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Immune System > Food allergy > Flashcards

Food allergy Flashcards

1
Q

What is an allergen?

A

Any substance stimulating the production of IgE or a cellular immune response. Usually a protein, but can be carbohydrates (much less common).

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2
Q

What is sensitivity?

A

Normal response to a stimuli

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3
Q

What is hypersensitivity?

A

Abnormally strong response to a stimulus

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4
Q

What is sensitisation?

A

Production of IgE antibodies (detected by serum IgE assay or SPT) after repeated exposure to an allergen

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5
Q

What is an allergy?

A

A hypersensitivity reaction initiated by specific immuno- logical mechanisms. This can be IgE mediated (e.g. peanut allergy) or non-IgE mediated (e.g. milk allergy)

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6
Q

What is atrophy?

A

A tendency to produce IgE antibodies in response to ordinary exposure to potential allergens. Strongly associated with asthma, rhinitis, eczema and food allergy.

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7
Q

What is anaphylaxis?

A

A serious allergic reaction with bronchial, laryngeal and cardiovascular involvement that is rapid in onset and can cause death.

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8
Q

What is food?

A

A substance, whether processed, semi-processed or raw, which is intended for human consumption (including drinks), and any substance used in the manufacture, preparation or treatment of food

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9
Q

What is a food allergy?

A

Immunologically mediated adverse reaction to food

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10
Q

What are the symptoms for allergic rhinitis? (hay fever)

A

Blocked or runny nose
itchy nose
sneezing
triggered by pollen, pets or HDM

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11
Q

How does allergic conjunctivitis present?

A

Red, swollen, itchy watery eyes, may occur with hay fever

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12
Q

How does asthma present?

A

Chest symptoms of wheeze, cough, shortness of breath and tight chest pain
only sometimes allergic

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13
Q

How does atopic dermatitis eczema?

A

Commonest chronic inflammatory skin disease with itch and excoriation

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14
Q

How does urticaria present?

A

Acute/chronic (±6w) maculo-papular pruritic rash without or with angioedema

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15
Q

How does insect allergy present?

A

bee or wasp mainly
mild-local
moderate-urticaria and severe- anaphylaxis

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16
Q

How does drug allergy present?

A

e.g. antibiotics

only minority who are labeled drug allergic are actually allergic

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17
Q

How does food allergy present

A

broad spectrum varying in timing of presentation and severity

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18
Q

Can children grow out of eczema, hay fever and food allergy ?

A

Yes

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19
Q

What is the allergy of adult hood?

A

Hayfever

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20
Q

How many UK adults suffer from at least one allergy?

A

1/2

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21
Q

How can an allergy cause disruption to life?

A

symptoms and impaired sleep reduces productivity
recurrent hospital admissions and restrictive diets cause social exclusion
fatal

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22
Q

What is a food allergy?

A

An adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a food. Definition encompasses immune responses that are IgE- mediated or non-IgE mediated.

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23
Q

What is food intolerance?

A

Numerous (frequently reported) adverse responses to

foods that do not involve an immune response.

24
Q

What is prevalence?

A

milk eggs and peanuts mainly
self reported food allergy is 6x higher than proven allergy and
6% in child, 1-2% in adult

25
Q

What is the difference between non-immune mediated and immune mediated adverse food reactions?

A

Immune mediated are allergies and are IGE or non IGE mediated

26
Q

How long does IGE mediated symptoms take to onset?

A

5-30mins

27
Q

What food may cause an IGE mediated response?

A

Milk, eggs, peanuts, fish, fruit and veg

28
Q

What is the presenting age for IGE mediated response?

A

Variable as at age of contact

29
Q

When would symptom onset start for non IGE mediated allergy?

A

Delayed- hours to days

30
Q

What are common foods that cause non IGE mediated?

A

Milk, soya, wheat, rice and oats

31
Q

What is presenting age of non IGE?

A

Infancy and early childhood

32
Q

Which is more likely to resolve IGE or non-iGE?

A

Non IGE

both can resolve but non IGE quicker

33
Q

What is the difference between IGE and non-IGE presentation?

A

IGE is multisystem

non- IGE is eczema and gastrointestinal system

34
Q

What is Urticaria/angioedema?

A

Acute (rarely chronic) hives and swelling with gastro- intestinal but not respiratory or CVS symptoms

35
Q

What is food associated exercise induced anaphylaxis?

A

Food triggers anaphylaxis only if ingestion is followed temporally (within 2 hours) by exercise.

36
Q

What is pollen food syndrome?

A

Pruritus and mild oedema confined to the oral cavity (lips, tongue, mouth and throat) uncommonly progressing. Associated with hay fever

37
Q

What is protocolitis?

A

Passage of bright red blood in mucousy stools in otherwise asymptomatic infants

38
Q

What is enterocolitis?

A

Multiple and varying gastrointestinal symptoms including feed refusal, persistent vomiting, abdominal cramps, loose and frequent stools and constipation

39
Q

What is Eosinophilic oesophagitis?

A

Symptoms from oesophageal inflammation and scarring of feeding disorders reflux symptoms, vomiting, dysphagia and food impaction

40
Q

What is food protein induced enterocolitis syndrome?

A

Primary affects infants. profuse vomiting leaing to pallor, lethargy and possibly shock
25% diarrhoea

41
Q

What are the most common food allergies in infancy?

A

milk
egg
peanut

42
Q

What are the most common foods allergies in early childhood?

A

Soya
wheat
trees nuts
fish, shellfish, kiwi, sesame

43
Q

What is the most common allergy in adolesence?

A

fresh fruit and vegetables

44
Q

What may make a food be less allergic?

A

If high temperatures or change in food matrix e.g. baked milk, baked egg, boiled peanut, tuna and salmon canned

45
Q

What 4 things would you do to evaluate a child with possible food allergy?

A

Medical history,
Physical examination,
screening test, diagnosis verification

46
Q

What would you find out in a medical history with a child with possible food allergy?

A

Context of reaction, symptoms and food considerations

47
Q

How would you physically examine a child with possible food allergy?

A

Indentify manifestations, differential diagosis, other allergic conditions

48
Q

What screening tests would you do to a child with possible food allergy?

A

Skin prick test and blood specific IGE

and an elimination die

49
Q

What would you do as diagnosis verification for a child with possible food allergy?

A

Controlled oral food challenges

50
Q

If you are allergic to one thing are you likely to be allergic to something similar?

A

yes e.g. cow and goats milk

51
Q

What is the typical immunoassay for detection of specific IGE in 3 steps?

A
  1. Allergen is adsorbed and immobilised
    to a solid phase. 2. Patient’s serum is added followed by
    incubation for 30-60 minutes
    followed by several washing steps. 3. Allergen-bound IgE is detected by an
    enzymatically labeled anti-human IgE
    monoclonal antibody.
52
Q

What are you looking at in an IGE test?

A

ige circulating in blood

53
Q

What are you looking at in a skin prick test?

A

Response of skin mast cells to allergens

54
Q

Does IGE circulating correlate with severity of reaction?

A

no

55
Q

How are food allergies managed?

A

Anticipatory allergy testing. dietetic advice for exclusions, emergency medication if needed, early introductions to food in infancy, desensitisation to food allergens, oral food challenges for diagnostic verification

56
Q

If you do a skin test, what size would show a 95% chance of food allergy?

A

8mm

Immune System (6 decks)

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