Anaphylaxis and Allergy Flashcards Preview

Hugh's MD3 Paediatrics > Anaphylaxis and Allergy > Flashcards

Flashcards in Anaphylaxis and Allergy Deck (13):
1

What is atopy? What are the diseases which it presents as?

The ability to mount an IgE response to one or more common inhaled aeroallergen

 

Eczema

Asthma

Allergic rhinoconjunctivitis

Atopic dermatitis  

2

What is adrenaline dose in adults and children?

Adult: 0.5mg IM

Children: 0.01ml/kg (1:1000) IM Lateral thigh

Up to every 5 minutes, if not responding, consider infusion

3

What the triggers of anaphylaxis?

Food: Peanuts, tree nuts, seafood, eggs, cow's milk

Bites/stings: Bees, wasps, jumping ants Medications:

Betablockers, ab infusions, vaccines

Others: exercise, idiopathic, latex, hydatid

4

What are clinical features of anaphylaxis? What is required for diagnosis?

Resp: Tongue swelling, angioedema, stridor, wheeze, cough, tightness/swelling in throat

Cardio: Cyanosis, Tachycardia, bradycardia, hypotension, cardiac arrest

Skin: Urticaria, angioedema, pruritis

Gastro: Vomiting, diarrhoea, nausea, abdo pain

 

At least one resp/cardio symptoms and at least one skin/gastro symptom

 

Except for non-food allergens where GIT involvement is considered anaphylaxis

5

How do you manage anaphylaxis?

Lie patient supine (or on side if vomiting)

Administer IM adrenaline

Repeat dose if required

Call ambulance if in GP setting

Consider anti-histamines, corticosteroids

Observe for 4 hours

Consider IV access

6

When do you admit a child after anaphylaxis?

Greater than one dose of adrenaline required

Fluid bolus given

Inadequate response to therapy

Long distance from medical services

7

What are the long term treatment goals for a child whose had an anaphylaxis?

Action plan: Epipen (20 epipen 300ug)

Alert bracelet

Referral to allergy specialist

Ensure tight control of asthma

8

What is the association between asthma and anaphylaxis?

Asthmatics are at increased risk of death from anaphylaxis

9

How do you interpret positive skin prick tests?

- THe presence of specific IgE to an allergen is only one factor and should be correlated with history and/or trial of allergen avoidance/challenge 

 

The negative predictive value is better than the positive predictive value

10

What is the greatest predictor for the development of atopy?

Positive family history

- 40-60% likelihood of developing it if positive FHx in parents 

11

What do you advise patients before having a skin prick test?

Don't take anti-histamines in the 5 days prior 

12

When is immunotherapy indicated?

Insert bite anaphylaxis

Intractable and debilitating pollen induced allergic rhinoconjunctivitis

13

What is the "allergic march"?

Atopic dermatitis - usually by 6 months of life

Approximately 50% of these children then develop asthma in early childhood

Resolution of asthma in late childhood and development of allergic rhinitis which may be lifelong