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Drug, Food, Hymenoptera allergies
Test 2 Sem 2
27
Medical
Graduate
02/03/2011

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Cards

Term
What is the most common iatrogenic illness?
Definition
Drug Allergies
Term
What are some drug factors that increase risk of drug allergies? (5)
Definition
1) higher molecular weight
2) ability to bind to proteins
3) higher dose
4) parental usage
5) repeated exposure
Term
What are some host factors that increase the risk of drug allergies? (4)
Definition
1) adult
2) Male
3) concurrent infections
4) HIV infection
Term
What are the 4 classifications of drug reactions?
Definition
1) anaphylactic - cross links IgE - antibiotics
2) cytotoxicity - cell destruction between IgG or IgM - heparin mediated thrombocytopenia
3) immune complex - drug combines with antibodies to form complexes
4) delayed hypersenstivity - sensitized CD4 T cells - allergic contact dermatitis
Term
What are some clinical presentations of dermatologic drug reactions? (4)
Definition
1) within days of use
2) symmetrical
3) truncal
4) pruritus
5) fever

*sometimes have esoinophila
Term
What are the two mechanisms of photosensitive drug rashes?
Definition
1) phototoxic - first exposure to drug - sunburn w/in 4-8 hours of light exposure
2) photoallergic - eczematous reactions after months of drug use
Term
What are the 3 testing techniques for drug allergies?
Definition
1) skin testing - IgE mediated
2) RAST - b-lactams and anesthetics
3) Drug Challenge
Term
When are non-immunologic reactions commonly seen with penicllins?
Definition
with ampicillin and amoxicillin patients with concomitant viral infections
Term
What are most immune reactions to penicillin direct at?
Definition
B-lactam core, often severe
Term
What test is 90% accurate for diagnosing allergies to penicillin?
Definition
skin testing
Term
What symptom is common with sulfa drug allergies? What group of people have higher sulfa allergies?
Definition
1) Drug exanthems
2) HIV patients (50%)
Term
What is red man syndrome associated with vancomycin allergies?
Definition
hypotension, flushing, erythema, pruritus, urticaria, pain/muscle spasms on chest and back
Term
What is the aspirin triad?
Definition
1) asthma
2) nasal polyps
3) aspirin sensitivity
Term
anesthetic agent rxns are most commonly from what? (4)
Definition
1) toxic response
2) overdose
3) rapid absorption
4) anxiety
Term
direct mast cell and complement activation are seen with what allergy?
Definition
Radiographic contrast media
Term
How is desensitization achieved with drug allergies?
Definition
administer drug in increasing doses and continue use
Term
Most food allergies are mediated by what?
Definition
IgE
Term
Oral allergy syndrome defined as rapid onset prurits, angioedema of lips, tongue, and throat are most common from ingestion of what?
Definition
fresh fruits and vegetables
Term
what skin reactions are most common with food allergies?
Definition
acute urticaria and angioedema
Term
What is a chronic skin condition affecting children with food allergies?
Definition
atopic dermatitis
Term
total villous atrophy and extensive cellular infiltrate are associated with what disease?
Definition
Celiac disease (non-IgE hypersensitivity to gluten
Term
What genetic predisposition exists with celiac disease?
Definition
-90% are HLA-B8 positive
-80% have HLA DW3 antigen
Term
What is the gold standard lab for food allergies?
Definition
double-blind placebo controlled food challenge
Term
Fatal reactions from hymenoptera occurs most commonly in whom and what do they have?
Definition
adults >45yo, hymenoptera venom-specific IgE antibodies
Term
children usually have what clinical manifestation with hymenoptera reactions?
Definition
cutaenous symptoms
Term
how are hymeoptera allergic reactions confirmed?
Definition
skin and RAST tests
Term
How do you treat hymenoptera reactions?
Definition
epinephrine and corticosteroids
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