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Human Diseases > Allergy and angioedema > Flashcards

Allergy and angioedema Flashcards

1
Q

What is hypersensitivity?

A

Inappropriate immune response to an otherwise harmless organisms

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2
Q

How is hypersensitivity mediated?

A

Antibodies or T cells

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3
Q

What kind of organisms can hypersensitivity reactions be against?

A

Environmental agents
Self antigens
Infectious agents

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4
Q

How can hypersensitivity reactions be classified?

A

Type I, II, III, IV

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5
Q

What mediates immediate (type I) hypersensitivity reactions?

A

Mast cells

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6
Q

What immunoglobulin is associated with mast ells and so type I hypersensitivity?

A

IgE

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7
Q

What mediates type II hypersensitivity?

What is the effect of this?

A

IgM or IgG antibodies react against cell surface or ECM antigens
Causes opsonisation and phagocytosis of cells, complements and leukocyte activation

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8
Q

What mediates type III hypersensitivity reaction?

What is the effect of this?

A

Immune complexes of circulating antigens and IgM or IgG antibodies
Causes complement recruitments and activation of leukocytes (macrophages and neutrophils)

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9
Q

What mediates type IV hypersensitivity reaction?

What is the effect of this?

A

CD4 and CD8 T cells
CD4 cells cause macrophage activation and inflammation
CD8 cells cause direct target cell killing and inflammation

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10
Q

What hypothesis describes why allergies are increasing?

A

Hygiene hypothesis - living in a cleanse world, reduced infection, increased immunisation, less exposure to microbiome

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11
Q

What characteristics of environmental agents make them good at causing hypersensitivity reactions?

A

Small - can be absorbed through lungs, skin, eye, mouth
Aeroallergens - in the air (pollen, dust mite, fungi)
Foods
Drugs
Venom

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12
Q

Describe a type I hypersensitivity reaction?

A

IgE mediated degranulation of mast cells causing release of histamine, lysosomal enzymes and proteases

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13
Q

What are some clinical consequences fo allergic reactions?

A

Swelling, rash

Contraction of airways

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14
Q

How can a type I hypersensitivity reaction be diagnosed?

A

History - did they have the symptoms - wheezing, rash, swelling
How long after the exposure did it occur - should be within seconds but some drugs can slow this down.
Did the reaction reoccur when re-exposed
Does it occur seasonally?
Do the symptoms go away when avoiding the allergen

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15
Q

How can the allergen be detected?

A 
Skin prick test
 - salt water
 - histamine
 - expected allergen
Observe the reactions to each
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16
Q

In what scenario may you not be able to do skin prick test?

A

Eczema

Heavily covered in tatoos

17
Q

If skin prick tests are not suitable to detect an allergen what can be used?

A

Blood tests
Specific monoclonal antibody is added to a plate with the patients blood serum, add an anti-igE antibody to cause colour change if it has bound

18
Q

What equipment often used in dental practice can cause type I hypersensitivity reaction?

A

Latex allergy

19
Q

If a patient doesn’t know they are allergic to latex how can you tell?

A

History - problems with balloons, condoms, gloves, kiwi, banana, pineapple

20
Q

How can latex allergy be diagnosed?

A

Skin prick test
specific IgE blood test
Challenge test

21
Q

Where can latex be found in the dental practice?

A 
Gloves
Dam
Gutte percha
amalgam carriers
protective eye wear
22
Q

Other than latex what are some common allergies in dental practice?

A

Formaldehyde - disinfectant for RCT
LA
Chlorhexidine
Antibiotics

23
Q

What are the guideline software anaphylaxis?

A

Sever allergic reaction with 1 or both of:
breathing difficulties
hypotension

24
Q

What should you do if a patient has anaphylaxis?

A

Administer adrenaline
Give antihistmaine
Keep patient lying flat to allow blood circulation to head

25
Q

What can be used to treat type I reactions?

A

Anti-histamines
Steroids
Bronchodilators

26
Q

What is angioedema?

A

Swelling

27
Q

What are the potential causes of angioedma?

A

Allergy
C1 inhibitor deficiency
Medication related

28
Q

Why is there no hives in C1 inhibitor deficiency?

A

No histamina involvement

29
Q

How is C1 inhibitor deficiency treated?

A

Replacement of the enzyme

30
Q

What is an example fo cell mediated type IV reaction?

A

Contact dermatitis

31
Q

What dental equipment commonly causes type IV reactions?

A 
Antiseptics, hygiene products
impression materials
LA
cements 
Metals
32
Q

How does type IV cell mediated hypersensitivity reaction present?

A

Stomitis, chelitis, lip swelling, facial swelling, oral lichenoid reactions

33
Q

How are type IV cell mediated reactions diagnosed?

A

Patch test on back

34
Q

How is oral lichenoid reaction managed?

A

Removal of metal (amalgam), cessation of drug

35
Q

How does burning mouth syndrome present?

A

Denture wearer, iron deficiency, candida infection, not an allergy

Human Diseases (37 decks)

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