Food Allergies

Question 1

A food allergy is n abnormal immunologic reaction to a food that results in the development of symptoms on exposure to a specific food. Is a food allergy and intolerance the same thing?

Answer 1

• no

Food intolerance involves a difficulty in digesting certain foods or ingredients which causes symptoms such as bloating, diarrhoea, headache

Question 2

At what age are food allergies most commonly diagnosed?

1 - <1 year
2 - <2 years
3 - <5 years
4 - <10 years

Answer 2

2 - <2 years

Question 3

What is the incidence of food allergies in the developed world?

1 - 3-6%
2 - 10-20%
3 - 25-50%
4 - >75%

Answer 3

1 - 3-6%

Accounts for 2 children to die each year in the UK

Question 4

Are all foods allergies IgE related?

Answer 4

• No

Can be:
- IgE related
- non-IgE related
- mix of IgE and non IgE related

Question 5

Food allergies can be can be
- IgE related
- non-IgE related
- mix of IgE and non IgE related

Of these which is the most difficult to diagnose?

Answer 5

• non-IgE related

Question 6

Food allergies can be can be
- IgE related
- non-IgE related
- mix of IgE and non IgE related

Of these which has the most rapid onset and is associated with anaphylaxis?

Answer 6

• IgE related
  Symptoms occur seconds to minutes

In non-IgE related, symptoms may not occur for hours

Question 7

In IgE related food allergies, which 2 of the following cells are typically involved?

1 - B cells
2 - mast cells
3 - basophils
4 - cytotoxic T cells

Answer 7

2 - mast cells
3 - basophils

Question 8

In non-IgE related food allergies, which 2 of the following cells are typically involved?

1 - B cells
2 - eosinophils
3 - basophils
4 - T cells

Answer 8

2 - eosinophils
4 - T cells

Question 9

In children with food allergies, which of the following are they most likley to also develop?

1 - urticaria
2 - atopic dermatitis
3 - acne vulgaris
4 - rosacea

Answer 9

2 - atopic dermatitis

Essentially all are linked with atopy

Question 10

In IgE related food allergies all of the following occur in the skin, but which is most common?

1 - urticaria
2 - angioedema
3 - uncomfortable skin
4 - all equally common

Answer 10

2 - angioedema

Essentially this is swelling of specific body parts

Question 11

In IgE related food allergies, all of the following occur in the respirator ytract, EXCEPT which one?

1 - irritation
2 - pneumonia
3 - swelling
4 - inspiratory wheeze

Answer 11

2 - pneumonia

Question 12

In IgE related food allergies, all of the following occur in the gastrointestinal tract, EXCEPT which one?

1 - bloody diarrhoea
2 - abdominal pain
3 - abdominal cramping
4 - nausea/vomiting

Question 13

In IgE related food allergies, anaphylaxis can occur, including all of the following, EXCEPT which one?

1 - vascular collapse
2 - hypertension
3 - cardiac dysrhythmias
4 - death

Answer 13

2 - hypertension

• hypotension occurs

Question 14

In non-IgE related food allergies, which of the following DO NOT typically occur?

1 - diarrhoea
2 - vomiting an nausea
3 - abdominal pain
4 - jaundice
5 - faltering growth
6 - blood in stools

Answer 14

4 - jaundice

Question 15

What is the most important clinical management of food allergies?

1 - epi-pens
2 - antihistamines
3 - IgE specific antibody test
4 - avoid food triggers/education

Answer 15

4 - avoid food triggers/education

Radioallergosorbent test (RAST) is a test on blood for specific antigens

Question 16

In food allergiesm which of the following children would get an Epi-pen?

1 - all children
2 - children whos parents ask for it
3 - children who have had a serious anaphylaxis reaction previously
4 - all of the above

Answer 16

3 - children who have had a serious anaphylaxis reaction previously

Question 17

Cows milk allergy is a reproducible immune-mediated allergic response to one or more proteins in cow’s milk. At what age is this typically diagnosed?

1 - <1 month
2 - <12 months
3 - <5 years
4 - <10 years

Answer 17

2 - <12 months

Question 18

Cows milk allergy is a reproducible immune-mediated allergic response to one or more proteins in cow’s milk. Is this IgE mediated, Non IgE or mixed?

Answer 18

• Can be all 3
• IgE = rash
• non-IgE = chronic symptoms

Question 19

Cows milk allergy is a reproducible immune-mediated allergic response to one or more proteins in cow’s milk. In a young baby, which of the following symptoms may tey present with if they have a cows milk allergy?

1 - rash/eczema
2 - unsettled with feeds
3 - constipation
4 - blood in stool
5 - vomiting
6 - diarrhoea
7 - all of the above

Answer 19

7 - all of the above

Question 20

Cows milk allergy is a reproducible immune-mediated allergic response to one or more proteins in cow’s milk. What is the management of this?

1 - stop cows milk formula
2 - all must switch to breast feeds
3 - slowly increase amount of cows milk in feeds
4 - move to pureed solids

Answer 20

1 - stop cows milk formula

Diagnosis of exclusion, then work with the dieticians to identify suitable foods

Question 21

All of the following could be differentials for cows milk allergy, but which is most likely?

1 - GORD
2 - pyloric stenosis
3 - ileum atresia
4 - duodenal atresia

Answer 21

1 - GORD

Can be hard to distinguish between the 2