Allergy
Terms
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- Cromolyn fxn
- anti-inflammatory. Stabilizes mast cells. not a bronchodilator.
- exercise induced asthma
- occurs at the end or after exercise. Takes at least 10 minutes of activity to trigger.
- age of allergies
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food allergies: younger kids
pollen allergies: >4yrs - food allergies: sx
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makes eczema worse, can cause anaphylaxis. Does not worsen asthma or rhinitis.
<7yrs: egg, milk, wheat
>7yr: egg, milk, wheat, peanut, seafood - acute urticaria, time and provocateur
- <6wk. usually virus. Staph
- chronic urticaria, time, sx
- >6wks duration, stress, chronic exposure to antigen, thyroid, liver disease, autoimmune, infection
- agammaglobulinemia
- X-linked. 6mo sx start, as maternal Ab stop. pyogenic infections. no lymph nodes, no tonsils, absence in all Ig classes. Initial Rx is IVIg. No Ab prophylaxis.
- meds contraindicated in asthma
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B-blockers. block B-agonist therapy (albuterol)
NSAIDS should be avoided (can trigger asthma, - Samter S
- 10-30 yr old. asthma, nasal polyps, sinusits, NSAID sensitivity.
- venom immunotherapy
- for patients with systemic reactions to allergens. anaphylaxis.
- Type I hypersensitivity
- IgE allergic rxn may progress to anaphylaxis. Ag links to IgE and attach to mast cell causing degran:
- Type II hypersensitivity
- IgG Ab + Ag casue a rxn. Rh incompatibility is clssic.
- Type III hypersensitivity.
- IgAb-Ag complexes react with comlement. Serum sickness.
- Type IV
- delyaed hyperseneitivity. PPD. T cell reacts to Ag.
- theophyline problems
- erythromycin increases level. phenobarb decreases level. viral illness can increase levle. therapeutic index low.toxicity = seizures, intractable emesis.
- breast feeding delay of allergic disease
- if done for 6 months with supplement only by hypoallergenic formula
- best way to reduce eczema in baby
- Delay solid foods til after 4 months. reduced incidence of eczema.
- subtle signs of anaphylaxis
- Absence of rash, Abdominal pain.Feeling unwell or sense of doom, dizzyness, respiratory symptoms. Treat with epi when in doubt in those with known anaphylaxis (food allergies)
- severe eczema and food
- 40% have food sensativity. Start with elimination diet for 2 weeks. If skin improves, systematically reintroduce foods. RAST and Skin testing not terribly helpful. Skin tests 50% false positive.
- timing of drug allergy
- usually within 24hrs of starting therapy. Rash developing later is usually. A rash that continues for 48hrs after D/C of med is almost certainly not a drug rxn.
- age of outgrowing food allergies
- Most by milk, egg, soy alergiew outgrown by 5y