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L22 Seasonal respiratory allergies

Deleted user 8 questions Updated 26 May 2019

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  1. 1Allergic Rhinitis is hay fever, caused by seasonal allergens like [blank_start]pollen and grasses[blank_end], and perennial allergens like [blank_start]animal dander, mould, and dust mites[blank_end].
    Common symptoms include a runny, stuffy [blank_start]nose[blank_end], sneezing, cough, wheezing, and itchy, red, watery [blank_start]eyes[blank_end].
    1. Apollen and grasses
    2. Banimal dander, mould, and dust mites
    3. Cnose
    4. Deyes
  2. 2The pathology of hay fever has 2 key stages, [blank_start]sensitisation[blank_end] and re-exposure causing inflammation.
    Upon re-exposure to an allergen, [blank_start]mast[blank_end] cells in the nasal [blank_start]mucosa[blank_end] primed with IgE antibodies release [blank_start]histamines[blank_end], leukotrienes, and prostaglandins. [blank_start]Cytokines[blank_end] cause the infiltration of lots of [blank_start]activated[blank_end] immune cells. These release mediators. The blood vessels become more porous, [blank_start]dilating[blank_end] and emptying easier. Histamines bind to blood vessels, [blank_start]goblet[blank_end] cells and nerves.
    1. Asensitisation
    2. Bmucosa
    3. Chistamines
    4. Dmast
    5. Eactivated
    6. FCytokines
    7. Gdilating
    8. Hgoblet
  3. 3Early-phase symptoms (minutes):
    - [blank_start]sneezing[blank_end]
    - nasal [blank_start]itching[blank_end] and congestion
    - rhinorrhoea ([blank_start]runny[blank_end] nose)
    Late-phase symptoms (6-12 hr):
    - nasal [blank_start]congestion/obstruction[blank_end]
    - nasal hyperactivity
    1. Asneezing
    2. Bitching
    3. Crunny
    4. Dcongestion/obstruction
  4. 4Therapy options for allergic rhinitis are drugs for symptomatic relief, and to avoid triggers. Dosage forms are:
    • [blank_start]Oral[blank_end] tablets
    • [blank_start]Intranasal[blank_end] sprays
    • [blank_start]Eye[blank_end] drops
    Drugs can:
    - Prevent release ([blank_start]Mast cell stabilisers[blank_end])
    - Prevent inflammation ([blank_start]Corticosteroids[blank_end])
    - Block action ([blank_start]Antihistamines and anticholinergics[blank_end])
    1. AOral
    2. BIntranasal
    3. CEye
    4. DMast cell stabilisers
    5. ECorticosteroids
    6. FAntihistamines and anticholinergics
  5. 5H1 antihistamines are [blank_start]inverse agonists[blank_end] and not receptor antagonists.
    Therefore they have no effect on histamine [blank_start]release[blank_end] from storage [blank_start]sites[blank_end] and are more effective if given [blank_start]before[blank_end] histamine release occurs. H1 antihistamines can decrease the itch, decrease vascular [blank_start]permeability and dilation[blank_end], decrease [blank_start]antigen[blank_end] presentation and pro-inflammatory cytokines, increase mast cell [blank_start]stability[blank_end] and decrease [blank_start]mediator[blank_end] release.
    1. Ainverse agonists
    2. Brelease
    3. Csites
    4. Dbefore
    5. Epermeability and dilation
    6. Fantigen
    7. Gstability
    8. Hmediator
  6. 6First generation H1 antihistamines have low [blank_start]H1[blank_end] selectivity and high [blank_start]BBB[blank_end] permeability. They take [blank_start]2-3[blank_end] hours to onset of action, and last [blank_start]12-24[blank_end] hours. They are taken [blank_start]tid or qid[blank_end]. Their side effects can include sedation, dry [blank_start]mouth[blank_end], urinary [blank_start]retention[blank_end], increased appetite, postural [blank_start]hypotension[blank_end] or dizziness, and possibly ventricular arrythmias.
    Second generation antihistamines have [blank_start]high[blank_end] H1 selectivity and [blank_start]low[blank_end] BBB permeability, therefore side effects are uncommon. They take [blank_start]1-2[blank_end] hours to onset of action, and the majority of them are dosed [blank_start]once[blank_end] daily, lasting for 24 hours.
    1. AH1
    2. BBBB
    3. C2-3
    4. D12-24
    5. Etid or qid
    6. Fmouth
    7. Gretention
    8. Hhypotension
    9. Ihigh
    10. Jlow
    11. K1-2
    12. Lonce
  7. 7Corticosteroid nasal sprays act primarily during the [blank_start]late[blank_end] phase and are good for [blank_start]long[blank_end] term management. For allergic rhinitis there is no linear association between glucocorticoid [blank_start]potency[blank_end] and clinical [blank_start]response[blank_end], meaning we can use a low potency glucocorticoid effectively.
    Since it is intranasally sprayed, systemic absorption would be negligible and would be expected to pose [blank_start]fewer[blank_end] side effects. But those are:
    • Dryness, stinging, burning, and [blank_start]epistaxis[blank_end]
    • Nasal mucosal atrophy, with [blank_start]chronic[blank_end] topical steroid use
    1. Alate
    2. Blong
    3. Cpotency
    4. Dresponse
    5. Efewer
    6. Fchronic
    7. Gepistaxis (nose bleed)
  8. 8Intranasal decongestants are [blank_start]sympathomimetic[blank_end] drugs like xylometazoline & oxymetazoline. They have a [blank_start]rapid[blank_end] onset of action though are used [blank_start]short[blank_end] duration, as you risk [blank_start]rebound[blank_end] congestion. The drugs act on [blank_start]alpha adrenoreceptors[blank_end] in the nasal blood vessels, fixing [blank_start]rhinorrhoea and/or sneezing[blank_end], but not congestion.
    1. Asympathomimetic
    2. Brapid
    3. Cshort
    4. Drebound
    5. Ealpha adrenoreceptors
    6. Frhinorrhoea and/or sneezing

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User has deleted their subject information Quiz on L22 Seasonal respiratory allergies, created by Deleted user on 14/04/2019.
Author
Deleted user
Language
English
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52
History
Created on 14 Apr 2019 · updated on 26 May 2019
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