Respiratory π« Flashcards
What is the skin prick test?
Most commonly used test for allergies, involving drops of diluted allergen placed on the skin and pierced with a needle. Results interpreted after 15 minutes.
Includes histamine (positive) and sterile water (negative) controls.
What does the radioallergosorbent test (RAST) measure?
Determines the amount of IgE that reacts specifically with suspected allergens, graded from 0 (negative) to 6 (strongly positive).
Useful for food allergies and inhaled allergens.
What is skin patch testing used for?
Useful for diagnosing contact dermatitis by placing allergens on the back and reading results after 48 hours.
May include testing for irritants.
Define oral allergy syndrome (OAS).
An IgE-mediated hypersensitivity reaction to specific raw plant-based foods, often linked to pollen allergies.
Presents with tingling or pruritus in the mouth.
How does OAS differ from traditional food allergies?
OAS is caused by cross-sensitization to similar proteins in pollen, while food allergies are due to direct sensitivity to food proteins.
Non-plant foods do not cause OAS.
What is the epidemiology of OAS in the UK?
About 2% of the UK population has OAS, often under-diagnosed.
1/2 of general pollen allergy patients and 3/4 of birch pollen allergy patients report OAS symptoms.
What are common associations with OAS?
- Birch pollen allergy
- Rye grass pollen allergy
- Rubber latex allergy
What are the common symptoms of OAS?
- Itching and tingling of lips, tongue, mouth
- Mild swelling and redness
- Nausea and vomiting in severe cases
- Symptoms resolve within one hour
Is anaphylaxis a common complication of OAS?
False
Anaphylaxis is very rare in OAS.
What investigations can be used for diagnosing OAS?
Clinical diagnosis; standard IgE RAST and skin prick testing for common allergens may be performed.
Positive skin prick test indicates allergy.
What is the primary management for OAS?
Avoidance of culprit foods.
Oral antihistamines can be used if symptoms develop.
What defines local and systemic reactions to venom allergies?
Local reactions are confined to the site of exposure, while systemic reactions occur away from the site and may involve widespread symptoms.
Anaphylaxis may occur with or without systemic reactions.
What is the first-line management for anaphylaxis?
Intramuscular adrenaline, intravenous steroids, and intravenous antihistamines as needed.
Oxygen and nebulised bronchodilators may also be required.
What is venom immunotherapy (VIT)?
An effective immunotherapy for patients with a history of systemic reactions and raised levels of venom-specific IgE.
Recommended for those with airway compromise or hemodynamic instability.
What are the βHsβ and βTsβ in reversible causes of cardiac arrest?
- Hs: Hypoxia, Hypovolaemia, Hyperkalemia, Hypokalaemia, Hypoglycaemia, Hypocalcaemia, Acidaemia, Hypothermia
- Ts: Thrombosis, Tension pneumothorax, Tamponade, Toxins
What is the recommended chest compression to ventilation ratio for adults during CPR?
30:2
What are the major points in the 2015 Resuscitation Council guidelines for cardiac arrest?
- Chest compressions
- Defibrillation
- Drug delivery via IV or IO
- Administration of adrenaline and amiodarone
What is the typical presentation of myocardial infarction?
Sudden onset of central, crushing chest pain, possibly radiating to the neck and left arm.
May include nausea and sweating.
What is the characteristic feature of a dissecting aortic aneurysm?
βTearingβ chest pain radiating through to the back and unequal upper limb blood pressure.
Most common in Afro-Caribbean males aged 50-70.
Which condition is associated with sharp chest pain relieved by sitting forwards?
Pericarditis
What is the common treatment for a perforated peptic ulcer?
Laparotomy, with small defects excised and larger defects managed with partial gastrectomy.
What type of pain is typically worse immediately after eating in gastric ulcers?
Gastric pain
This is a characteristic symptom associated with gastric ulcers.
What diagnostic tool may show free intra-abdominal air in cases of perforated gastric ulcers?
Erect chest x-ray
A small amount of free air may indicate perforation.
What is the typical treatment for a perforated gastric ulcer?
Laparotomy
Smaller defects may be managed with an omental patch, while larger defects may require partial gastrectomy.