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CP5-1 allergic diseases Flashcards

(52 cards)

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1
Q

What are symptoms of rhinitis?

A

Blocked/runny/itchy nose
Sneezing
Often with eye symptoms - itching, burning, redness, watery eyes

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2
Q

What are the two types of allergic rhinitis?

A

Seasonal
Perennial

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3
Q

What causes seasonal allergic rhinitis?

A

Pollen
Moulds

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4
Q

What causes perennial allergic rhinitis?

A

House dust mite
Animal dander

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5
Q

What causes non-allergic rhinitis?

A

Vasomotor changes
Infection
Structural changes
Drugs
Hormones
Polyps

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6
Q

How is rhinitis treated?

A

With antihistamines and intranasal steroids

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7
Q

What is asthma?

A

A disease of inflammation and hypersensitivity of small airways

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8
Q

What causes asthma in childhood?

A

Aero-allergic stimuli like house dust mites

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9
Q

What type of hypersensitivity causes anaphylaxis?

A

Type I

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10
Q

What hypersensitivity reactions are caused by IgG antibodies?

A

Type II and III

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11
Q

How do IgE antibodies cause allergic reactions?

A

Binding to mast cells

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12
Q

What immunoglobulin causes the immediate symptoms of asthma?

A

IgE

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13
Q

Fill in the blank.

Damaged airways due to asthma are ____________________ to non-allergic stimuli e.g. fumes.

A

Hyper-reactive

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14
Q

What is the pathogenesis of asthma?

A

Allergen taken up by antigen presenting cell which binds to Th2 cell. IL-4 and IL-13 convert Th2 into B cells/plasma cells resulting in release of IgE. IgE binds to mast cells/basophil

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15
Q

Where do asthma drugs target in the pathway?

A

G protein-coupled receptors (GPCRs)

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16
Q

What are the three types of dermatitis?

A

Eczema
Contact
Other types

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17
Q

What are the two subtypes of eczema?

A

Atopic
Non-atopic

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18
Q

What three conditions form the atopic triad?

A

Eczema
Asthma
Hay fever

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19
Q

What are the two sub-types of contact dermatitis?

A

Allergic
Non-allergic

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20
Q

What are symptoms of eczema?

A

Intense itching
Blistering/weeping
Cracking of skin

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21
Q

What is a major trigger for atopic eczema?

Study These Flashcards
A

House dust mite

22
Q

What three factors interplay with eczema?

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A

Skin barrier
Pruritus/scratching
Allergy

23
Q

What is the pathway of sensitisation and memory induction?

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A

Allergen binds to dendritic cell —> T cell binds to dendritic cell via MHC II molecule —> T cell differentiates into T helper 2 cell and there’s clonal expansion —> T helper 2 cells trigger memory B cells to produce IgE —> there is IgE memory B cell clonal expansion

24
Q

What is the pathway of immediate phase/type 1 reaction response?

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A

IgE released by B cells binds to mast cells + allergen binds to basophils —> degranulation + release of vasoactive amines, lipid mediators, chemokines and other cytokines

25
What is the pathway of late phase/allergic inflammation?
T helper cells: - activate eosinophils to release mediators, chemokines and inflammatory cytokines - initiates smooth muscle cells to contract and release chemokines and pro-inflammatory cytokines - increased adhesion of endothelial cells and inflammatory cell transmigration - initiates basophil entry into tissues and mast cell and basophil degranulation - causes atopic dermatitis by inducing keratinocyte apoptosis and activating epithelial cells to release chemokines and pro-inflammatory cytokines - causes allergic rhinitis and asthma by inducing increased mucus production, increased IgE production and induction of bronchial epithelial cell apoptosis.
26
Which cells secrete IgE?
Plasma cells
27
What are three specific IgE tests used?
Immulite 2000/Siemens ImmunoCAP/ThermoFisher Hytec 288 Plus/Hycor
28
What are the two types of ImmunoCAP? What are each used to test?
Extract - tests extraction of allergens raw material Component - sets allergen raw material after recombinant technology or purification.
29
What are two skin tests used to test for allergies?
Skin prick test - >2mm wheal = positive Intra-dermal
30
What are all the used tests for allergies?
Specific IgE tests Skin prick tests Intra-dermal tests Basophil activation tests Graded challenge test
31
What is a basophil activation test?
Patients basophil is exposed to allergen and then analysed for its response.
32
How do you treat allergies?
By symptoms - antihistamines, steroids, adrenaline Immunotherapy
33
What allergic diseases benefit from immunotherapy?
Life threatening reactions to wasp and bee stings Severe hay fever Animal dander allergies
34
What allergic disease is immunotherapy not helpful in?
Multiple allergies Food allergies Eczema Spontaneous urticaria (aka hives)
35
What is the gold standard test for allergies?
Graded challenge test
36
What is a graded challenge test for allergies?
A feeding test where allergen is consumed in gradually increasing amounts to diagnose or rule out a food allergy
37
What drug prevents skin prick tests from working?
Antihistamines
38
What are the two types of immunotherapy for allergies?
Subcutaneous Sublingual
39
What cells does allergic-specific immunotherapy target?
Eosinophils and mast cells - reduces numbers and mediation release T-cells - decreases their allergen specific proliferation, reduced number of T cells in late phase reaction, reduces number of t helper 1 and 2 cytokines in blood and T helper 2 in tissues (increased T helper 1 in tissues) + increases regulator T cells and IL-10 B-cells - reduction in allergen specific IgE and IgE facilitated antigen presentation , increase in IL-10 and blocking antibodies Monocytes - increase IL-10 production
40
What are benefits of allergen-specific immunotherapy?
improved quality of life Reduction of symptoms and drug/treatment use Decrease in response to allergen-challenge test and skin prick test Decrease in size and number of cells in late phase reaction Prevents progression of allergy Prevents new sensitisation
41
What are the two types of adverse food reactions?
Allergy Intolerance
42
What are the two sub categories of food intolerance?
Caused by food characteristics Caused by host characteristics
43
What are examples of food characteristics which cause intolerance?
Pharmacological e.g. contain caffeine Toxin e.g. bacterial
44
What are examples of host characteristics that cause food intolerances?
Metabolic e.g. lactase deficiency Psychological e.g. panic disorder
45
What are the three subtypes of food allergy?
IgE mediated Mixed Non-IgE mediated
46
What are examples of IgE mediated food allergic reactions?
Anaphylaxis Urticaria (aka hives = raised itchy skin rash) Angioedema (sudden swelling of part of the body) Oral allergy syndrome (itchy mouth and throat after consumption of allergen) Acute rhinitis Acute asthma
47
What are examples of mixed food allergy reactions?
Atopic dermatitis Eosinophillic esophagitis (inflammation of oesophagus) Eosinophillic enteritis (infiltration in bowel wall)
48
What are examples of non-IgE mediated food allergies?
Contact dermatitis Dermatitis herpetiformis Proctocolitis (inflammation of rectum and colon) FPIES (food protein-induced enterocolitis syndrome - usually affecting babies) Coeliac disease Heiner’s syndrome (a cow milk induced pulmonary disease mainly affecting infants)
49
What are the 6 major food allergens?
Cow’s milk Egg Legumes (peanut, soybean, tree nuts) Fish Crustaceans Cereal grains
50
What are the clinical manifestations of adverse food reactions?
Gastrointestinal- vomiting, diarrhoea, oral symptoms Respiratory - rhinitis, bronchospasm Cutaneous - urticaria, angioedema Anaphylaxis
51
What in a history will help with determining a drug allergy/what type of reaction it is?
Indication for the drug Description of the reaction Time between drug intake and symptom onset Number of doses take before onset Know the pharmacological effects of the drug
52
If a drug allergy is suspected, how is this managed?
Intradermal testing Graded challenge Desensitisation

Clinical Pathology (65 decks)

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