Immunology

Question 1

Anaphylaxis dosing

4

Answer 1

Adults & >12: 0.5mg (0.5ml of 1 in 1000)

> 12 and small: 0.3mg

6-12yo: 0.3mg

Up to 6yo: 0.15mg

Question 2

Allergy vs Intolerance

Answer 2

Allergy = adverse IMMUNE response to food

Intolerance = non-immunological reaction to food (eg. Due to lack of enzymes)

Question 3

Food allergy types

2

Answer 3

1. IgE mediated = immediate, can be life-threatening

2. T cell mediated = delayed, often not life-threatening

Question 4

Diagnosis of food allergy

5

Answer 4

1. Clinical history
2. Elimination diets
3. RAST - IgE for specific foods
4. Skin prick tests (secondary care)
5. Oral challenge (secondary care) if uncertain diagnosis or to see if child has ‘outgrown’ allergy

Question 5

Anaphylaxis

Defn; Rx 3; Symp Rx 2; other Mx 2

Answer 5

= life-threatening hypersensitivity reaction rapidly affecting airway and circulation

Rx:

1. Adrenaline
2. Chlorpheniramine
3. Hydrocortisone

Symp Rx:

1. Salbutamol nebs
2. Ipratropium nebs

Other Mx:

1. Offer referral to ALL PATIENTS with suspected anaphylaxis
2. 2x adrenaline auto-injectors should be offered