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Emergency Medical Technician > Allergy & Anaphylaxis > Flashcards

Allergy & Anaphylaxis Flashcards

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Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

The study of the body’s immune system

A

Immunology

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2
Q

Protects the human body from foreign substances and organisms

A

Immune system

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3
Q

Exaggerated immune response to any substance

A

Allergic reaction

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4
Q

Common chemicals released by body to combat a stimulus

A

Histamines and leukotrienes

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5
Q

The first time someone is exposed to an allergen they are ___

A

Sensitized

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6
Q

An extreme allergic reaction that is life threatening and involves multiple organ systems

A

Anaphylaxis

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7
Q

Two most common signs of anaphylaxis

A
  1. Urticaria
  2. Angioedema
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8
Q

Small areas of generalized itching or burning that appear as multiple small, raised areas on the skin

A

Urticaria (hives)

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9
Q

Areas of localized swelling

A

Angioedema

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10
Q

High-pitched whistling breath sound that is typically heard on expiration

A

Wheezing

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11
Q

Wheezing from anaphylaxis is usually caused by ___

A

Bronchospasm/bronchoconstriction and increased mucus production

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12
Q

Signs of possible upper airway narrowing

A

Voice changes and stridor

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13
Q

High-pitched respiratory sound that is usually hear on inspiration

A

Stridor

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14
Q

During anaphylaxis, you may note hypotension due to ___

A

Vasodilation

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15
Q

During anaphylaxis, you may note increased ___, causing fluid from the bloodstream to seep into the tissues

A

Capillary permeability

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16
Q

One symptom that is often overlooked in anaphylaxis patients

A

Gastrointestinal dysfunction

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17
Q

Five general categories of allergens

A
  1. Food
  2. Medication
  3. Plants
  4. Chemicals
  5. Insect bites and stings
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18
Q

Food allergy symptoms may take more than ___ to appear

A

30 minutes

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19
Q

Food allergy symptoms may not include ___

A

Skin signs

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20
Q

Common symptom of food allergy

A

Abdominal cramping, vomiting, & diarrhea

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21
Q

Most common source of anaphylaxis

A

Food allergy

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22
Q

Second most common source of anaphylaxis

A

Medication

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23
Q

Most common medication types to cause anaphylaxis

A

Antibiotics and NSAIDs

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24
Q

If medication is ___, the reaction may be immediate

A

Injected

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25
Q

An immediate reaction is within ___

A

30 minutes

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26
Q

Common plant allergens

A

Ragweed, ryegrass, maple, and oak

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27
Q

Common chemical allergen that affects health care

A

Latex

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28
Q

The act of injecting venom

A

Envenomation

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29
Q

If a bee stinger is not removed it can continue to inject venom fro up to ___

A

20 minutes

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30
Q

A harmful substance produced by living cells or organisms

A

Toxin

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31
Q

Signs and symptoms of insect stings and bites

A
  1. Sudden pain
  2. Swelling
  3. Localized heat
  4. Widespread urticaria
  5. Redness in light-skinned people
    May be:
  6. Itching
  7. Wheal
32
Q

A raised, swollen, well-defined area on the skin

A

Wheal

33
Q

Signs and symptoms of insect stings and bites in anaphylactic patients

A
  1. Stridor
  2. Bronchospasm
  3. Wheezing
  4. Chest tightness
  5. Coughing
  6. Dyspnea
  7. Anxiety
  8. GI complaints
  9. Hypotension
  10. Respiratory failure
  11. Confusion
34
Q

Allergic reactions may present as ___ distress or as ___ distress in the form of shock

A
  1. Respiratory
  2. Cardiovascular
35
Q

If your general impression finds the person anxious and in distress, ___

A

Immediately call for ALS backup

36
Q

Most severe form of allergic reaction

A

Anaphylaxis

37
Q

Anaphylaxis can cause rapid swelling of the ___

A

Upper airway

38
Q

Can provide clues as to an allergy in a patient who cannot tell you

A

Medical identification tag

39
Q

Signs of impending airway obstruction

A
  1. Swollen lips or tongue
  2. Hoarseness
  3. Stridor
40
Q

Dyspnea may present with ___

A
  1. Increased work of breathing
  2. Use of accessory muscles
  3. Head bobbing
  4. Tripod positioning
  5. Nostril flaring
  6. Abnormal breath sounds
41
Q

Wheezing occurs because of ___

A

Narrowing of the lower air passages

42
Q

Narrowing of the lower air passages is mainly the result of ___

A

Contraction of muscles around the bronchioles in reaction to the allergen, and mobilization of mucus in an attempt to push out the allergen

43
Q

Stridor occurs when ___

A

Swelling in the upper airway begins to close off the airway

44
Q

Generally the best position for a patient with breathing distress from an allergic reaction

A

Fowler position

45
Q

If a patient develops signs of shock, they should be placed in the ___ position

A

Supine

46
Q

Positive pressure ventilations will force air beyond ___

A

The selling in the airway and into the lungs while you wait for more definitive treatment

47
Q

Not all patients with anaphylaxis will present with respiratory distress, some will present with ___ such as ___

A
  1. Circulatory distress
  2. Hyptension
48
Q

How to determine if patient is in circulatory distress quickly

A

Palpating for the presence and quality of a radial pulse

49
Q

If anaphylaxis is suspected, or if a relatively mild allergic reaction appears to be worsening, ___

A

Immediate transport is warranted after epinephrine is given

50
Q

Before leaving the scene of anaphylaxis, be sure to take along the patient’s ___

A

Medications

51
Q

History taking questions specific to an allergic reaction

A
  1. Have any interventions already been completed?
  2. Has the patient experienced a severe allergic reaction in the past?
  3. Be alert for any statements regarding the ingestion of foods that commonly cause allergic reactions
52
Q

Respiratory signs and symptoms of an allergic reaction

A
  1. Sneezing or an itchy, runny nose (early sign)
  2. Dyspnea
  3. Tightness in the chest or throat
  4. Irritating, persistent dry cough
  5. Hoarseness
  6. Rapid, labored, or noisy respirations
  7. Wheezing and/or stridor (may progress to a silent chest as a late sign)
53
Q

Cardiovascular signs and symptoms of an allergic reaction

A
  1. Tachycardia (early sign)
  2. Red, flushed, hot skin (early sign) or pale, cyanotic, cook skin (late sign) as the vascular system fails
  3. Hypotension (late sign) as the blood vessels dilate
54
Q

Skin signs and symptoms of an allergic reaction

A
  1. Flushing, itching, or burning skin, common over the face and chest
  2. Urticaria over large areas of the body (internal or external)
  3. Swelling, especially of the face, neck, hands, feet, and/or tongue, either local (angioedema) or generalized
  4. Cyanosis or pallor around the lips
  5. Warm, tingling feeling in the face, mouth, chest, feet, and hands
55
Q

Other signs and symptoms of an allergic reaction

A
  1. Decreasing mental status (early sign of hypoperfusion), from mild confusion or lethargy to loss of consciousness or coma
  2. Anxiety, sense of impending doom
  3. Gastrointestinal problems, including nausea, vomiting, or abdominal cramps
  4. Headache
  5. Itchy, watery eyes
  6. Dizziness
56
Q

If a patient with an allergic reaction is unconscious for the secondary assessment, remove clothing as necessary and observe for ___

A

Presence of bee stingers, signs of contact with chemicals, and other clues suggestive of a reaction. Look for a medical alert tag

57
Q

How to remove an insect stinger

A

Scrape the skin with the edge of a sharp, stiff object like a credit card

58
Q

After removing an insect stinger ___

A

Gently wash the area with soap and water or mild antiseptic

59
Q

Position the patient with the insect stinger injection site positioned ___

A

Slightly below the level of the heart, and apply ice or cold packs to the area

60
Q

Epinephrine is a ___

A

Sympathomimetic hormone

61
Q

Sympathomimetic hormone

A

Mimics the sympathetic response

62
Q

Epinephrine causes blood vessels to ___

A

Constrict

63
Q

Epinephrine comes in two common forms

A

EpiPen
Auvi-Q

64
Q

Auvi-Q comes in a third dose of ___ for those patients weighing ___

A

0.1 mg
17 to 33 lbs

65
Q

The adult EpiPen delivers ___ of epinephrine

A

0.3 mg

66
Q

The EpiPen Jr for infants/children delivers ___ of epinephrine

A

0.15 mg

67
Q

How long to hold the EpiPen in place

A

3 seconds

68
Q

After injecting the EpiPen, rub the area for ___

A

10 seconds

69
Q

If the patient’s condition does not improve after ___, consider using another EpiPen

A

5 minutes

70
Q

Indications for epinephrine

A

Severe allergic reaction causing airway, breathing, or circulatory compromise or an anaphylactic reaction

71
Q

Contraindications for epinephrine

A

None in a life-threatening emergency; however consult medical control when the patient has a history of heart disease or acute coronary syndrome

72
Q

Actions of epinephrine

A

Vasoconstriction and increased cardiac contractility, bronchodilation

73
Q

Side effects of epinephrine

A

Tachycardia, sweating, pale skin, dizziness, headache, palpitations

74
Q

An adult EpiPen can be used for a patient weighing over ___

A

66 lbs

75
Q

Patients weighing less than ___ will have to be dosed individually for epinephrine

A

33 lbs

76
Q

Epinephrine concentration for IM injection

A

1 mg/mL

Emergency Medical Technician (100 decks)

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