Module information

Module details

Title
Allergy
Type
Specialist
Module code
S-CI-S3
Credits
10
Phase
3
Requirement
Compulsory

Aim of this module

This module aims to provide trainees with knowledge and understanding of the mechanisms of hypersensitivity, and the presentation of allergic disease and diseases with similar presentations. They will become familiar with laboratory and clinical methods for investigating immune function in these conditions.

Work-based content

Competencies

# Learning outcome Competency Action
# 1 Learning outcome 1,2,4 Competency

Identify appropriate tests that may contribute to diagnosis or monitoring in all of the following conditions:

  • Multiple food allergy
  • Oral allergy syndrome
  • Drug allergy
  • Insect venom allergy
  • Anaphylaxis
  • Angioedema
  • Mast cell disorders
Action View
# 2 Learning outcome 1,2,4 Competency

Identify appropriate tests that may contribute to diagnosis or monitoring in all of the following conditions:

  • Extrinsic allergic alveolitis
  • Allergic bronchopulmonary aspergillosis
Action View
# 3 Learning outcome 2,5 Competency

Perform and technically validate laboratory tests for:

  • Specific IgE (whole allergens)
  • Total IgE
  • Tryptase
  • C1 Inhibitor level and function
Action View
# 4 Learning outcome 3,4,6 Competency

Provide advice and explain to non-specialist healthcare professional the basis and indications for performing in vivo tests for investigation of allergic disease, including all of the following:

  • Skin prick testing
  • Patch testing
  • Challenge testing
  • Intradermal testing
Action View
# 5 Learning outcome 2,4 Competency

Interpret panels for component resolved diagnostics and their limitations for patients with a range of allergic conditions to include oral allergy syndrome (pollen food syndrome)

Action View
# 6 Learning outcome 2,4,6 Competency

Interpret in light of clinical details and exposure history allergy test results in a patient presenting:

  • To emergency department with suspected anaphylaxis
  • With suspected anaphylaxis during surgery
Action View
# 7 Learning outcome 2,4,6 Competency

Interpret in light of clinical details and exposure history allergy test results in a patient presenting with two of the following:

  • Serious asthma
  • Suspected food allergy
  • Possible allergic skin reaction
  • A child with apparent multiple food allergies
Action View
# 8 Learning outcome 2,4,6 Competency

Interpret in light of clinical details and other laboratory results a patient presenting with suspected C1 inhibitor deficiency

Action View
# 9 Learning outcome 3,6 Competency

Present a case for discussion at a multidisciplinary team meeting for a patient with suspected allergy

Action View
# 10 Learning outcome 3,4,6 Competency

Write or review user information for allergy testing

Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Perform the test to measure sIgE, tIgE, sIgG or tryptase in patient samples.
  • Perform the test to measure C1Inhibitor functional activity and/or concentration in patient sample.
  • Authorise test results for sIgE, tIgE, sIgG or typtase.
  • Authorise test results for C1Inhibitor.
  • Interpret an allergy EQA report, including root cause investigation for an out-of-consensus result.

Observed Clinical Event Titles

  • Advise a healthcare professional on the appropriate testing for a patient with suspected allergic disease.
  • Communicate results on a patient with a C1 inhibitor deficiency to the requesting healthcare professional.
  • Summarise a multidisciplinary team meeting for a patient under investigation for allergy.

Learning outcomes

# Learning outcome
1

Select and apply tests for the diagnosis, prognosis and monitoring of allergic disease.

2

Perform and interpret tests for the diagnosis, prognosis and monitoring of allergic disease.

3

Summarise the services provided by immunology laboratories and advise other healthcare professionals on their application in patient management.

4

Explain the limitations of laboratory tests for allergic disease and associated in vivo.

5

Assess the performance of laboratory tests and take corrective action where required.

6

Practice in partnership with relevant clinical specialisms in the investigation of allergic disease.

Clinical experiences

Important information

Clinical experiences help you to develop insight into your practice and greater understanding of your specialty. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. While Clinical Experiences are not assessed, reflections and observations from your experiences can be used to support evidence for competencies to demonstrate your awareness and appreciation of your specialty and it’s impact on patient care. You may find it helpful to capture thoughts from your experiences in your reflective log.

Activities

  1. Attend a dietician clinic to appreciate the patient experience and pathway of investigation.
  2. Attend a paediatric allergy clinic to appreciate the patient experience and pathway of investigation.
  3. Attend a drug challenge clinic to appreciate the patient experience and pathway of investigation.
  4. Attend an adult allergy or immunotherapy clinic to appreciate the patient experience and pathway of investigation.

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

On successful completion of this module the trainee will be able to:

  1. Explain and distinguish the immunopathological mechanisms between the different classifications of hypersensitivity reaction.
  2. Apply integrative knowledge of the sensitisation and elicitation reactions.
  3. Discuss the important features of clinical presentation and history in the investigation of allergy.
  4. Compare and contrast the indications and performance of clinical and laboratory tests used to diagnose allergy.
  5. Critically appraise the pharmacological treatments available in the management of hypersensitivity reactions to the immunopathological mechanisms of the disorder.

Indicative content

  • Classification and immune pathogenesis of hypersensitivity reactions:
    • Type I immediate hypersensitivity (IgE-mediated)
    • Type II antibody-dependent cytotoxic hypersensitivity (organ-specific autoimmune diseases, autoimmune cytopenias, haemolytic disease of the newborn)
    • Type III immune complex-mediated hypersensitivity (serum sickness, hypersensitivity pneumonitis, arthus reaction).
    • Type IV delayed cell-mediated hypersensitivity (allergic contact dermatitis, tuberculin reaction (Mantoux test), graft rejection / graft versus host disease)
    • Type V stimulatory hypersensitivity (autoantibodies against cell receptors (thyroid stimulatory autoantibodies))
  • Indications of allergy:
    • Allergen structures and interactions with the immune system
    • The role of mast cells and chemical mediators of allergy
    • Atopy
    • Anaphylaxis
    • Allergic diseases (asthma, allergic rhinitis, atopic eczema, urticaria, angioedema)
    • Co-factors and cross-reactivity
    • Allergen immunotherapy and desensitisation
    • Allergy subtypes (food, pollen, venom, drug, fungal/HDM)
    • Immunotoxicology
  • Diagnostic tests for allergy:
    • Biomarkers of anaphylaxis
    • Clinical evaluation to include contraindications, limitations and precautions (clinical history, SPT/IDT, challenge)
    • Laboratory evaluation to include assay design and limitations (specific IgE, component-resolved diagnostics (multiplex), BAT).
  • Drug hypersensitivity reactions (non-allergic)

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SLS1-3-22 Specialty title Clinical Immunology [2022] Action View