Immune (including Vaccinations)

Question 1

What does the term atopic mean?

Answer 1

When a reaction is associated with IgE antibodies to common inhalant allergens

Question 2

What symptoms may patients with allergic rhinitis may complain of?

Answer 2

Congested nose
Itchy eyes 
Sneezing
Cough from post-nasal drip
Sleep disturbance from chronically blocked nose

Question 3

What are the 3 main classifications of allergic rhinitis? Describe each

Answer 3

Seasonal: symptoms occur around the same time every year. Seasonal rhinitis which occurs secondary to pollen is called hay fever.
Perennial: Symptoms occur throughout the year
Occupational: Symptoms follow exposure to particular allergens within the work place

Question 4

What is the typical management of allergic rhinitis?

Answer 4

1) Allergen avoidance
2) Non sedating antihistamines (topical or systemic)
3) Topical corticosteroids - nasal or eye preparations
4) Short term nasal decongestants

Question 5

What other conditions is allergic rhinitis associated with?

Answer 5

Asthma
Eczema
Sinusitis
Adenoidal hypertrophy

Question 6

What is the definition of a food allergy?

Answer 6

Pathological response is mounted against a specific food protein. It can be either IgE or non IgE mediated.

Question 7

What is a food intolerance?

Answer 7

A non immune hypersensitivity reaction to a specific food

Question 8

What are the most common causes of food allergy in:

a) Infants
b) Older children?

Answer 8

a) Infants: Most common causes are milk, egg and peanut

b) Older children: Peanut, tree nut fish and shellfish

Question 9

How does a non Ig-E food allergy typically present?

Answer 9

Typically delayed by a few hours after eating the food.

GI symptoms including diarrhoea, vomiting, abdo pain and sometimes faltering of growth

Question 10

How does IgE mediated food allergy typically present>

Answer 10

There is usually a history of allergic symptoms varying from urticaria to facial swelling to anaphylaxis usually occurring 10-15 minutes (max 2 hours) after ingestion of food

Question 11

What are the most useful confirmatory tests for IgE mediated food allergy?

Answer 11

Skin-prick tests

Measurement of IgE antibodies in blood

Question 12

How are non IgE mediated food allergies typically diagnosed?

Answer 12

Diagnosis relies on clinical history and examination. If indicated, endoscopy and intestinal biopsy may be obtained. The diagnosis is supported by the presences of eosinophilic infiltrates

Question 13

What is the gold standard investigation for both IgE and non IgE mediated food allergies?

Answer 13

Exclusion of the relevant food under dietician’s supervision, followed by a double-blind placebo-controlled food challenge (performed in hospital with full resus facilities)

Question 14

How are food allergies managed?

Answer 14

Avoidance of the trigger food

Management plan for allergic attack - mild - antihistamines, severe - epipen

Question 15

How is measles spread?

How should measles be managed on a ward setting?

Answer 15

Respiratory droplets

Ensure the patient is being managed in a side room with respiratory precautions

Question 16

What are the initial symptoms seen with measles?

Answer 16

Runny nose
Sneezing
Irritable
Conjunctivitis (sensitivity to light)
Fever (can reach 40)
Cough

Then KOPLIK spots are seen before the rash which are white spots on the buccal mucosa

Question 17

Describe the rash seen with measles

Answer 17

Starts behind the ears then spreads to the whole body.

Is it a discrete maculopapular rash which becomes blotchy and confluent

Question 18

What are some complications of measles?

Answer 18

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Question 19

What is the management of measles?

Answer 19

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