Flashcards in Allergies Deck (66):
What types of reactions are allergic reactions?
IgE Mediated Reactions
Rapid in onset
What are the top 8 sources of IgE mediated responses?
Which of the top 8 sources of IgE mediated responses resolve by age 5?
Which of the top 8 sources of IgE mediated responses are lifelong?
Non-IgE Mediated Reactions
Hours to days after exposure
Presents in infants
Present as chronic skin conditions or GI symptoms
Common GI Symptoms for Non-IgE Mediated Reactions
Cutaneous Symptoms of Food Induced Allergic Reactions
Ocular Symptoms of Food Induced Allergic Reactions
Upper Respiratory Symptoms of Food Induced Allergic Reactions
Lower Respiratory Symptoms of Food Induced Allergic Reactions
GI Oral Symptoms of Food Induced Allergic Reactions
Angioedema of the lips
Tongue or palate
Lower GI Symptoms of Food Induced Allergic Reactions
Colicky abdominal pain
CV Symptoms of Food Induced Allergic Reactions
Diagnostic Tests for Food Induced Allergic Reactions
Skin prick test (SPT)
Allergen specific serum IgE
Oral food challenge
Treatment of Food Induced Allergic Reactions
Eli-Pen for anaphylacis
Is/are atopic dermatitis, chronic nasal congestion, or acute urticaria associated with food allergies?
What happens to atopic dermatitis after the elimination of the allergen?
When do you want to consider evaluation of atopic dermatitis in infants & children?
When there is moderate to severe atopic dermatitis
History of exacerbation with eating specific foods
Causes of Acute Urticaria
Is acute or chronic urticaria present with a food allergy?
Nasopharyngeal Symptoms with Food Allergies
Pruritis of the throat
What must be continued in order to do skin prick testing?
Which serum specific IgE tests need to be correlated with the patient's clinical history?
What is the gold standard for a diagnosis of food allergies?
Oral food challenge
How does the oral food challenge work?
Patient given gradually increasing amounts of the suspected food allergen over a time period of hours to a day
Close medical supervision
What are atopy patch tests used for?
Diagnose delayed hypersensitivity T-cell mediated reactions such as contact dermatitis
Diagnostics of Food Allergies
Serum specific IgE
Established Cutoff Values for Serum Specific IgE for Eggs
3-17 years: 7 kU/L
Established Cutoff Values for Serum Specific IgE for Cow's Milk
3-17 years: 15 kU/L
Established Cutoff Value for Serum Specific IgE for Peanuts
Established Cutoff Value for Serum Specific IgE for Fish
Treatment of Food Allergies
Avoidance of food
Notify adult when they eat something that may contain the food
Epi-pen auto injector
Where should Epi-pens be available for the child?
Define pollen-food allergy syndrome (PFAS)
Occur from cross-reactivity between proteins present in pollens and those expressed by fruits & veggies
Another Name for Pollen-Food Allergy Syndrome
Oral Allergy Syndrome (OAS)
Symptoms of PFAS and OAS
Tingling & itching of the lips, tongue, and palate when eating certain raw fruits & veggies
Do symptoms of PFAS/OAS occur when the fruit or vegetable is cooked?
Birch Pollen Cross Reactivity is Associated with Which Fruits/Veggies
Ragweed Pollen Cross Reactivity is Associated with Which Fruits/Veggies
Grass Pollen Cross Reactivity is Associated with Which Fruits/Veggies
Diagnosis of PFAS/OSA
Confirmed through skin prick testing to the fresh foods and pollen
Also with oral food challenges
Treatment of PFAS/OSA
Controlled with antihistamines
Avoid consumption of raw food product
Strictly avoid food in all forms if systemic symptoms
What advice would you give a peanut/tree nut allergy regarding their risk of fatal anaphylaxis?
Foods may unknowingly contaminated with peanuts/tree nuts and therefore having an Epi-pen is critical at all times
Who is at a higher risk for fatal food-induced anaphylaxis?
Why are teenagers at a higher risk for fatal food-induced anaphylaxis than younger children?
Decreased dose with increasing age
Poor understanding when reactions are severe and when Epi-pen use is needed
Are shellfish, eggs, or peanuts more common in adults than children?
What are the most common food allergies in children?
What are the most common food allergies in adults?
Symptoms of Allergic Rhinitis
Itching of the eyes, nose, palate, ear canals
Postnasal drip, cough
Allergic Rhinitis Significant Impact on QOL & Cognitive function
Sleep disordered breathing
Cognitive & psychiatric issues in children
What types of cognitive and psychiatric issues are there in children?
Lower exam scores in peak pollen season
Impaired athletic performance
Low self esteem
Diseases Associated with Allergic Rhinitis
Eustachian tube dysfunction
Sleep-related breathing disorders
Physical Findings of Allergic Rhinitis
Dennie Morgan lines
Diagnosis of Allergic Rhinitis
Presence of specific IgE to an allergen
Evidence of sensitization
Treatment of Allergic Rhinitis
Pharmacotherapy Options for Allergic Rhinitis
Mast cell stabilizers
Treatment in Children
Cromolyn nasal spray
Intranasal glucocorticoids (severe)
Treatment for Allergic Rhinitis with Mild or Episodic Symptoms
Cetirizine, loratidine, or fexofenidine
Azelastine (>5 years)
Olopatidine (>12 years)
Treatment for Allergic Rhinitis with Persistent or Severe Symptoms
Topical nasal antihistamines
Start with 1st and work down
Intranasal Glucocorticoids for Children
Memetasone (Nasonex) >2 years
Fluticasone furoate (Veramyst) >2 years
Fluticasone propionate (Flonase) >4 years
Topical Nasal Antihistamines for Children
Azelastine (Asteline) >5 years
Olopatidine (Patanase) >12 years
Combo azelastine & fluticasone (Dymista) >12 years
Treatment of Allergic Rhinitis with Allergic Conjunctivitis
Topical Ophthalmic antihistamine drops