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2 Peds Allergy

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Question
Answer
Allergic Rhinitis Pathophysiology   On exposure to certain antigens, IgE fixed to mast cells causes the release of chemical mediators leading to inflammation, vasodilation and increased capillary permeability  
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Histamine containing granules are found with the...   mast cells  
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Allergic Rhinitis History to obtain   Symptoms, Severity of Sx, Pattern of sx: relationship to seasons, antigen exposure  
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PE of Allergic Rhinitis: Face-long,narrow face, high arched palate, allergic salute, mouth breathing; Eyes- infraorbital shiners, conjunctival injection and cobblestoning, stringy discharge; AND   Nose -pale, swollen mucosa, clear discharge, transverse nasal creasel. Mouth - dry lips, PND  
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Differential Diagnosis with Allergic Rhinitis   Sinusitis: purulent Discharge, HA, PND. Rhinitis medicamentosa: overuse of topical decongestants. Local disorders: polyps, dev septum, adenoid hypertrophy, fb. Vasomotor rhinitis  
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Allergy Prick Skin tests in for Allergic Rhinitis labs:   pollens (trees-spring, grass-summer, ragweed-fall), dust mites, animals, mold, cockroaches  
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Tx of Allergic Rhinitis   Avoid offending allergens, medication, allergy vaccine therapy  
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Decongestant for Allergic Rhinitis   Sudafed  
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Antihistamines for Allergic Rhinitis   Allegra, Xyzal, Clarinex, Zyrtec, Claritin  
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Nasal Steroids for Allergic Rhinitis   Veramyst, Rhinocort, Nasonex, Nasalide, Nasocort, Flonase  
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Eye Tx for allergic Rhinitis   Pataday, Zaditor, Ellistat  
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Immunotherapy process in treating allergic rhinitis   3-5 years of injections containing antigens causing symptoms. Decreases symptoms, medication use  
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Major Criteria of Clinical Manifestations in Atopic Dermatitis   Pruritis, Typical distribution of rash, chronic and relapsing, hx of other allergic sx  
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Common locations for Infantile Atopic Dermatitis   Face, elbows, knees  
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Common location for Toddler Atopic Dermatitis   Wrist, popliteal and antecubital fossae  
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Hyperpigmentation and Lichenification can be seen in   Atopic Dermatitis  
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Minor clinical manifestations of atopic dermatitis   Xerosis, hyperlinear palms, early age of onset, Dennie’s lines, infraorbital shiners, food intolerances, cutaneous infections, intolerance to wool, increased itch with sweating  
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Labs for atopic dermatitis   allergy skin tests, IgE levels (usually elevated), skin culture, double blind food challenge  
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Differential Diagnosis for atopic dermatitis   Seborrhea (scalp and face), Contact dermatitis (nickel dermatitis), Scabies (intense itching)  
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Tx for atopic dermatitis   Emollients (cetaphil, cerave, etc), Topical steroids (mildest effective potency), Nonsteroidal creams (elidil, protopic), Abx for 2ndary infxn (keflex, check for mrsa), Antipuritics (atarax, benadryl, zyrtec)  
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Tx Continued for Atopic dermatitis   Daily soaking baths, avoid environmental irritants, elimination diet (if indicated), Complementary treatments (biofeedback, massage, behavior modification, counseling)  
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