Urticaria, Angioedema And Allerhic Rhinitis Flashcards
What is atopy?
tendency to manifest asthma, rhinitis, urticaria, and atopic dermatitis alone or in combination, in association with the presence of allergen-specific IgE
Key effector cells in allergic rhinitis and asthma
Mast cells
dominant effector in urticaria, anaphylaxis, and systemic mastocytosis
Mast cells
binding of IgE to human mast cells and basophils
sensitization
Most potent known bronchoconstrictor
LTD4, acting at CysLT1 receptors
induces a vascular leak and mediates the recruitment of eosinophils to the bronchial mucosa
LTE4
Involves dilation of vascular structures in the superficial dermis,
Urticaria
originates from the deeper dermis and subcutaneous tissues.
angioedema
Urticarial lesions last for?
<24 hours
well-circumscribed wheals with erythematous raised serpiginous borders and blanched centers that may coalesce to become giant wheals
Urticaria
dramatic swelling with more pain than pruritus and minimal erythema, which may develop with a pruritic prodrome
Angioedema
takes hours to days to resolve.
Urticaria or angioedema?
Angioedema
Acute vs chronic urticaria/angioedema
Acute <6 weeks
Chronic >6 weeks
Usually idiopathic.
Acute or chronic urticaria?
chronic urticaria
linear wheal with surrounding erythema at the site of a brisk stroke with a firm object
Dermographism
Dermographism: Peak, duration and association with atopy?
Peaks in the 2nd to 3rd decades.
Duration <5 years.
Not influenced by atopy.
distinctive in that the pruritic wheals are of small size (1–2 mm) and are surrounded by a large area of erythema; attacks are precipitated by fever, a hot bath or shower, or exercise and are presumptively attributed to a rise in core body temperature
Cholinergic urticaria
association with the presence of IgE specific for α-5 gliadin, a component of wheat
Exercise-induced anaphylaxis
Urticaria associated with polycythemia vera
Aquagenic urticaria
Can be due to C1 inhibitor deficiency, resulting to generation of bradykinin
Angioedema without urticaria
Kay common sites for angioedema
Periorbital and perioral
Concomitant flushing and hyperpigmented papules that urticate with stroking in the absence of angioedema
mastocytosis
Hallmark of allergic rhinitis.
Episodic rhinorrhea, sneezing, obstruction of the nasal passages with lacrimation, and pruritus of the conjunctiva, nasal mucosa, and oropharynx.
occurs in the middle decades of life and is characterized by nasal obstruction, anosmia, chronic sinusitis, and prominent eosinophilic nasal discharge in the absence of allergen sensitization.
Perennial nonallergic rhinitis with eosinophilia syndrome (NARES)
Acute vs chronic rhinitis
<4 weeks
Oral long-acting H1 antihistamines are effective for the ff, except: A. nasopharyngeal itching B. Nasal congestion C. Watery rhinorrhea D. Ocular itching
Oral long-acting H1 antihistamines are effective for nasopharyngeal itching, sneezing, and watery rhinorrhea and for such ocular manifestations as itching, tearing, and erythema and less efficacious for nasal congestion.
most potent drugs available for the relief of established rhinitis, seasonal or perennial, and are effective in relieving nasal congestion as well as ocular symptoms
Intranasal high-potency glucocorticoids
Most common side effects of intranasal glucocorticoids?
local irritation
standard for the management of nasal congestion
Oral α-adrenergic agonist decongestants containing pseudoephedrine, generally in combination with an antihistamine.
