Allergy - Drugs Flashcards
What % of the population report an allergy to penicillin?
1 - 1%
2 - 5%
3 - 10%
4 - 20%
3 - 10%
What % of the hospital inpatients report allergy to penicillin?
1 - 1%
2 - 5%
3 - 10%
4 - 30%
4 - 30%
Although allergy to penicillin may be reported between 10-30%, what is the true prevalence?
1 - 0.1%
2 - 1-2%
3 - 5-10%
4 - >20%
2 - 1-2%
- patients may have had a reaction initially, but sensitisation is lost at around 10%/year
What type of response is a type 1 hypersensitivity?
1 - IgE antibodies produced
2 - antibody-dependent cytotoxic
3 - antibody complex mediated
4 - cell mediated or delayed
1 - IgE antibodies produced
- cause mass cell sensitisation
What type of response is a type 2 hypersensitivity?
1 - IgE antibodies produced
2 - antibody-dependent cytotoxic
3 - antibody complex mediated
4 - cell mediated or delayed
2 - antibody-dependent cytotoxic
- complement system is activated causing immune response
What type of response is a type 3 hypersensitivity?
1 - IgE antibodies produced
2 - antibody-dependent cytotoxic
3 - antibody complex mediated
4 - cell mediated or delayed
3 - antibody complex mediated
- anti-bodies react with soluble antigens and then clump together in tissue
What type of response is a type 4 hypersensitivity?
1 - IgE antibodies produced
2 - antibody-dependent cytotoxic
3 - antibody complex mediated
4 - cell mediated or delayed
4 - cell mediated or delayed
- no antibodies
Type I hypersensitivity is caused by sensitisation of mast cells and the secretion of IgE antibodies. How long does it normally take for this reaction to occur if a patient is allergic to a drug?
1 - 1 minute
2 - 10 minutes
3 - 1 hour
4 - 10 hours
3 - 1 hour
- severity is scored according to Ring and Messemer 4 step grading scale based on clinical manifestations
Which of the 4 main hypersensitivities does anaphylactic shock come under?
1 - type I
2 - type II
3 - type III
4 - type VI
1 - type I
Are atopic patients more likely to suffer a type I anaphylactic shock than non atopic patients?
- no same risk
In a non-allergic type I hypersensitivity will patients experience anaphylactic shock immediately?
- no
- first exposure sensitises mast cells with IgE
- second exposure means mast cells are primed and anaphylactic shock follows
During degranulation of mast cells in a type I hypersensitivity, what are the 2 chemicals that are released by mast cells causing anaphylactic shock?
1 - histamine and CRP
2 - histamine and tryptase
3 - tryptase and CRP
4 - CRP and CK
2 - histamine and tryptase
During degranulation of mast cells in a type I hypersensitivity, histamine and tryptase are released following degranulation of mast cells. What do these 2 molecules then go onto to form which causes anaphylactic shock?
1 - leukotriene, CRP, thromboxane
2 - leukotriene, prostoglandin, thromboxane
3 - prostoglandin, CRP, thromboxane
4 - leukotriene, prostoglandin, CRP
2 - leukotriene, prostoglandin, thromboxane
During degranulation of mast cells in a type I hypersensitivity, some drugs are able to bind with mast cells and sensitise them causing the issue. What are some key drugs that this has been shown in?
- vancomyocin
- NSAIDs
- ACE inhibitors
- opiates
What is the Ring and Messemer 4 step grading scale?
- clinical scale used for type I anaphylaxis
Using the clinical scaled for type 1 anaphylaxis called the Ring and Messemer 4 step grading scale, what is grade I?
1 - cardiac arrest
2 - moderate multi-visceral signs (swelling), hypotension, tachycardia, GIT upset and some brochospasms
3 - life threatening swelling, tachycardia, hypotension, GIT issues and brochospasms
4 - erythema, itchy, may or may not have angioedema
4 - erythema, itchy, may or may not have angioedema
Using the clinical scaled for type 1 anaphylaxis called the Ring and Messemer 4 step grading scale, what is grade 2?
1 - cardiac arrest
2 - moderate multi-visceral signs (swelling), hypotension, tachycardia, GIT upset and some brochospasms
3 - life threatening swelling, tachycardia, hypotension, GIT issues and brochospasms
4 - erythema, itchy, may or may not have angioedema
2 - moderate multi-visceral signs (swelling), hypotension, tachycardia, GIT upset and some brochospasms
Using the clinical scaled for type 1 anaphylaxis called the Ring and Messemer 4 step grading scale, what is grade 3?
1 - cardiac arrest
2 - moderate multi-visceral signs (swelling), hypotension, tachycardia, GIT upset and some brochospasms
3 - life threatening swelling, tachycardia, hypotension, GIT issues and brochospasms
4 - erythema, itchy, may or may not have angioedema
3 - life threatening swelling, tachycardia, hypotension, GIT issues and brochospasms
Using the clinical scaled for type 1 anaphylaxis called the Ring and Messemer 4 step grading scale, what is grade 4?
1 - cardiac arrest
2 - moderate multi-visceral signs (swelling), hypotension, tachycardia, GIT upset and some brochospasms
3 - life threatening swelling, tachycardia, hypotension, GIT issues and brochospasms
4 - erythema, itchy, may or may not have angioedema
1 - cardiac arrest
Type II, III or IV drug hypersensitivity responses are not immediate. How long from being given the first exposure to a drug do symptoms present?
1 - 1-5 days
2 - 3-5 days
3 - 5-8 days
4 - >5 days
3 - 5-8 days
- this would be the first sensitisation
- type IV is most common
Type II, III or IV drug hypersensitivity responses are not immediate. How long do symptoms present if they patient has previous been exposed to this drug before?
1 - 1-5 days
2 - 3-5 days
3 - 5-8 days
4 - >5 days
2 - 3-5 days
- type IV is most common
What is the most common group of drugs that cause Type II, III or IV drug hypersensitivity responses?
1 - antibiotics
2 - NSAIDs
3 - antimicrobials
4 - ACE inhibitors
3 - antimicrobials