotherapy used to treat allergic reactions

A

Stops body from producing specific IgE against the allergen by stopping it from recognising it as a foreign antigen

Patient is admitted to ITU and gradually increasing doses of the allergen are injected over 6 weeks for 3 consecutive years to allow immune system to become less sensitive to the allergen

H and N (14 decks)

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