Paediatric Allergy Flashcards
(18 cards)
1
Q
How do allergies develop?
A
- If exposed cutaneously - more likely to develop allergy (eg via eczema leaky skin)
- If eat during weaning period - more likely to be tolerant and can prevent allergy
2
Q
Sensitisation vs allergy
A
- Not everyone sensitised (has positive IgE test) is actually allergic
- Need positive test and symptoms
3
Q
What happens in IgE allergy?
A
IgE binds to mast cells
Cross links IgE whilst on mast cells = release of histamine, tryptase, leukotrines, prostaglandins
4
Q
Non IgE allergy testing
A
- Remove food
- Slowly reintroduce
5
Q
Minimum age to diagnose asthma
A
Not usually under 5 years old
6
Q
Rhinitis intermittent vs persistent
A
- Intermittent - < 4 days / week or <4 week at a time
- Persistent - 4 days or more per week and 4 or more weeks at a time
7
Q
Moderate rhinitis
A
- Abnormal sleep
- Impaired daily activities
- Problems at school/work
- Troublesome symptoms
8
Q
Eczema and allergy risk
A
- If you have eczema you have risk of IgE mediated allergy
- Do allergy testing on these children
9
Q
IgE assays - how do they work
A
- Allergen on plate
- Serum (patients) added - if Ab to allergen it will bind
- Labelled anti-human IgE added
10
Q
Gold standard for food allergy
A
- Double blind placebo controlled food challenge
- Tend to do open challenge in clinic
11
Q
Management of allergy
A
- Allergen avoidance - dietary avoidance
- Disease specific treatment - allergic rhinitis, urticaria, eczema
- Immunotherapy - some food allergies and rhinoconjunctivitis
12
Q
Define anaphylaxis
A
- Anaphylaxis is a severe, life threatening, systemic hypersensitivity reaction.
- Characterised by rapidly developing, life threatening problems involving airway and/or breathing and/or circulation.
- In most cases, there are associated skin and mucosal changes.
13
Q
Risk of anaphylaxis
A
- 80% with no treatment gets better
- Most respond to adrenaline
- Actually safer than travelling in a care (more people die / yr from this)
14
Q
Adrenaline doses based on children age
A
15
Q
Posture position someone should be in when anaphyalxsis
A
- Lie down with legs up
- OR sit up
16
Q
Advice re carrying epipens
A
- Carry two at all times
- Incase of misfire or if need 2nd dose
- BSACI allergy action plan - have photo on phone
17
Q
Pen vs needle for adrenaline
A
- Pen needles arent always long enough to penetrate IM
- Recommend using needles and syringe when in hosptial
18
Q
What is not part of initial anaphylaxis management?
A
- Antihistamines and corticsteroids - prevent biphasic reaction
- Steroids can be considered after initial resuscitation
