Allergic DO including hay fever Flashcards

(55 cards)

1
Q

________ are one of the most common

causes of food-induced anaphylaxis in adults

A

Peanuts

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2
Q

Another special case is the___________, in which people with some degree of seasonal allergy to grass pollens or birch pollen suffer oral itch and swelling when they come into contact with certain fruits.

A

oral allergy syndrome

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3
Q

The development of urticaria on contact with latex is highly suggestive of underlying______

A

type 1 hypersensitivity

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4
Q

__________refers to those 40% of people who have an
inherited tendency for an exaggerated IgE antibody
response to common environmental antigens

A

Atopy

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5
Q

Of those who are atopic, onehalf
to one-third manifest an allergic disorder, most
commonly

1
2
3
4

A

allergic rhinitis, asthma, atopic dermatitis or allergic gastroenteropathy

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6
Q

MC manifestation of inhalant allergies

A

Allergic rhinoconjunctivitis and asthma are the main

manifestations

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7
Q

The history provides a strong pointer to the causative allergen. If symptoms are seasonal,_______ is most likely; perennial symptoms indicate an allergy to _____

A

pollen allergy

dust mites, household pets or moulds.

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8
Q

A_________ is an adverse reaction to a
specific food or food ingredient. It is regarded as a
food allergy if the reaction is immune based

A

food intolerance

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9
Q

Food allergies can be simply classified as:

1
2

A

• immediate reactions—occurring within 2 hours
• delayed reactions—occur up to 24 hours after
ingestion

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10
Q

These are immediate immune-mediated responses to

a foreign protein that are relatively easy to diagnose.

A

IgE-mediated food reactions

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11
Q

Pathophysio of IgE mediated food reactions

A

Due to release of mast cell mediators

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12
Q

Cow’s milk can cross-react with_____ and ______

A

goat’s milk and soy protein

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13
Q

Examples of Non-IgE-mediated food reactions

A

This includes cow’s milk protein intolerance with both breast milk- and formula-fed infants

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14
Q

T or F

Non-IgE-mediated food reactions

Uncommon after 3 years of age—50% resolve in
1–2 years

A

T

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15
Q

For milk protein intolerance first-line treatment
is a formula containing_______

Don’t use soy-based formulas under_______
months since many are also soy protein intolerant.

A

cow’s milk protein hydrolysate.

6

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16
Q

This is seen in young infants usually <6 months and
it is usually due to cow’s milk, soy or cereals. It can be
seen in breastfed infants and older children

A

Food protein induced enterocolitis syndrome (FPIES)

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17
Q

SSx of Food protein induced enterocolitis

syndrome (FPIES)

A

A typical reaction is delayed onset of projectile vomiting and protracted diarrhoea

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18
Q

Dx of Food protein induced enterocolitis

syndrome (FPIES)

A

The stool contains blood and eosinophils.

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19
Q

_____________testing is indicated

where skin testing contraindicated

A

Radioallergosorbent (RAST)

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20
Q

The combination of _____ and _______ is dangerous, as evidenced by fatal or near-fatal reactions in young children

A

peanut allergy

and asthma

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21
Q

Example of Adult anaphylaxis kit

A

Autoinjector 300 mcg adrenaline 1:1000 IM injection
Inject into outer thigh muscle at first sign of swelling of
throat or tongue, or other reaction (e.g. breathlessness)

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22
Q

What vaccine may not be given for pts with egg allergy?

A

Current vaccinations do not include egg; it is present

in only minute amounts in the MMR vaccine

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23
Q

Latex allergy is what type of allergic reaction?

A

The clinical manifestations of type 1 hypersensitivity
reactions to latex protein are wide-ranging, from
urticaria to life-threatening anaphylaxis and death

24
Q

IgE testing

This is the preferred method as results can be read
at the first consultation, provided the high-quality
allergen preparations are used

A

Skin-prick tests

25
When is Skin-prick tests useful?
If tests are negative. A negative | test is very useful for excluding IgE-mediated allergy
26
A number of tests, including______________ measure allergen-specific IgE in the serum.
RAST tests and ELISA | tests,
27
Indications for Detection of serum specific IgE
history and skin tests not matching, extensive eczema, dermographism, infants and very young children, immunotherapy work-up, antihistamine use in past 48 hours
28
This involves repeated administration of small, increasing | doses of allergen by subcutaneous injection
Immunotherapy (desensitisation)
29
This is the treatment of choice for severe wasp or bee venom allergy and for resistant allergic rhinoconjunctivitis where a single causative allergen can be identified.
Immunotherapy (desensitisation
30
May be seasonal or perennial. It can be classified as either intermittent (lasting for <4 days of the week or <4 weeks) or persistent (lasting >4 days of the week or >4 weeks).
Allergic rhinitis
31
This is the most common type of allergic rhinitis and is due to a specific allergic reaction of the nasal mucosa, principally to pollens
Seasonal allergic rhinoconjunctivitis (hay fever)
32
The allergens responsible for perennial allergic rhinitis include
inhaled dust, dust | mite, animal dander and fungal spores
33
While patients with________tend to have widespread itching (nose, throat and eyes), those with ______ rarely have eye or throat symptoms but mainly sneezing and watery rhinorrhoea
hay fever perennial rhinitis
34
In MX of hay fever, Avoid using __________: although they soothe at first, a worse effect occurs on the rebound
decongestant nose drops and sprays
35
Pharma Tx for Mx of hay fever
1 antihistamines: 2 decongestants (oral or topical) 3 sodium cromoglycate 4 corticosteroids
36
What kind of Tx for hay fever • oral (not so effective for vasomotor rhinitis) • intranasal spray (rapid action) • ophthalmic drops
Antihistamine
37
What kind of Tx for hay fever * intranasal: powder insufflation or spray * ophthalmic drops for associated conjunctivitis
sodium cromoglycate
38
What kind of Tx for hay fever? • intranasal (not so effective for non-eosinophilic vasomotor rhinitis) • oral (very effective if other methods fail) • ophthalmic drops for allergic conjunctivitis
corticosteroids
39
Consider __________ when specific allergens are known (very important) and conventional response is inadequate
hyposensitisation/immunotherapy
40
Immunotherapy by _____ or ______ administration can be intensive, often taking years
injection or oral
41
__________ are the first line of treatment for seasonal hay fever and are generally effective where symptoms are intermittent, or when they can be used prophylactically before periods of high pollen exposure
Oral antihistamines
42
___________either used alone or in combination with antihistamines (where they may help reduce drowsiness), may be of value, particularly where nasal discharge and stuffiness are major symptoms
Oral sympathomimetics,
43
When to use caution oral sympathomimetics
They should be used cautiously in patients with hypertension, heart disease, hyperthyroidism, glaucoma and prostatic hypertrophy.
44
Intranasal decongestants should be used for limited periods only (i.e. less than a week) or intermittently (3–4 doses per week) because of the potential problems with _____ and _________
rebound congestion and rhinitis | medicamentosa
45
when are the decongestants of value?
They are often of particular value during the first week of treatment with intranasal corticosteroids (where the onset of action is delayed several days), improving nasal patency and allowing more complete insufflation of the corticosteroids.
46
Intranasal ___________acts by preventing mast cell degranulation and is effective without serious side effects.
sodium cromoglycate
47
__________ sprays are the most | effective agents for treating seasonal allergic rhinitis
Intranasal corticosteroid
48
What to tell to pts with intranasal steroid
Patients should be informed that these medications will not give immediate relief (often taking 10–14 days to have peak effect) and must be used continuously throughout the hay fever season for at least 6–8 weeks
49
Mild SE of intranasal steroid
Local side effects include dryness and mild | epistaxis
50
__________ eyedrops are usually very | effective for springtime conjunctivitis
Sodium cromoglycate
51
best use of Sodium cromoglycate
They can used as necessary (there is no dosage limit) and are most helpful when used prophylactically before periods of high pollen exposure
52
These can be very effective where other treatments or methods have failed. A 6–10 day short course can be used.
Oral CS
53
The nasal preparation of this topical anti-cholinergic is often very effective when rhinorrhoea is the major problem.
Ipratropium bromide (Atrovent
54
Regarded as equivalent to oral antihistamines, they have a place in the management of children with concurrent asthma and hay fever
Leukotriene receptor antagonist
55
________ aims to reduce the size of turbinates and so reduce nasal obstruction when congested
Inferior turbinate reduction