Food Allergy Flashcards
What are diagnoses associated with an IgE-mediated adverse food reaction?
(1) anaphylaxis
(2) urticaria
(3) angioedema
(4) oral food syndrome
(5) acute rhinitis
(6) acute asthma
What childhood food allergies are typically outgrown?
Wheat, milk, egg, soy.
Do you need to see cutaneous effects in an IgE-mediated reaction?
No, though they are usually present.
What are cutaneous findings in an IgE-mediated reaction?
(1) hives
(2) swollen lips
(3) swollen tongue
What are gastrointestinal findings in an IgE-mediated reaction?
(1) nausea
(2) vomiting
(3) diarrhea
(4) abdominal pain
What are respiratory findings in an IgE-mediated reaction?
(1) runny nose
(2) sneezing
(3) congestion
(4) cough
(5) wheezing
What are multiorgan findings in IgE-mediated reactions?
(1) cardiological
(2) neurological
What is the most prominent feature reported by children in an IgE-mediated reaction?
Inability to breathe.
What is the drug of choice for anaphylaxis?
Epinephrine.
What are the alpha-adrenergic properties of epinephrine?
(1) vasoconstriction
(2) increased BP
(3) decreased capillary leakage
What are the beta-adrenergic properties of epinephrine?
(1) relaxation of bronchial smooth muscle
(2) increased HR
(3) increased cardiac contractility
What is the initial response in anaphylaxis?
(1) vasodilation
(2) vascular leakage
(3) smooth muscle spasm
What is the late phase reaction in anaphylaxis?
(1) mucosal edema
(2) mucus secretion
(3) leukocyte infiltration
(4) epithelial damage
(5) bronchospasm
J: This IgE mechanism entails a complex interaction between food, APCs, T cells and B cells.
What is anaphylaxis?
What is oral tolerance?
A state if active inhibition of immune responses to an antigen by means of prior exposure to that antigen orally.
What are the 3 most important cells in the GI tract for maintaining immune homeostasis?
(1) intestinal epithelial cells
(2) dendritic cells
(3) T regulatory cells
What qualities of an ingested antigen influence the strength of the immune response?
(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
What barriers prevent antigens from penetrating through the GI epithelium?
(1) junctional complexes between cells
(2) hydrophobic layer of mucin oligosaccharides
(3) secretory IgA
Still 2% get through.
What role do intestinal epithelial cells play in the immune system?
Normally, they present luminal antigens, leading to inactivation or suppression of immune response.
Where are M cells found?
They are GI epithelial cells that are found overlying Peyer’s patches.
What role do M cells play in the immune system?
The take up antigen from the GI lumen and deliver it to underlying immune cells.
Where in the GI system are dendritic cells found?
Intestinal lamina propia, Peyer’s patches and mesenteric lymph nodes.
How is low dose tolerance achieved?
A repeated lower dose activates T reg cells, leading to tolerance.
How is high dose tolerance achieved?
Deletion or lymphocytic anergy after a single high dose.
