18 topics with brief reviews: definitions, key facts, and class questions.
Allergies are the scourge of the 21st century, and in pediatric practice, you will encounter them daily. This chapter covers the key manifestations of the "atopic march" and other hypersensitivity reactions in children. We will analyze food allergy, atopic dermatitis, allergic rhinitis, bronchial asthma, and all forms of urticaria.
The material is strictly structured: from etiology and pathogenesis to clinical presentation, diagnosis, and modern treatment protocols. We have paid special attention to pharmacotherapy, including the nuances of prescribing intranasal glucocorticoids and advanced methods of allergen-specific immunotherapy (AIT).
What are the most frequent questions in class? Instructors traditionally emphasize the step-by-step therapy of bronchial asthma and the pathogenetic link between asthma and allergic rhinitis. You will also be strictly required to know the diagnostic criteria for atopic dermatitis, the differential diagnosis of urticaria forms, and the strict indications for AIT. Read thoughtfully — these algorithms will be useful to you on every shift.
What time threshold separates acute and chronic spontaneous urticaria?
The boundary between these forms is exactly 6 weeks. If symptoms last less, it is acute urticaria; if more, chronic.
Is virus-induced obstruction in infancy a 100% guarantee of developing asthma?
No. Although viruses are a potent primary trigger, not all children with episodes of virus-induced obstruction at an early age develop asthma.
What is a "silent chest" and when does it occur?
This is a pathological condition where, due to critical narrowing of the bronchi, breath sounds and wheezing are no longer audible upon auscultation. It is a ominous sign of status asthmaticus.
Can long-acting drugs be used as monotherapy?
No, long-acting $\beta_2$-agonists (LABA) are strictly contraindicated for use as monotherapy. They are prescribed strictly in combination with inhaled glucocorticoids.
Can AIT be used to relieve an acute asthma attack?
No, allergen-specific immunotherapy is not used for emergency care. It is a scheduled baseline treatment method aimed at long-term modification of the immune response.
Can a diagnosis of atopic dermatitis be made if the patient does not complain of itching?
No, the obligatory presence of skin itching (pruritus) is part of the classic diagnostic triad and is a key criterion for the disease.
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