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CR2 > Anaphylactic shock and Type 1 hypersensitivity > Flashcards

Anaphylactic shock and Type 1 hypersensitivity Flashcards

1
Q

What is shock?

A

Failure to maintain an adequate cardiac output, or similar definition.

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2
Q

What are the different types of shock? Give examples of each.

A

Hypovolaemic - haemorrhage, severe fluid loss
Obstructive - pulmonary embolus or tamponade
Cardiogenic - MI, valvular disease, myocarditis, cardiomyopathy
Distributive - septic, anaphylactic

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3
Q

What is sepsis?

A

Organ injury/damage in response to infection

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4
Q

How many cells can those in the innate and adaptive immune systems recognise?

A

Innate - each can recognise a variety, 20-30

Adaptive- each recognises only one

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5
Q

How diverse are cells in the innate and adaptive system?

A

Innate - all cells are the same

Adaptive - vast diversity of cells

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6
Q

How are antigen receptors encoded?

A

Innate - directly

Adaptive - each cell randomly mutates gene

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7
Q

In which system is there immuno-memory?

A

Adaptive - B and T memory cells

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8
Q

In which immune system is there danger of autoimmunity?

A

Adaptive - clonal deletion is required to remove autoreactive clones

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9
Q

What cells are in the innate and adaptive immune system?

A

Innate - neutrophils, monocytes, eosinophils, mast cells

Adaptive - B and T lymphocytes

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10
Q

Where are T and B cells made?

A

T - thymus gland

B - bone marrow

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11
Q

What is central tolerance?

A

When lymphocytes encounter an antigen from a cell and fit into receptor for a response, then lymphocyte deleted

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12
Q

What are Fc receptors?

A

Fragment of crystallisation, cells of the innate system bind to antibodies via these, meaning they can use their antigen specificty

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13
Q

What are the cells of the innate immune system?

A

Neutrophils, monocytes, eosinophils, mast cells, basophils

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14
Q

What are the roles of IgA?

A

Found in mucous, saliva, tears and breast milk, blocks pathogen binding via neutralisation

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15
Q

What are the roles of IgE?

A

Protects against parasitic worms, responsible for allergic reactions, activates mast cells

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16
Q

What is the role of IgM?

A

block pathogen binding, activate complement, may be attached to B cell surface or secreted into blood

17
Q

What is the role of IgG?

A

Secreted by plasma cells, blocks pathogen binding, activates complement and opsonises antigens for phagocytes

18
Q

What is the role of IgD?

A

Not secreted, unknown role

19
Q

How can mast cells and basophils be activated?

A
  • Cross linking of surface IgE by antigen
  • via complement proteins C3a and C5a
  • via nerves: axon reflex of sensory nerves, substance P (released from primary afferent neurons)
  • direct contact with pathogen through innate receptors (TLRs)
20
Q

What is atopy?

A

hypersensitivity to environmental antigens leading to a IgE response

21
Q

What are the local manifestations of type 1 hypersensitivity?

A

allergic rhinitis, asthma, atopic eczema, urticaria, angiodema

22
Q

What are the systemic manifestations of type 1 hypersensitivity?

A

Anaphylactic shock

23
Q

Why do you get a drop in blood pressure in anaphylactic shock?

A

Leak of fluid into interstitial space (resdistribution) & veins dilate

24
Q

What is urticaria?

A

Hives, raised itchy red rash, dermis inflammation, sore red itchy eyes

25
Q

What is erythema?

A

sudden onset of nasal soreness, secretions, sneezing

26
Q

What is angioedema?

A

Swelling of subcutaneous tissues (face,, lips, hands, feet, pharynx, larynx)

27
Q

What are the clinical manifestations of anaphylactic shock?

A 
drop in blood pressure
urticaria
angioedema
bronchoconstriction
nausea & vomiting
headache, confusion, loss of consciousness
cardiac arrest & death
28
Q

What can trigger anaphylaxis?

A 
Drugs
Latex
Foods - peanuts, fish, shellfish, milk, eggs
Arthropod venoms - be stings
exercise
29
Q

What drugs can trigger anaphylaxis?

A 
beta lactams (penicillin)
aspirin 
NSAIDs
Insulin
Local and general anaethetics
30
Q

How can you acutely treat anaphylaxis?

A 
IM adrenaline, EpiPen self administered
oxygen high flow
IV drip
antihistamines
glucocorticosteroids
31
Q

What is anaphylactoid shock?

A

same as anaphylaxis but IgE is not involved, mast cells and basophils activated by another mechanism

32
Q

How do you prevent anaphylactic shock?

A

take careful history and ask about drug allergies

specific IgE blood tests and skin prick tests

33
Q

What is omalizumab?

A

A monoclonal antibody against IgE, very expensive, licensed for specific use only, impractical

CR2 (35 decks)

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