Session 2 - Group Work

Question 1

p28

Before you see the patient, you consider the possible causes for these symptoms.
List your differential diagnosis.

Answer 1

1. Acute allergic reaction
2. Food poisoning
3. Anaphylaxis
4. Meningitis
5. Contact allergy
6. Drug reaction/allergy (however, steroids are generally not immunogenic)

Question 2

p29

Spend 10 minutes on this next section.
What questions do you ask in your history to differentiate more likely causes?

Hint: Consider feeding history, past medical history, family history.

Your tutors have further information to share to help with the history taking.

Answer 2

• What did they eat?
• Have you had it before/is this the first time it’s happened?
• Do you have any family history of allergies?
• Do you have any family history of atopic conditions, e.g. eczema.
• When did it come on?
• What was he doing when it came on?
• Have you done any exercise prior to the symptoms?
• How are your asthma symptoms, do you have adequate control?
• Are there any other drugs you’re taking, e.g. OTC drugs?
• Do they have any pets?
• Timing: ask before, during and after?
• Are you refusing any food?
• Have you had any abdominal pain?
• Stools: consistency, frequency, colour. Any blood in stool?
• Any swelling?
• Any itchiness?

So do SQITARPS then system-specific questions (see Slide 24 of Immunology Session 2 - Lecture 1)

Question 3

p30

What clinic-based investigation would be useful?

Answer 3

Patch/pin prick test and IgE blood

Question 4

p31

Answer 4

Patient 1 - Brazil nuts 9 mm (and peanuts 5 mm)

Patient 2 - Viral infection (pt had hives and a fever on onset)

Question 5

p32

What treatment advice would you recommend for patient 1?

Answer 5

• Avoid nuts and anything that may contains nuts

- Carry 2 EpiPen and know how to use it and/or someone close to you knows how to use it.