Allergies

Question 1

Risk factors for allergies?

Answer 1

1. Family history of atopy
2. Male
3. Birth during pollen season
4. Firstborn
5. Early use of antibiotics
6. Maternal smoking exposure
7. Exposure to indoor allergens

Question 2

What is atophy?

Answer 2

• Atopy refers to the genetic tendency to develop allergic diseases such asallergic rhinitis,asthmaandatopic dermatitis(eczema)
• Atopy is typically associated with heightened immune responses to common allergens, especially inhaled allergens and food allergens

Question 3

Clinical manifestations of allergies?

Answer 3

1. Sneezing
2. Rhinorrhea
3. Nasal obstruction
4. Nasal itching
5. Postnasal drip
6. Cough
7. Fatigue
8. Itching
9. Tearing

Question 4

Physical exam features in allergies?

Answer 4

1. “Allergic shiners”
2. Dennie-Morgan lines
   3 “Allergic salute”
3. Highly arched palate
4. Pale blue nasal mucosa in allergic rhinitis
5. Clear rhinorrhea
6. Hyperplastic lymphoid tissue “cobblestoneing”

Question 5

Associated conditions with allergies?

Answer 5

1. Allergic rhinitis
2. Allergic conjunctivitis
3. Sinusitis
4. Asthma
5. Atopic dermatitis
6. Oral allergy syndrome

Question 6

What is oral allergy syndrome?

Answer 6

also known as Pollen Food Allergy Syndrome)
- can be seen in patients with pollen allergy who experience mouth and throat itching, typically when eating fresh fruit and vegetables such as apples, melons, celery and carrots, but also with peanuts and tree nuts such as hazelnut.

Question 7

Treatment of allergies?

Answer 7

1. Avoid trigger
2. Cetirizine
3. Loratadine
4. Avoid sedating antihistamines in young children (diphenhydramine)
5. Antihistamine nasal spray (>6 years)
6. Glucocorticoid nasal spray

Question 8

History taking in anaphylaxis?

Answer 8

1. History of exposure
2. Chronology of symptoms
3. 2 or more systems involved
   - Wheezing + hives
   - Lip swelling + vomiting
   - Throat itching + hypotension
   Etc

Question 9

Common signs of anaphylaxis?

Answer 9

1. cutaneous urticaria
2. angioedema
3. flushing
4. pruritus

Question 10

Danger signs of anaphylaxis?

Answer 10

1. Stridor/Wheezing
2. Dyspnea
3. Cyanosis
4. Poor perfusion
5. Abdominal pain
6. Hypotension
7. Dysrrthymia

Question 11

Treatment of anaphylaxis?

Answer 11

1. Adrenaline 0.01 mg/kg IM outer thigh
2. Recumbent position
3. Oxygen via facemask
4. Treat poor perfusion with fluid bolus if needed
5. Salbutamol for bronchospasm
6. Consider:
   - H1 antihistamine
   - H2 antihistamine
   - Glucocorticoid
7. REASSESS! May need additional dose