Food Allergy and Intolerance

Question 1

any adverse response to food

Answer 1

Adverse food reaction

Question 2

Difficulty of digesting food
Gas
Lactose intolerance - inability to digest lactose
Routine allergy testing - not effective in Food intolerance

Answer 2

Food intolerances

Question 3

IgE mediated reaction, occurs when the immune system, erroneously identified food protein as harmful

Answer 3

Food allergy

Question 4

caused by toxic, pharmacologic, metabolic, idiosyncratic, or non-immunoglobulin E (IgE) reactions to food or chemical substances in food.

ICD - 10 code K90.4

Answer 4

Food intolerance

Question 5

Immunoglobulin A

Answer 5

Celiac

Question 6

Lack of enzyme

Answer 6

Metabolic

Question 7

Caffeine sensitivity

Answer 7

Pharmacologic

Question 8

Red tide seasons

Answer 8

Toxic

Question 9

Undefined
Sulfites

Answer 9

Idiopathic

Question 10

represent altered reactivity to antigen called allergens

Answer 10

Allergic reactions

Question 11

defined as those specific components of food and ingredients within food (typically protein) that are recognized by allergen-specific immune cells and elicit specific immunologic

Answer 11

Food allergens

Question 12

foods with high protein content, usually of plant or marine origin

Answer 12

Common Food Allergens

Question 13

Hereditary, Antigen exposure, GI permeability, Amount of antigen presented, Environmental factors

Answer 13

Risk Factors

Question 14

this law identified eight foods as major food allergens: milk, eggs, fish, Crustacean shellfish, tree nuts, peanuts, wheat, and soybeans.

Answer 14

Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA)

Question 15

was signed into law, declaring sesame as the 9th major food allergen recognized by the United States.

Answer 15

Food Allergy Safety, Treatment, Education, and Research (FASTER) Act of 2021

Question 16

Swelling of lips, face, eyes
Hives or welts
Tingling of mouth
Abdominal pain, vomiting

Answer 16

Mild to Moderate

Question 17

Difficult or noisy breathing
Swelling of tongue
Swelling/tightness in throat
Difficulty talking and/or hoarse voice
Wheeze or persistent cough
Persistent dizziness or collapse
Pale and floppy (young children)

Answer 17

Severe allergic reactions (anaphylaxis)

Question 18

used for chronic symptoms such as hives, angioedema, and eczema all forms of food must be removed from the diet.

Answer 18

Food elimination diet

Question 19

Only _____ suspect foods at a time for each 2-week period is eliminated.

Answer 19

1 or 2

Question 20

foods are challenged one at a time on different days
Double blind placebo controlled challenge(DBPCF)

Answer 20

Oral food challenge

Question 21

Gold standard in diagnosing an allergy

Answer 21

Double blind placebo controlled challenge(DBPCF)

Question 22

do not point to the severity

Answer 22

Skin and blood

Question 23

When oral challenge is made

Answer 23

4-6 doses
15-20 minutes

Question 24

feed normal portion in a safe way

Answer 24

Main goal

Question 25

Patients asked to avoid

Answer 25

antihistamines

Question 26

IgE mediated typically occurs

Answer 26

1-2 hrs upon intake

Question 27

given medication

Answer 27

Epinephrine

Question 28

Most patients have increased QOL and safe for Food allergies.

Answer 28

Oral challenge

Question 29

measures the levels of allergy antibody, or IgE, produced when your blood is mixed with a series of allergens in a laboratory.

Answer 29

The blood test

Question 30

applying an extract of an allergy to your skin through: scratching or pricking the skin to allow exposure injecting the allergen under the skin applying it to a patch that is worn on the skin for a specified period of time Types: scratch test, intradermal test, and the patch test Skin prick or scratch test Intradermal skin testing

Answer 30

Skin testing

Question 31

A drop of antigen is placed on the skin and the skin is then scratched or punctured to allow penetration

Answer 31

Skin testing (scratch, prick, puncture)

Question 32

Serum is mixed with food on a paper disk and then washed with radioactively labeled IgE

Answer 32

Radioallegosorbent

Question 33

Much like RAST, except that no radioactive material is used

Answer 33

Enzyme-linked immunosorbent assay (ELISA)

Question 34

Compared to RAST, this test binds more allergen

Answer 34

CAP-RAST fluroscein-enzyme immunoassay (FEIA)

Question 35

Allergen is disguised and given orally and patient monitored for reaction; patient and MD blinded; also tested with placebo

Answer 35

Double-blind, placebo-contolled food challenge (DBPCFC)

Question 36

Techniques of precipitation hemaggulation, complement fixation; requires special expertise

Answer 36

Specific IgH, IgM, igA antibody assays

Question 37

Blood testing for food-specific IgG4.

Answer 37

IgG4

Question 38

giving minute amounts of offending food until the persons tolerates it completely

Answer 38

Desensitization

Question 39

total avoidance of the offending food or food substance

Answer 39

Elimination

Question 40

Essentiality of nutrient Fatality of symptoms

Answer 40

Bases of dietary judgment

Question 41

4 steps in elimination diet

Answer 41

Planning Avoiding Challenging Create a long term diet

Question 42

is a serious, potentially life-threatening allergic response that is marked by swelling

Answer 42

Anaphylaxis

Question 43

Anti- histamine Anti-inflammatory Epinephrine

Answer 43

MNT

Question 44

if you have been diagnosed with IgE-mediated food allergy, non-IgEmediated food allergy, or food allergy in combination with eczema, asthma, or EoE,

Answer 44

you should avoid the --allergenic food.

Question 45

if you have eczema, asthma, or EoE and you have not been diagnosed with food allergy

Answer 45

you should not avoid foods that may be allergenic as a way to manage your eczema, asthma, or EoE.

Question 46

Caused by nonimmunologic or non-IgE mechanisms adverse reaction to a food caused by toxic, pharmacologic, metabolic, or idiosyncratic reactions to the food or chemical substances in the food

Answer 46

Food Intolerance

Question 47

you may be able to eat small amounts of the offending food without trouble

Answer 47

food intolerance

Question 48

Uses various substrates like glucose, lactulose, lactose and fructose Used to diagnose small intestinal bacterial overgrowth (SIBO) and lactose or fructose malabsorption

Answer 48

Hydrogen Breath Test

Question 49

__ g lactulose, __ g glucose, __ g lactose or __ g fructose

Answer 49

10, 100, 50, 25

Question 50

Fasting overnight Avoid slowly absorbed carbohydrates (like bread and potato) and fiber No smoking and exercise 2 hours before the test No pro-motility, anti-motility drugs, antibiotics and other drugs Brush teeth and rinse mouth

Answer 50

Before the test

Question 51

All samples of breath are analyzed for hydrogen and methane every

Answer 51

15 minutes for 2 to 4 hours.

Question 52

Rise in hydrogen by 20 ppm above basal after lactose ingestion is considered

Answer 52

positive lactose HBT

Question 53

Failure of blood sugar to rise by 20 mg/dL at 30 minutes after ingestion of lactose is considered as

Answer 53

positive lactose tolerance test

Question 54

Rise in hydrogen by 20 ppm above basal after fructose ingestion is

Answer 54

positive fructose HBT

Question 55

Group of diseases that affect a wide variety of metabolic processes. These are genetic errors caused by defects in specific proteins (enzymes) needed to effectively process or transport small molecules such as amino acids, fatty acids, sugars, and metals. The disorder may result in the accumulation of harmful compounds in the body or can result in deficiencies of substances needed for normal growth and development. Some of the symptoms are fatal and irreversible (Nelms et al., 2016)

Answer 55

Inborn Errors of Metabolism

Question 56

Foods containing lactose and mammalian milk

Answer 56

Enzyme deficiency lactase

Question 57

Fava or broad beans

Answer 57

Glucose-6 phosphate dehydrogenase

Question 58

Foods containing sucrose or fructose

Answer 58

Fructase

Question 59

Symptoms may be precipitated by many foods, especially high-fat foods or certain proteins

Answer 59

Cystic Fibrosis Gallbladder disease Enteropathies

Question 60

Foods containing phenylalanine

Answer 60

Phenylketonuria

Question 61

Foods containing lactose or galactose

Answer 61

Galactosemia

Question 62

Symptoms may be precipitated by any food.

Answer 62

Psychological reactions

Question 63

Chocolate, aged cheese, red wine

Answer 63

Phenylethylamine

Question 64

Cheddar cheese, french cheeses, brewer’s yeast, chianti wine, canned fish

Answer 64

Tyramine

Question 65

Fermented cheeses, fermented foods 9e.g. Sauerkraut, pork, sausages, canned tuna, anchovies, sardines)

Answer 65

Hystamine

Question 66

Shellfish, chocolate, strawberries, tomatoes, peanuts, pork, wine, pineapple

Answer 66

Hystamine-releasing agents

Question 67

Yellow or yellow orange-colored foods, soft drinks, medicine

Answer 67

Tartrazine or FD&C yellow no.5

Question 68

Soft drinks and some cheeses, salt- free margarines and processed potato products

Answer 68

Benzoic acid or sodium benzoate

Question 69

Shrimp, many processed foods, avocado, instant potatoes, dried fruits and vegetables and fresh fruits and vegetables treated with sulfites to prevent browning, acidic juices, wine beer.

Answer 69

Sulfites

Question 70

Unrefrigerated scombroid fish (tuna, bonita, mackerel); het-stable toxin produced

Answer 70

Proteus causes histidine to breakdown to a histamine-like substance (anaphylactic type reaction)

Question 71

Mussels and clams that ingest the organism that produces saxitoin, a heat-stable neurotoxin

Answer 71

Gonyaulax catanella (red tide)

Question 72

Diagnosis of inherited metabolic disorders may be done thru

Answer 72

testing for specific metabolites.

Question 74

Elevations or deficiencies of certain substrates can point to the

Answer 74

location of the enzymatic block and thus the specific disorder.

Question 75

is the screening of all newborns for a limited number of the more common inborn errors of metabolism (Nelms, 2016). NBS is done immediately after 24 h from birth of the infant.

Answer 75

Newborn screening (NBS)

Question 76

Maintain biochemical equilibrium for the affected pathway;

Answer 76

The goals of medical nutrition therapy