Paediatrics & Child Health: Immunology and Allergy

Presentations

• Allergic presentations, such as urticaria

Conditions

• Adverse drug reactions:
  
  • allergic reactions, such as anaphylaxis
  • serum sickness
  • Stevens–Johnson syndrome
• Allergic disorders:
  
  • atopic dermatitis and eczema
  • conjunctivitis
  • food allergy
  • rhinitis
  • sinusitis
• Henoch–Schönlein purpura
• Immunodeficiency syndromes:
  
  • acquired, such as HIV
  • agammaglobulinaemias and hypogammaglobulinaemias
  • combined B- and T-cell immunodeficiencies
  • primary defects of cellular immunity

For each presentation and condition, Basic Trainees will know how to:

Synthesise

• recognise the clinical presentation
• identify relevant epidemiology, pathophysiology, and clinical science
• take a relevant clinical history
• conduct an appropriate examination
• establish a differential diagnosis
• plan and arrange appropriate investigations
• consider the impact of illness and disease on patients¹ and their quality of life

Manage

• provide evidence-based management
  For less common or more complex presentations and conditions the trainee must also seek expert opinions
• prescribe therapies tailored to patients’ needs and conditions
• recognise potential complications of disease and its management, and initiate preventative strategies
• involve multidisciplinary teams

Consider other factors

• identify individual and social factors and the impact of these on diagnosis and management

Conditions

• Autoimmune diseases:
  
  • inflammatory myopathies, such as juvenile dermatomyositis
  • juvenile systemic sclerosis
  • localised scleroderma
  • periodic fever syndromes
  • polymyositis
  • primary Sjögren syndrome
  • systemic lupus erythematosus
• Complement deficiencies
• Neutrophil abnormalities:
  
  • chronic granulomatous disease
  • leucocyte adhesion deficiency
• Systemic vasculitis

For each presentation and condition, Basic Trainees will know how to:

Synthesise

• recognise the clinical presentation
• identify relevant epidemiology, pathophysiology, and clinical science
• take a relevant clinical history
• conduct an appropriate examination
• establish a differential diagnosis
• plan and arrange appropriate investigations
• consider the impact of illness and disease on patients¹ and their quality of life

Manage

• provide evidence-based management
  For less common or more complex presentations and conditions the trainee must also seek expert opinions
• prescribe therapies tailored to patients’ needs and conditions
• recognise potential complications of disease and its management, and initiate preventative strategies
• involve multidisciplinary teams

Consider other factors

• identify individual and social factors and the impact of these on diagnosis and management

• Allergic reaction subtypes and mechanisms
• Autoimmunity principles
• Drug interactions, both common and life-threatening, and drug-induced disease
• Immune responses, adaptive and innate
• Immunisation
• Immunosuppressive agent mechanisms
• Inflammation pathophysiology
• Process of healing and repair
• Reticuloendothelial system structure and function:
  
  • lymph nodes
  • other lymphoid tissues
  • spleen
• Transplant biology principles, including human leucocyte antigen (HLA)

Investigations

• Allergy investigations:
  
  • allergen-specific IgE
  • skin prick testing
• Immune function assessments:
  
  • full blood count (FBC)
  • HIV viral load and serology
  • immunoglobulins
  • neutrophil function tests
  • serological response to immunisation
  • T-cell function assays
• Inflammatory disease assessment:
  
  • auto-antibody testing
  • complement profiles
  • inflammatory markers
  • skin and lesion biopsy (report interpretation only, not images)

• Anaphylaxis management, including use of adrenaline and action plans
• Appropriate and safe prescription of:
  • adrenaline
  • corticosteroids
• Immunodeficiency syndromes acquired post-transplantation
• Principles of immunisation in the immunocompromised host and at-risk groups