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Allergy Midterm Notes

The document provides an overview of allergies and hypersensitivity, defining allergies as exaggerated immune responses to harmless substances and categorizing hypersensitivity into four types based on the Gell and Coombs classification. It discusses various allergens, diagnostic methods, and specific conditions such as bronchial asthma, drug allergies, anaphylaxis, urticaria, angioedema, and food allergies, along with their management strategies. Key points include the importance of avoiding triggers, utilizing medications like epinephrine for severe reactions, and the role of immunologic mechanisms in these conditions.

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15 views3 pages

Allergy Midterm Notes

The document provides an overview of allergies and hypersensitivity, defining allergies as exaggerated immune responses to harmless substances and categorizing hypersensitivity into four types based on the Gell and Coombs classification. It discusses various allergens, diagnostic methods, and specific conditions such as bronchial asthma, drug allergies, anaphylaxis, urticaria, angioedema, and food allergies, along with their management strategies. Key points include the importance of avoiding triggers, utilizing medications like epinephrine for severe reactions, and the role of immunologic mechanisms in these conditions.

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Medical School Midterm Notes: Allergy & Hypersensitivity

Allergy - Definition

An allergy is an exaggerated immune response to a normally harmless substance (allergen),

resulting in hypersensitivity reactions. It involves an inappropriate immune reaction mediated by IgE

antibodies or other immunologic mechanisms.

Types of Hypersensitivity & Pathogenic Mechanisms (Gell and Coombs Classification)

Type I - Immediate (Anaphylactic): IgE-mediated; examples: allergic rhinitis, asthma, anaphylaxis.

Type II - Cytotoxic: IgG/IgM antibodies target cell surface antigens; examples: hemolytic anemia.

Type III - Immune Complex-Mediated: Antigen-antibody complexes deposit in tissues; examples:

serum sickness.

Type IV - Delayed-Type (Cell-Mediated): T-cell mediated; examples: contact dermatitis, TB skin test.

Classification of Allergens

- Inhalant: Pollen, dust mites, mold spores, animal dander

- Ingestant: Foods, drugs

- Injectant: Insect stings, injected drugs

- Contact: Latex, metals, cosmetics

Allergy Diagnostics

In Vivo: Skin prick test, intradermal test, patch test, challenge tests.

In Vitro: Serum-specific IgE, total IgE, basophil activation test, eosinophil cationic protein.

Bronchial Asthma

Definition: Chronic inflammatory airway disorder with variable obstruction.

Risk Factors: Atopy, smoking, pollution, obesity.


Etiology: Atopic (IgE-mediated) or non-atopic.

Phenotypes: Allergic, non-allergic, late-onset, fixed obstruction, obesity-associated.

Pathogenesis: Th2 inflammation, mast cell degranulation, eosinophils, remodeling.

Classification: Intermittent, mild/moderate/severe persistent.

Diagnosis: Spirometry, PEFR, FeNO, allergy tests.

Management: Avoid triggers, ICS, LABA, SABA, biologics, stepwise therapy.

Adverse Drug Reactions (ADR)

Type A: Predictable, dose-dependent.

Type B: Unpredictable, immune-mediated.

Drug Allergy

Definition: Immune-mediated reaction to a drug.

Risk Factors: Genetic, previous exposure, dose, route.

Phenotypes: Immediate (IgE), delayed (T-cell).

Diagnosis: History, skin tests, provocation, LTT.

Management: Stop drug, antihistamines, desensitization, epinephrine.

Anaphylaxis

Definition: Severe, life-threatening systemic allergy.

Etiology: Foods, drugs, stings, latex.

Pathogenesis: IgE-mediated mast cell degranulation.

Symptoms: Urticaria, hypotension, bronchospasm.

Diagnosis: Clinical criteria.

Management: IM epinephrine, antihistamines, steroids, fluids.

Urticaria & Angioedema


Urticaria: Transient itchy wheals; acute/chronic; triggers include food, drugs.

Angioedema: Deep swelling; histaminergic or bradykinin-mediated.

Management: Antihistamines, epinephrine, C1-INH for hereditary.

Food Allergy

Definition: Immune response to food protein (IgE/non-IgE/mixed).

Diagnosis: History, IgE tests, oral challenge.

Management: Allergen avoidance, epinephrine auto-injector.

Prophylaxis: Early allergen introduction, breastfeeding.

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