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Head and Neck > ENT - Allergy > Flashcards

ENT - Allergy Flashcards

1
Q

Name reasons for why allergies are becoming increasingly common?

A
  • Children not developing immunity as kept too clean
  • Climate change
  • Eating more processed food
  • Sedentary lifestyles and obesity
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2
Q

What happens to IgE in allergic reactions?

A

Specific IgE made for allergens and their levels are raised during allergic reactions

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3
Q

Name risk factors for developing allergies

A
  • Host factors
  • Environmental factors
  • Occupational factors
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4
Q

What are host factors that increase risk of developing allergies?

A
  • Hereditary
  • Race
  • Age
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5
Q

What are environmental factors that increase risk of developing allergies?

A

Alterations in exposure to infectious diseases during early childhood, environmental pollution, allergen levels and dietary changes

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6
Q

What are occupational causes that increase the risk of developing allergies?

A

Flour, latex, wood dust

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7
Q

Name allergies of different parts of the body?

A
  • Skin: urticaria / angioedema
  • Upper respiratory: rhinitis
  • Lower respiratory: asthma
  • Systemic: anaphylaxis
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8
Q

What changes in the body occur in systemic allergies-allergen reactions?

A

Whole body swells due to massive allergic reaction – allergen antibody reaction to release histamines, prostaglandins, leukatrine etc causing loads of oedema which closes airways causing death

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9
Q

Name risk factors for allergic rhinitis?

A
  • Atopy
  • Family history
  • Environmental factors - exposure to infectious diseases during early childhood
  • Environmental pollution
  • Allergen levels
  • Dietary changes
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10
Q

Name intermediate symptoms of allergic rhinitis

A
  • Sneezing
  • Itch
  • Nasal blockage
  • Rhinorrhoea
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11
Q

Name the late symptoms of allergic rhinitis

A
  • Chronic obstruction
  • Hyposmia
  • Hyperreactivity
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12
Q

Define allergy

A

Hypersensitive disorder of the immune system

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13
Q

Are allergies congenital?

A

No - allergic reactions occur to normally harmless environmental substances known as allergens, these reactions are acquired as child develops sensitivity

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14
Q

Define allergen

A

Antigen that causes allergic reactions - usually proteins

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15
Q

What type of reaction occurs in allergic reactions?

A

Type 1 - Immediate hypersensitivity reaction

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16
Q

Describes what happens in type 1 immediate hypersensitivity reaction

A
  1. Sensitisation: plasma cells produce IgE which binds to mast cells
  2. Re-exposure: Mast cells degranulate which release histamine, leukotrienes, prostaglandins and chemotactic factors
17
Q

What is an allergic reaction?

A

It’s an exaggerated or inappropriate immune reaction and causes damage to the host

18
Q

What do mast cell release after degranulation?

A
  • Histamine
  • Leukotrienes
  • Prostaglandins
  • Chemotactic agents
19
Q

What is the effect of mast cell degranulation?

A
  • Vasodilation
  • Vascular permeability
  • Smooth muscle contraction
  • Leukocyte infiltration
20
Q

What occurs during the acute response of an allergic reaction?

A
  • Exposure of allergen
  • Ag+ specific IgE
  • Degranulation with release of histamine, cytokines, interleukins, leukotrienes and prostaglandins from their granules causing systemic effects, such as vasodilation, mucous secretion, nerve stimulation and smooth muscle contraction
21
Q

What occurs during the late phase response of an allergic reaction?

A
  • 2-4hrs
  • This is due to the migration of other leukocytes such neutrophils, lymphocytes, eosinophils and macrophages to the initial site
22
Q

What are systemic effects occurs during inflammatory response?

A
  • Sneezing
  • Coughing
  • Wheezing
  • Runny nose
  • Weepy eyes
  • Itchiness
23
Q

What is allergic rhinitis?

A

Allergic inflammation of the nasal airways

24
Q

What triggers allergic rhinitis?

A

Occurs when allergen is inhaled by an individual with a sensitised immune system

25
Q

Describe allergic rhinitis classification for intermittent AR?

A

Symptoms
• < 4days per weeks
• or < 4 consecutive weeks

26
Q

Describe allergic rhinitis classification for persistent AR?

A

Symptoms
• > 4 days/weeks
• and > 4 days consecutive weeks

27
Q

Describe allergic rhinitis classification for mild AR?

A
  • Normal sleep
  • No impairment of activities / work / school
  • Symptoms present but not troublesome
28
Q

Describe allergic rhinitis classification for mild AR?

A
  • Sleep disturbance
  • Impairment of activities / work / school
  • Troublesome symptoms
29
Q

What two tests are used to diagnose allergic rhinitis?

A
  • Skin tests

* RAST

30
Q

What is RAST test?

A

Detects presence and levels of allergen-specific IgE

31
Q

Name three other tests for allergy investigations

A
  • Total serum IgE
  • Nasal allergen challenge
  • Nasal cytology
32
Q

When is a total serum IgE test carried out?

A

If patient is highly atopic as would require a different treatment than anti-histamines and avoiding allergens

33
Q

What are three treatment options for allergies?

A
  • Allergen avoidance
  • Pharmacotherapy
  • Immunotherapy
34
Q

Name six different types of pharmacotherapy

A
  • Topical Intranasal steroids
  • Systemic Steroids
  • Antihistamines
  • Sodium Cromoglycate
  • Allergen Immunotherapy
  • Anti-IgE
35
Q

What is immunotherapy?

A

Give tiny bits of allergen to patient so that the body producing IgE against allergen so body stops recognising allergen in foreign body – in controlled environment over 3 days developing immune tolerance to allergen by repeated exposure

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