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#Phase 2.2: Paediatrics > Anaphylaxis > Flashcards

Anaphylaxis Flashcards

1
Q

What type of reaction causes Anaphylaxis?

A

Type 1 Hypersensitivity reaction

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2
Q

What is the pathophysiology of Anaphylaxis?

A

IgE stimulates Mast cells to release Histamine (aka Mast cell degranulation)

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3
Q

How is the Dx of Anaphylaxis made?

A

Clinical

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4
Q

What is the key CF that differentiates Anaphylaxis from non-anaphylactic allergic reaction?

A

Airway / breathing / circulation compromise

(ABC)

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5
Q

What can the CF of Anaphylaxis be divided into?

A

ABCDE

(emergency examination tings)

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6
Q

What are the AIRWAY CF of Anaphylaxis? (5 things)

A
  1. Lip / tongue / pharynx / epiglottis swelling
  2. Cough
  3. Swallowing difficulty
  4. Hoarse voice
  5. Stridor
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7
Q

What are the BREATHING CF of Anaphylaxis? (7 things)

A
  1. Tachypnoea / SOB
  2. Cough
  3. Wheezing
  4. Laryngeal oedema
  5. Bronchospasm
  6. Chest tightness
  7. Hypoxia / Hypercapnia
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8
Q

What are the CIRCULATION CF of Anaphylaxis? (6 things)

A
  1. Dizziness / Drowsiness / Collapse
  2. Pallor
  3. Tachycardia / Arrhythmias / ECG changes
  4. Hypotension
  5. Clammy skin
  6. Prolonged CRT
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9
Q

Why do you get Circulation CF in Anaphylaxis? (3 steps)

A
  1. Peripheral vasodilation + Increased permeability
  2. Plasma leakage from circulation
  3. Decreased intravascular volume
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10
Q

What are the DISABILITY / OTHER CF of Anaphylaxis? (6 things)

A
  1. Neuro: Confusion / Anxiety / Collapse
  2. GI: Abd cramping / DnV
  3. Other: Feeling of impending death
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11
Q

What are the EXPOSURE CF of Anaphylaxis? (4 things)

A
  1. Angioedema (puffy lips / eyes)
  2. Urticaria (see pic)
  3. Pruritis (itchy skin)
  4. Erythema
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12
Q

What can the Differential Dx similar to Anaphylaxis be divided into? (2 things)

A
  1. Life threatening DDx
  2. Non-life threatening DDx
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13
Q

What are the Life threatening DDx that present similarly to Anaphylaxis? (3 things)

A
  1. Life-threatening Asthma
  2. Septic shock
  3. Hereditary Angioedema
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14
Q

What makes Life threatening Asthma different from Anaphylaxis? (2 things)

A
  1. Resp features
  2. No Skin / CVS / GI features
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15
Q

What makes Septic shock different from Anaphylaxis?

A

Temp below 36 / above 38

(temp usually normal in anaphylaxis)

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16
Q

What makes Hereditary Angioedema different from Anaphylaxis?

A

No urticaria

17
Q

What are the NON-Life threatening DDx that present similarly to Anaphylaxis? (4 things)

A
  1. Vasovagal episode
  2. Panic attack
  3. Breath-holding episode
  4. Idiopathic (non-allergic) urticaria / angioedema
18
Q

What is a Breath-holding episode?

A

When a kid invol holds their breath after being angry / frustrated / startled / in pain

19
Q

What makes a Vasovagal episode different from Anaphylaxis? (4 things)

A
  1. No urticaria / angioedema / hoarseness / wheezing
  2. Bradycardia (instead of tachy in anaphylaxis)
  3. Pallor (instead of erythema in anaphylaxis)
  4. Improves on lying down
20
Q

What makes a Panic attack different from Anaphylaxis? (3 things)

A

No urticaria / hypotension / wheeze

21
Q

What makes a Breath-holding episode different from Anaphylaxis?

A

Usually resolves within 1 min

22
Q

What makes Idiopathic (non-allergic) urticaria / angioedema different from Anaphylaxis?

A

Skin changes only, no other CF

23
Q

What are the immediate Mx options for sus Anaphylaxis? (5 things)

A
  • A: Secure Airway
  • B: 100% High flow O2 // Salbutamol if wheezing
  • C: IV fluids
  • D: Lie pt flat (to improve cerebral perfusion)
  • E: Look for flushing / urticaria / angioedema
24
Q

How do you confirm Dx of Anaphylaxis?

A

Serum Mast Cell Tryptase within 6 hours of event

(impressive knowledge)

25
Q

What is Tryptase? (2 points)

A
  1. Something released during Mast Cell degranulation
  2. Stays in blood for 6 hours
26
Q

What meds should you give once Anaphylaxis Dx confirmed? (3 things)

A
  1. IM Adrenaline
  2. Antihistamines
  3. Steroids
27
Q

When should you repeat IM Adrenaline PRN?

A

Every 5 mins

28
Q

What effects does Adrenaline have? (4 things)

A
  • A-adrenergic action: Increases BP
  • B-agonist adrenergic action: Increases contractility + HR + Bronchiole dilation
29
Q

What Antihistamines can you give in Anaphylaxis? (2 things)

A
  1. Chlorphenamine
  2. Cetirizine
30
Q

What Steroids can you give in Anaphylaxis?

A

IV Hydrocortisone

31
Q

What should you do with the kid after Anaphylaxis and Tx is over?

A

Admit for assessment + observation

32
Q

Why should you admit kids for assessment + observation after Anaphylaxis and Tx is over?

A

Bc they might have a Biphasic Reaction

(second anaphylaxis within 72 hours even with no allergen exposure)

33
Q

What should you offer parents of a Anaphylaxis kid?

A

EpiPen (adrenaline autoinjector)

34
Q

What is a complication of Anaphylaxis?

A

Anaphylactic shock

35
Q

What does Anaphylactic shock involve? (3 things)

A
  1. Resp: Upper + Lower Airway narrowing
  2. CVS: Shock vasodilation / Increased Vasc Perm

#Phase 2.2: Paediatrics (18 decks)

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