VIT

Question 1

when to continue VIT past 5 years

Answer 1

Exterme reaction, inc tryptase, SR on VIT and honeybee

Consider if no dec in IgE/CVD disease, ACE or beta, qol

Question 2

when to measure tryptase

Answer 2

Sever reaction hypotension, lack of urticaria, systemic reactionw ith NEG IgE test result
Consdeir: sytemis rxn during VIT, before stopping VIT anyone who is canddiate for VIT

Question 3

what r risk factor for severe rxn

Answer 3

Very specific prev rxn, no urticara or angioedema, male, over 45yo, insect species, multiple stings, ACE in (labs venom spt, basal serum typtase, BAD, IgE, ACE)

Question 4

FP rate for intrademral testing VIT

Answer 4

25%

Question 5

how many ppl have sytemic rxn during build up

Answer 5

10-15%

Question 6

if postivie hx and SPT , what % will have SR in future

Answer 6

30-70%

Question 7

envt chagnes to prevent stining

1 sting is 50mcg

Answer 7

closed drink, wear long sleeves, dont keep food exposed, avoid eating outdoors, avoid flowering plant, dont drink from straw, remove fallen fruit or pet feces, cover trash, watch for nets and dont go otusdie barefoot
NOT EFFECTIVE: colors, fragrence running, insect repelant

Question 8

risk factor for fatal anaphylaxi

Answer 8

UTD:
•Most consistently noted risk factor for fatal anaphylaxis is concomitant asthma

• Delayed or no administration of epinephrine
• Upright posture during anaphylaxis
• Other cardiopulmonary diseases - eg. ischemic heart disease, heart failure, COPD
• Taking medications that prevent optimal epinephrine effect: beta blocker, alpha blocker, ACE inhibitors
• Systemic mastocytosis
• Beta lactam antibiotics cause more fatalities than other drugs

◦Other drugs implicated: radiocontrast agents, neuromuscular blockers, allergen immunotherapy, other antibiotics

• Food: peanuts and tree nuts account for majority of food-induced fatalities; cow’s milk and seafood are also leading causes
• Hymenoptera sting anaphylaxis