pediatric allergies Flashcards
Typically rapid in onset, Skin, GI tract, Respiratory tract, Anaphylaxis
IgE mediated rxns
length of duration of the following allergies: Peanuts, Tree nuts, fish, Shellfish
lifelong
length of duration of the following allergies: cow’s milk, eggs, soybean, wheat
80% resolve by age 5
Occur hours to days after exposure. Typically presents in infants. Can present as chronic skin conditions or most commonly manifests as GI symptoms
non-IgE mediated reactions
associated with food allergies
atopic dermatitis and acute urticaria
appropriate initial tests for food allergy
serum specific IgE testing or skin prick testing
Gold standard for diagnosis of food allergy
A double-blind, placebo controlled food challenge
The patient is given gradually increasing amounts of the suspected food allergen over a time period of hours to a day
oral food challenge
A positive reaction is defined as a wheal at least 3mm greater than the negative control
Skin prick testing
cannot be performed on skin with extensive eczema/rash or in patients with dermatographia
skin prick testing
Detection of serum IgE to specific allergens
serum specific IgE testing
currently used to diagnose delayed hypersensitivity T-cell mediated reactions such as contact dermatitis. not recommended for food allergy testing
atopy patch tests
provide evidence of sensitization and help determine when a challenge is appropriate
skin tests and serum specific IgE
How should an epi pen be administered?
IM in the thigh
IgE-mediated reaction that affects the oropharynx
It is thought to occur from the cross-reactivity between proteins present in pollens and those expressed by fruits and vegetables
Pollen-food allergy syndrome (PFAS), also known as oral allergy syndrome (OAS)
Patients develop tingling and itching of the lips, tongue and palate when eating certain raw fruits and vegetables.
Pollen-food allergy syndrome (PFAS), also known as oral allergy syndrome (OAS)
This syndrome affects up to 50% of adults with allergic rhinitis secondary to pollens
Pollen-food allergy syndrome (PFAS), also known as oral allergy syndrome (OAS)
Tx of PFAS
antihistamines, avoid consumption of raw foods that produce sx
T/F Teenagers are at lower risk for fatal food-induced anaphylaxis than younger children
False, teenageers are at a higher risk.
most common food allergies in children
milk, egg, peanut
most common food allergies in adults
shellfish, peanut, tree nut
Sx include: sneezing, rhinorrhea, nasal congestion, itching of eyes, postnasal drip, irritability, fatigue
allergic rhinitis
Diseases associated with allergic rhinitis
OM, sinusitis, asthma, sleep-related breathing disorder
Transverse crease across nasal bridge
allergic salute
Dark swollen, infra-orbital tissue
allergic shiner
Infra-orbital creases due to edema and thickening of the skin
dennie morgan lines
Most effective first line treatment for allergic rhinitis in children < 2yrs
avoidance therapy
Meds for allergic rhinitis that should never be given to a child < 2yrs
first generation antihistamines (H1 blockers)
Medication for allergic rhinitis for childrean < 2 yrs
cromolyn nasal spray, 2nd gen antihistamines (ceterizine, fexofenadine).
Medications for kids > 2 yrs old for mild allergic rhinitis
Cetirizine, loratidine, or fexofenidine. intranasal glucocorticoid, cromolyn 30 min prior to exposure
Treatment for severe allergic rhinitis for children > 2yrs
intranasal glucocorticoid, topical nasal antihistamines, oral antihistamine, decongestant
Name the 3 intranasal glucocorticoids approved for kids due to less systemic absorption
Mometasone (Nasonex). Fluticasone furoate (Veramyst). Fluticasone propionate (Flonase) ≥ 4 years
Name the three topical nasal antihistamines and their corresponding age for recommended use
Azelastine (Astelin) > 5 years. Olopatidine (Patanase) > 12 years. Combo azelastine and fluticasone (Dymista) > 12 years
Medication that is good for allergic rhinitis with asthma and its corresponding age for recommended use
Monteleukast (Singulair). Approved for use in children as young as 6 months
