pediatric allergies

Question 1

Typically rapid in onset, Skin, GI tract, Respiratory tract, Anaphylaxis

Answer 1

IgE mediated rxns

Question 2

length of duration of the following allergies: Peanuts, Tree nuts, fish, Shellfish

Answer 2

lifelong

Question 3

length of duration of the following allergies: cow’s milk, eggs, soybean, wheat

Answer 3

80% resolve by age 5

Question 4

Occur hours to days after exposure. Typically presents in infants. Can present as chronic skin conditions or most commonly manifests as GI symptoms

Answer 4

non-IgE mediated reactions

Question 5

associated with food allergies

Answer 5

atopic dermatitis and acute urticaria

Question 6

appropriate initial tests for food allergy

Answer 6

serum specific IgE testing or skin prick testing

Question 7

Gold standard for diagnosis of food allergy

Answer 7

A double-blind, placebo controlled food challenge

Question 8

The patient is given gradually increasing amounts of the suspected food allergen over a time period of hours to a day

Answer 8

oral food challenge

Question 9

A positive reaction is defined as a wheal at least 3mm greater than the negative control

Answer 9

Skin prick testing

Question 10

cannot be performed on skin with extensive eczema/rash or in patients with dermatographia

Answer 10

skin prick testing

Question 11

Detection of serum IgE to specific allergens

Answer 11

serum specific IgE testing

Question 12

currently used to diagnose delayed hypersensitivity T-cell mediated reactions such as contact dermatitis. not recommended for food allergy testing

Answer 12

atopy patch tests

Question 13

provide evidence of sensitization and help determine when a challenge is appropriate

Answer 13

skin tests and serum specific IgE

Question 14

How should an epi pen be administered?

Answer 14

IM in the thigh

Question 15

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

Answer 15

Pollen-food allergy syndrome (PFAS), also known as oral allergy syndrome (OAS)

Question 16

Patients develop tingling and itching of the lips, tongue and palate when eating certain raw fruits and vegetables.

Answer 16

Pollen-food allergy syndrome (PFAS), also known as oral allergy syndrome (OAS)

Question 17

This syndrome affects up to 50% of adults with allergic rhinitis secondary to pollens

Answer 17

Pollen-food allergy syndrome (PFAS), also known as oral allergy syndrome (OAS)

Question 18

Tx of PFAS

Answer 18

antihistamines, avoid consumption of raw foods that produce sx

Question 19

T/F Teenagers are at lower risk for fatal food-induced anaphylaxis than younger children

Answer 19

False, teenageers are at a higher risk.

Question 20

most common food allergies in children

Answer 20

milk, egg, peanut

Question 21

most common food allergies in adults

Answer 21

shellfish, peanut, tree nut

Question 22

Sx include: sneezing, rhinorrhea, nasal congestion, itching of eyes, postnasal drip, irritability, fatigue

Answer 22

allergic rhinitis

Question 23

Diseases associated with allergic rhinitis

Answer 23

OM, sinusitis, asthma, sleep-related breathing disorder

Question 24

Transverse crease across nasal bridge

Answer 24

allergic salute

Question 25

Dark swollen, infra-orbital tissue

Answer 25

allergic shiner

Question 26

Infra-orbital creases due to edema and thickening of the skin

Answer 26

dennie morgan lines

Question 27

Most effective first line treatment for allergic rhinitis in children < 2yrs

Answer 27

avoidance therapy

Question 28

Meds for allergic rhinitis that should never be given to a child < 2yrs

Answer 28

first generation antihistamines (H1 blockers)

Question 29

Medication for allergic rhinitis for childrean < 2 yrs

Answer 29

cromolyn nasal spray, 2nd gen antihistamines (ceterizine, fexofenadine).

Question 30

Medications for kids > 2 yrs old for mild allergic rhinitis

Answer 30

Cetirizine, loratidine, or fexofenidine. intranasal glucocorticoid, cromolyn 30 min prior to exposure

Question 31

Treatment for severe allergic rhinitis for children > 2yrs

Answer 31

intranasal glucocorticoid, topical nasal antihistamines, oral antihistamine, decongestant

Question 32

Name the 3 intranasal glucocorticoids approved for kids due to less systemic absorption

Answer 32

Mometasone (Nasonex). Fluticasone furoate (Veramyst). Fluticasone propionate (Flonase) ≥ 4 years

Question 33

Name the three topical nasal antihistamines and their corresponding age for recommended use

Answer 33

Azelastine (Astelin) > 5 years. Olopatidine (Patanase) > 12 years. Combo azelastine and fluticasone (Dymista) > 12 years

Question 34

Medication that is good for allergic rhinitis with asthma and its corresponding age for recommended use

Answer 34

Monteleukast (Singulair). Approved for use in children as young as 6 months