Cf Fm Ch 6 Allergic Disorders 1

Front 1

1. Allergic rhinitis?

Back 1

a. Inflammation of the nasal membranes/passages caused by allergic reaction to airborne substances.

Front 2

2. Presentation of allergic rhinitis?

Back 2

a. Involves inflammation of the mucous membranes of the nose, eyes, eustachian tubes, middle ear, sinuses, pharynx.

Front 3

3. Pathophysiology of allergic rhinitis?

Back 3

a. Complex interaction of inflammatory mediators but, ultimately, is triggered by a IgE-mediated response to an extrinsic protein.

Front 4

4. What causes congestion allergic rhinitis?

Back 4

a. Vasodilation from inflammatory mediators

Front 5

5. What supports the diagnosis of allergic rhinitis?

Back 5

a. Response to treatment with antihistamines

Front 6

6. Physical exam findings in the nose w/ allergic rhinitis?

Back 6

a. Swollen (boggy) with
b. A pale, bluish-grey colour.
c. Thin and watery secretions frequently associated with allergic rhinitis whereas thinking purulent secretions are usually associated with sinusitis (this is not always diagnostic or consistent)

Front 7

7. Presentation of nasal polyps?

Back 7

a. Firm, gray masses that are often attacked by a stalk, which may not be visible. Polyps do not shrink, whereas the surrounding nasal mucosa does shrink

Front 8

8. Dennie-Morgan lines?

Back 8

a. Prominent creases below the inferior eyelid
b. Associated with allergic rhinitis

Front 9

9. What is often observed in the posterior pharynx with allergic rhinitis?

Back 9

a. “Cobblestoning”
b. This is caused by the presence of streaks lymphoid tissue on the posterior pharynx
c. Tonsillar hypertrophy can also be seen
d. The neck should also be examined for the presence of lymphadenopathy.

Front 10

10. Pharmacotherapy for allergies?

Back 10

a. Antihistamines
b. Decongestants
c. Intranasal steroids
d. Systemic steroids.

Front 11

11. Side effects of first-generation antihistamines (diphenhydramine, chlorpheniramine, and hydroxyzine)?

Back 11

a. Sedation
b. Anticholinergic effects:
1. Dry mouth
2. Dry eyes
3. Blurred vision
4. Urinary retention

Front 12

12. Why do second-generation antihistamines have less side effects?

Back 12

a. They have much less penetration into the CNS, resulting in less sedation
b. They also have fewer anticholinergic effects

Front 13

13. MOA of decongestants?

Back 13

a. They constrict blood vessels in the nasal mucosa and reduce the overall volume of the mucosa.

Front 14

14. Most commonly used congestant?

Back 14

a. Pseudoephedrine

Front 15

15. MOA of pseudoephedrine?

Back 15

a. α- adrenoreceptor agonists.

Front 16

16. SE of oral decongestants?

Back 16

1. Tachycardia
2. Tremors
3. Insomnia
b. Rebound hyperemia worsening of symptoms can occur with chronic use for upon discontinuation of nasal decongestants

Front 17

17. Utility of corticosteroid nasal sprays?

Back 17

a. Effective for the long-term management of allergic rhinitis
b. They reduce the production of inflammatory mediators and the recruitment of inflammatory cells.

Front 18

18. Side effects of corticosteroid nasal sprays?

Back 18

1. Nosebleeds
2. Pharyngitis
3. Upper respiratory tract infections

Front 19

19. Indications for leukotriene inhibitors?

Back 19

a. Indicated for both allergic rhinitis and for maintenance therapy for persistent asthma.

Front 20

20. Utility of leukotriene inhibitors?

Back 20

a. They're particularly useful in patients with asthma or allergies and particularly in those whose asthma may be triggered by allergens.
b. They are taken orally and only available by prescription

Front 21

21. Utility of oral steroids for allergies?

Back 21

a. Oral steroids of food inhibitors of cell mediated immunity
b. However, the use of systemic steroids limited by adverse effects
c. Only used for severe allergies and are used in the lowest effective dose for the shortest possible time.

Front 22

22. Urticaria?

Back 22

a. Large, irregularly shaped, pruritic, erythematous wheals.

Front 23

23. Angioedema presentation?

Back 23

a. Painless, deep, subcutaneus swelling that often involves the periorbital, circumoral, and facial regions.

Front 24

24. Treatment of the 1st suspicion of anaphylaxis?

Back 24

a. Injection of aqueous epinephrine 1:1000, and it is of 0.2-0.5 mL (0.2-0.5 mg)
b. Injected subcutaneously or intramuscularly
c. Repeated injections can be given every 15 to 30 min. when necessary
d. Rapid IV infusion of large volumes of fluids (saline, lactated ringer's solution, plasma or plasma expanders) is essential to replace loss of intravascular plasma into tissues.
e. Endotracheal intubation may be required
f. Bronchospasm responds to subcutaneous epinephrine or is.
g. Antihistamines may be useful as adjuvant therapy or alleviating cutaneous manifestations of urticaria or angioedema and pruritus

Front 25

25. MOA of terbutaline?

Back 25

a. β2-agonist.

Front 26

26. What are the 2 major triggers of asthma in childhood?

Back 26

1. Viral infections
2. Allergens.

Front 27

27. Progression of bacterial conjunctivitis?

Back 27

a. Usually self-limited, lasting about 10-14 days if untreated.

Front 28

28. Tx of bacterial conjunctivitis?

Back 28

a. Local sulfonamide will usually clear the infection in 2-3 days.

Front 29

29. Most common cause of epidemic keratoconjunctivitis (pink-eye)?

Back 29

a. Adenovirus.

Front 30

30. Eye symptoms of adenovirus conjunctivitis?

Back 30

a. Red palpebral conjunctiva
b. Copious watery d/c
c. Scanty exudates.