CSP CSP Pediatric Food Allergy & Dietary Management 1 — Questions and Answers
Question 1: Which immunoglobulin mediates IgE-mediated food allergic reactions in children?
- IgA
- IgG
- IgE (Correct answer)
- IgM
Correct answer: IgE
IgE antibodies sensitize mast cells and basophils; upon re-exposure to the allergen, cross-linking of IgE triggers immediate hypersensitivity reactions.
Question 2: A 9-month-old exclusively breastfed infant presents with blood-streaked stools and no other symptoms. What is the most likely diagnosis?
- Crohn's disease
- Food protein-induced allergic proctocolitis (FPIAP) (Correct answer)
- Celiac disease
- Necrotizing enterocolitis
Correct answer: Food protein-induced allergic proctocolitis (FPIAP)
FPIAP typically presents in healthy-appearing infants with isolated rectal bleeding, most often due to cow's milk or soy proteins transmitted through breast milk.
Question 3: Which dietary change is first-line management for a breastfeeding mother whose infant has been diagnosed with cow's milk protein allergy (CMPA)?
- Switch infant to a soy-based formula
- Eliminate all cow's milk and dairy products from the mother's diet (Correct answer)
- Supplement infant with vitamin D only
- Introduce cow's milk directly to desensitize the infant
Correct answer: Eliminate all cow's milk and dairy products from the mother's diet
Maternal elimination of cow's milk protein is the first-line approach to managing CMPA in breastfed infants, allowing continued breastfeeding.
Question 4: What is the most common food allergen causing anaphylaxis in school-age children in the United States?
- Wheat
- Tree nuts
- Peanuts (Correct answer)
- Shellfish
Correct answer: Peanuts
Peanut allergy is the leading cause of food-induced anaphylaxis and fatal allergic reactions in school-age children in the US.
Question 5: A child diagnosed with non-IgE mediated food protein-induced enterocolitis syndrome (FPIES) most commonly reacts to which food?
- Peanuts
- Cow's milk or soy (Correct answer)
- Eggs
- Wheat
Correct answer: Cow's milk or soy
Cow's milk and soy are the most common FPIES triggers in infants, causing profuse vomiting and lethargy 1–4 hours after ingestion.
Question 6: When counseling a family on managing a child's peanut allergy, which label reading instruction is most critical for preventing accidental exposure?
- Only avoid products that list peanuts as the first ingredient
- Check for 'may contain peanuts' and 'processed in a facility with peanuts' advisory statements (Correct answer)
- Avoid only products manufactured in the US
- Rely solely on the 'allergen-free' claim on the label
Correct answer: Check for 'may contain peanuts' and 'processed in a facility with peanuts' advisory statements
Advisory statements like 'may contain peanuts' indicate cross-contact risk and are critical for families managing peanut allergy, as these are not required by law but indicate real risk.
CSP CSP Pediatric Food Allergy & Dietary Management 1
Which immunoglobulin mediates IgE-mediated food allergic reactions in children?