Food Allergy

Question 0

What are diagnoses associated with an IgE-mediated adverse food reaction?

Answer 0

(1) anaphylaxis
(2) urticaria
(3) angioedema
(4) oral food syndrome
(5) acute rhinitis
(6) acute asthma

Question 1

What childhood food allergies are typically outgrown?

Answer 1

Wheat, milk, egg, soy.

Question 2

Do you need to see cutaneous effects in an IgE-mediated reaction?

Answer 2

No, though they are usually present.

Question 3

What are cutaneous findings in an IgE-mediated reaction?

Answer 3

(1) hives
(2) swollen lips
(3) swollen tongue

Question 4

What are gastrointestinal findings in an IgE-mediated reaction?

Answer 4

(1) nausea
(2) vomiting
(3) diarrhea
(4) abdominal pain

Question 5

What are respiratory findings in an IgE-mediated reaction?

Answer 5

(1) runny nose
(2) sneezing
(3) congestion
(4) cough
(5) wheezing

Question 6

What are multiorgan findings in IgE-mediated reactions?

Answer 6

(1) cardiological

(2) neurological

Question 7

What is the most prominent feature reported by children in an IgE-mediated reaction?

Answer 7

Inability to breathe.

Question 8

What is the drug of choice for anaphylaxis?

Answer 8

Epinephrine.

Question 9

What are the alpha-adrenergic properties of epinephrine?

Answer 9

(1) vasoconstriction
(2) increased BP
(3) decreased capillary leakage

Question 10

What are the beta-adrenergic properties of epinephrine?

Answer 10

(1) relaxation of bronchial smooth muscle
(2) increased HR
(3) increased cardiac contractility

Question 11

What is the initial response in anaphylaxis?

Answer 11

(1) vasodilation
(2) vascular leakage
(3) smooth muscle spasm

Question 12

What is the late phase reaction in anaphylaxis?

Answer 12

(1) mucosal edema
(2) mucus secretion
(3) leukocyte infiltration
(4) epithelial damage
(5) bronchospasm

Question 13

J: This IgE mechanism entails a complex interaction between food, APCs, T cells and B cells.

Answer 13

What is anaphylaxis?

Question 14

What is oral tolerance?

Answer 14

A state if active inhibition of immune responses to an antigen by means of prior exposure to that antigen orally.

Question 15

What are the 3 most important cells in the GI tract for maintaining immune homeostasis?

Answer 15

(1) intestinal epithelial cells
(2) dendritic cells
(3) T regulatory cells

Question 16

What qualities of an ingested antigen influence the strength of the immune response?

Answer 16

(1) dose
(2) form
(3) size (smaller is worse)
(4) glycosylation
(5) resistance to thermal and chemical denaturation
(6) abundance in food
(7) linear epitopes
(8) solubility in water

Question 17

What barriers prevent antigens from penetrating through the GI epithelium?

Answer 17

(1) junctional complexes between cells
(2) hydrophobic layer of mucin oligosaccharides
(3) secretory IgA

Still 2% get through.

Question 18

What role do intestinal epithelial cells play in the immune system?

Answer 18

Normally, they present luminal antigens, leading to inactivation or suppression of immune response.

Question 19

Where are M cells found?

Answer 19

They are GI epithelial cells that are found overlying Peyer’s patches.

Question 20

What role do M cells play in the immune system?

Answer 20

The take up antigen from the GI lumen and deliver it to underlying immune cells.

Question 21

Where in the GI system are dendritic cells found?

Answer 21

Intestinal lamina propia, Peyer’s patches and mesenteric lymph nodes.

Question 22

How is low dose tolerance achieved?

Answer 22

A repeated lower dose activates T reg cells, leading to tolerance.

Question 23

How is high dose tolerance achieved?

Answer 23

Deletion or lymphocytic anergy after a single high dose.