hypersensitivity, allergy and inflammation

Question 1

5 investigations for diagnosis of allergy

Answer 1

careful history, skin prick test, RAST (blood specific IgE; in lab, IgE in sampled blood bind to specific allergens), total IgE, lung function (asthma)

Question 2

emergency treatment for anaphylaxis, and what 3 things do these contain

Answer 2

EpiPen and analphylaxis kit, and seek immediate medical aid; contain antihistamine, steroid, adrenaline

Question 3

4 ways to prevent anaphylaxis or improve outcome

Answer 3

avoid known allergen, always carry kit and EpiPen, inform immediate family and caregivers, wear MedicAlert bracelet

Question 4

3 treatments for allergic rhinitis

Answer 4

anti-histamines (better for seasonal; sneezing, itching, rhinorrhoea), nasal steroid spray (nasal blockage), cromoglycate (blocks degranulation of mast cells in children, eyes)

Question 5

2 treatments for eczema

Answer 5

emollients (improve barrier aspects of skin), topical steroid cream (reduce type IV hypersensitivity)

Question 6

3 monoclonal antibody treatments if severe allergic rhinitis or eczema

Answer 6

anti-IgE, anti-IL -4/-13 or anti-IL-5

Question 7

asthma treatment: step 1

Answer 7

use short acting B2 agonist drug by inhalation e.g. salbutamol for mild, intermittent asthma

Question 8

asthma treatment: step 2

Answer 8

inhaled steroid low-moderate dose e.g. beclomethasone

Question 9

asthma treatment: step 3

Answer 9

add further therapy e.g. long acting bronchodilators, leukotriene antagonists, high dose inhaled steroids

Question 10

asthma treatment: step 4

Answer 10

add courses of oral steroids e.g. prednisolone, SLIT, azithromycin (anti-inflammatory properties); if severe, use monoclonal antibodies (anti-IgE, anti-IL-5, anti-IL -4/13)

Question 11

when is immunotherapy effective for

Answer 11

single antigen hypersensitivities

Question 12

4 examples of single antigen hypersensitivities which immunotherapy is useful for

Answer 12

venom allergy (bee/wasp stings), pollens, house dust mite

Question 13

2 types of immunotherapy following purification of antigen

Answer 13

subcutaneous (SCIT), sublingual (SLIT)

Question 14

subcutaneous (SCIT) vs sublingual (SLIT) immunotherapy

Answer 14

both 3 years but SCIT must be clinically administered whereas SLIT can be administered at home