2025 – PAGE 102 – ALLERGY & IMMUNOLOGY

FIXED DRUG REACTION

A fixed drug reaction presents as a violaceous rash that presents on the same part of the body every time a particular medication is taken.

TRUE MILK PROTEIN ALLERGY

True milk protein allergy is a true IgE mediated allergy. Look for GI symptoms (vomiting, diarrhea, GI bleeding) and extraintestinal symptoms (eczema, wheezing) to make the diagnosis! Refer to an allergist and prescribe casein HYDROLYSATE formula (contains hydrolyzed cow’s milk proteins), NOT soy. (There are some reports of cross reactivity.) You can also try asking the mother to discontinue ingestion of all milk products.

• PEARL: This is just like a peanut allergy, but with milk. You can get anaphylaxis.

MNEMONICS

• On the pediatric boards, if “milk protein ALLERGY” is an answer choice, it is referring to a true IgE mediated ALLERGY so it should present with more than just GI symptoms.
• MP = Milk Protein. The M of Milk can be made to look like a V for VOMITING. The P of Protein can be made to look like an R for RASH