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Block 3 Week 8 > Pediatric Food Allergies > Flashcards

Pediatric Food Allergies Flashcards

1
Q

What are the 2 ways you can classify adverse food reactions?

A

1) immunologically mediated

2) food interolerance

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2
Q

What are the 2 kinds of immunologically mediated adverse food reactions?

A

mediated by IgE

non IgE mediated (take hours to evolve)

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3
Q

What is food intolerance?

A

Adverse physiologic response to a food or food additive not immunologically mediated

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4
Q

Immune reponses to food are considered food allergies while non immune adverse reaction are considered to be a problem in one of four different categories which are?

A

metabolic
pharmacologic
toxic
other

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5
Q

What are the five metabolic disorders that can cause adverse reactions to food?

A 
lactase deficiency
fructose intolerance
galactosemia
pancreatic insufficiency
gallbladder/ liver disease
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6
Q

What are the four pharmacological disorders that can cause adverse reactions to food?

A

histamine
tyramine
caffeine
theobromine

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7
Q

What are the three toxic disorders that can cause adverse reactions to food?

A

food poisioning
scombroid fish poisioning
ciguaterra fish poisoning

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8
Q

What are considered to be part of the ‘other’ category of non immune related adverse food reactions?

A

panic, anxiety
hiatal hernia
reflux

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9
Q

What are food allergens?

A

water soluble glycoproteins that are heat and proteolysis resistant that get absorbed across mucosal surfaces

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10
Q 
What are these:
peanut Ara h1, Ara h2, and Ara h3
chicken egg white Gal d1, Gal d2, and Gal d3; 
soybean-Gly m1
fish-Gad c1
shrimp-Pen a1.
A

purified food allergens

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11
Q

How many people think they have food allergies?

actual?

A

30% believe 1 family member has it

6% in infants and 3.7% of adults

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12
Q

What are the most common food allergies in children?

A 
cow milk, 2.5% 
eggs, 1.3% 
peanuts, 0.8%
wheat, 0.4% 
soy, 0.4%
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13
Q

Is a food allergy a disease?

When is it most prevalent?

A

yes

in children, after age 15 it drops (allergies disappear with age and dont occur as often in later years)

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14
Q

What does IgE mediated adverse food reactions cause?

A

anaphylaxis, food associated excercis induced anaphylaxi, uticaria (hives) /angioedema (swelling), immediate GI problem, pollen-food allergy syndrome, bronchospasm

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15
Q

What will mixed IgE mediated and non mediated adverse food reactions cause?

A

atopic dermatitis (exzema), asthma, eosinophilic esophagitis/gastroenteritis

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16
Q

What will non-IgE mediated adverse food reactions cause?

A

dermatitis herpetiformis, celiac disease; enteropathy, food-induced enterocolitis syndrome, allergic proctocolitis, Heiner’s syndrome

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17
Q

Is celiacs disease IgE mediated?

A

NO

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18
Q

What is the most common mechanism of food hypersensitivity?

A

IgE

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19
Q

Where do we find mast cells and basophils and why is this important?

A

in skin, Gi tract, and respiratory tract
cuz when IgE is activated by specific antigen it will bind to these mast and basophils and cause the IgE to dimerize and cause cross-linking which will release histamine, prostaglandins, leukotrienes, chemotactic factors, and cytokines

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20
Q

What does IgE due to you vascular system and smooth muscle?

A

vasodilation, smooth muscle contraction and mucus secretion

21
Q

Is the IgE reaction fast or slow?

A

Super fast

22
Q

Is IgE specific to an antigen?

A

yes

23
Q

What is anaphylaxis?

A

worse case scenario and caused within hour of food ingestion and is IgE mediated

24
Q

What are these symptoms of:
Urticaria, angioedema, difficulty breathing, wheezing, hypotension, oropharyngeal pruritus, angioedema, stridor, dysphonia, cough, dyspnea, nausea, vomiting, diarrhea, flushing
“Sense of impending doom”

A

Food anaphylaxis

25
Q

How do you die from anaphylaxis?

A

Fatalities result from severe laryngeal edema, irreversible bronchospasm, refractory hypotension, or a combination.
(HAPPENS REALLY FAST SO BE AWARE)

26
Q

What is pollen-food allergy syndrome?

A

patients eat food and get itching/tingling/ on tongue, palate, throat not due to food, but due to a pollen allergy (lots of food have the same protein of pollen in their skin)

27
Q

Bananas, pumpkins, and melons have a specific protein in them as (blank) pollen which will induce a allergic reaction.

A

ragweed

28
Q

What is this:

Caused by cross-reactivity between certain pollen and food allergens.

A

Pollen-food allergy syndrome (Oral allergy syndrome)

29
Q

What are the four tests needed to test food allergies?

A

Skin tests
RAST tests
Patch tests
Food Challenges

30
Q

What is the allergy prick test (skin test)?

A

Used for immediate hypersensitivity reactions (IgE)
has high false positive rates
uses fruits and vegetables
test is blocked with antihistamines

31
Q 
What are these:
Ragweed pollen
Birch pollen
Alder pollen
Grass pollen
A

pollens that can cause cross-reactivity to food

32
Q

What is the most common cause of food-induced anaphylactic reaction?

A

peanuts, tree nuts, shellfish

33
Q

Can benedryl stop an anaphylaxis reaction?

A

no, you need epinephrine and you cant hesitate and you must recognize the symptoms.

34
Q

What is the RAST test?

A

Blood test-> measures serum IgE against foods
VERY high false positive rate
No effects from antihistamines :)
(pnt doesnt need to cooperate)

35
Q

Is the IgG RAST test good?

A

NO! it is worthless, the IgE test is great through :)

36
Q

To assess food allergies, your diagnosis must be based on (blank)

A

patient history

37
Q

Does food allergies cause behavioral problems?

A

NO

38
Q

What is the allergy patch test?

A

used for non-mediated IgE reactions, tape allergen to skin and read in 72 hours to check out if you have sensitized lymphocytes.
Doesnt really work with food. Good for nickel allergy.
Can tell us about:
Food protein induced enterocolitis syndrome
Eosinophilic esophagitis

39
Q

What is the food challenge?

A

placebo controlled blind study to check for food allergy.

Takes hours

40
Q

What is food protein-induced enterocolitis syndrome (FPIES)?

A

Seen in infants; cell mediated GI hypersensitivity to food with vomiting, diarrhea,lethargy and severe dehydration.
Can be due to milk, sow, grains, vegies, poultry

41
Q

Do kids grow out of FPIES?

A

yes

42
Q

What is eosinophilc esophagitis?

A 
disorder of all ages; 
infant->stunted growth
children-> vomit
adolescents-> heart burn
adults-> food impactions
Have asthma and hay fever
43
Q

What causes eosinophlic esophagitis?

A

dieases, steroids, allergies (cant diagnosis with pulmonary function test, you need GI doc to look around)

44
Q

What allergy is most associated with AD (eczema)

A

egg!!!!!!!!!!>milk>peanuts (only in older kids)

45
Q

How do you treat food allergies?

A 
strict elimination (touch, inhalation, ingestion, injection)
epinephrine
46
Q

How do you treat eosinophilc esophagitis?

A

Elimination of foods (most affective)

corticosteroids (prednisone, fluticason) budesonides (safe for children), allergy shots

47
Q

How can kids possibly be able to eat peanuts again after having an allergy?
How about for milk?

A

gradual oral immunotherapy

same but less proven

48
Q

Indiscriminate RAST testing is a bad idea

T or F?

A

T

49
Q

With EE, kids are more sensitive to (blank)

while adults are more sensitive to (blank)

A

IgE and patch sensitization to foods

IgE to inhalant allergens

Block 3 Week 8 (8 decks)

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