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Allergies (Peds) (Acute (Path: IgE mediated Trigger (doesn't matter…

- - - - Urticaria
        
        Anaphylaxis
        
        has urticaria (full body rash)
        
        Hypotension
        
        wheezing & loss of airway
        
        Dx: Clinical (no time to confirm)
        
        Tx: lifesaving. :warning:Epinephrine 1-1000 IM
        
        its an epi pen
        
        immediate vasopressor
        
        Etiology dx: Give H1 & H2 blockers
        
        Give steroids (anti-immune: blocks subsequent rxn)
        
        insect sting/bite?
        
        poss. bee allergy
        
        2 more items...
        
        Rash: wheal, welt or erythema
        
        ~~hypotension~~
        
        Dx: Clinical
        
        Tx: Self-limiting (usually)
        
        observe
        
        use topicsl antihistamines
        
        :warning:Must R/o anaphylaxis
        
        Angioedema
        
        swelling
        
        ~~wheal~~
        
        ~~urticaria~~
        
        ~~hypotension~~
        
        :pencil2:Almost always associated w/ ACEi :spades:
        
        no other meds can do it
        
        C1 esterase deficiency (rare)
        
        Dx: Clinical
        Swollen airway
        
        inspiratory stridor/wheeze
        
        but swelling can happen anywhere
        
        swelling occurs in 1 spot, doesn't spread
        
        Tx: Secure the airway
        
        give ±H1/H2 blockers?
        
        give ± steroids?
        decisions on the wards, but clearly not on the test.
        
        1 more item...
- - - - Path: either
        
        seasonal
        
        perennial ( :smoking:, dust mites, :dog:)
        
        Pt: Child w/ allergic shiner
        
        Conjunctival injection :eye:
        
        Swelling : Chemosis
        
        Dx: Clinical
        
        ~~RAST~~
        
        ~~skin testing~~
        Only perform if refractory to testing, or if will do desensitization therapy (need specific trigger)
        
        Tx: Avoidance of the trigger
        ( true of all allergies)
        
        Intranasal Steroids: answer for shelf/step
        
        option H2 > H1 blockers, LTE antagonists
      - Food allergies
        
        In general
        
        Milk protein allergies :glass_of_milk:
        
        Path: Specifically from Soy Formula :baby_bottle:
        
        Pt: Nausea, vomiting Diarrhea :poop:
        
        bloody bowel movement
        
        Failure to thrive baby : despite good amounts and frequency of food, baby doesn't grow :seedling:
        
        Dx: Clinical : mom using that formula :baby_bottle:
        
        1 more item...
        
        Path: 2 forms
        
        Kids outgrow it (wheat, soy, milk :glass_of_milk:, eggs :fried_egg:)
        
        Full blown anaphylaxis (nuts :peanuts:, shellfish :shell::shrimp:) : possibly lifelong
        
        Pt: Nausea, vomiting, diarrhea :poop:
        
        Allergic A's : Allergies, Atopy, Asthma
        
        look for Atopic dermatitis (eczema) or asthma
        
        :warning:Even though its a Chronic condition, can cause Anaphylaxis
        Epi pen (must carry w/ them all the time)
        
        Tx: Avoidance of triggers
        
        1 more item...
    - - Pt: Child w/ allergic shiner
        
        allergic salute ( crease in :nose::skin-tone-2:)
        
        Pale boggy mucosa
        
        Nasal polyps w/ Cobblestoning
        
        Dx: Clinical
        
        ~~RAST~~
        
        ~~skin testing~~
        Only perform if refractory to testing, or if will do desensitization therapy (need specific trigger)
        
        Tx: Avoidance of the trigger
        ( true of all allergies)
        
        Intranasal Steroids: answer for shelf/step
        
        option H1/H2 blockers, LTE antagonists