You have a two-year-old patient who has been transported to the ER with anaphylactic shock. She has eaten a piece of apple crumb cake that had...

You have a two-year-old patient who has been transported to the ER with anaphylactic shock. She has eaten a piece of apple crumb cake that had walnuts on top. It is clear she is allergic to walnuts. She survived, and her mom has now come to your office to find out what else the child is allergic to and the mom can do. 

You advise skin tests to determine what substances may trigger an allergic response. You explain that a small amount of food will be placed on the skin of the child's arm, and then it will be pricked with a needle. If the child is allergic to a particular substance, she will develop a raised bump or reaction. You perform the following tests, and the child immediately produces angry, read, raised welts in response to the following nuts: 

Almonds Cashews Hazelnuts Macadamia Nuts Peanuts 

Pecans Pistachios Walnuts 

She also produces the same response to the following items: 

Eggs Vanilla Apples Cherries Peaches Pears 

You also order a blood test to measure the child's immune response to particular foods by checking immunoglobulin E (IgE) antibodies. The bloodwork shows exceptionally high levels of IgE in the child. 

Naturally, when the mom and child return for a follow-up visit, the mother has a lot of questions and concerns. Please provide answers to her questions. 

1. How is my daughter's allergy different from hay fever - why doesn't she just get a reaction in her stomach when she eats these things - why does she get anaphylaxis that stops her breathing? 

2. I thought this was a peanut allergy - my friend's son is only allergic to peanuts - how is it that my daughter is allergic to more than one kind of nut? 

3.OK, so she is allergic to all nuts. Now I understand that, but why did that also make her allergic to so many tree fruits?

4.How do we make this allergy go away? What is the treatment for it?

1.What is(are) the cause(s) of DCM?

2. How is it treated? 

3. What is the prognosis for people suffering from this disease? 

4. We usually think of enlarged muscles as stronger (bigger biceps, for example). Explain why an enlarged heart, however, is not a good thing physiologically.