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anaphylaxis Flashcards

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USMLE® Step 1 flashcards
1
Q

Type 1 Hypersensitivity Reaction

A

Immediate Anaphylaxis -

mast cell activation which releases histamines.

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2
Q

Type 2 Hypersensitivity Reaction

A

Antibody targeting antigens on the cell surface.

AUTOIMMUNE REACTIONS or INCORRECT BLOOD TRANSFUSION

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3
Q

Type 3 Hypersensitivity Reaction

A

Immune Complex Reaction -

antigen-antibody complex which lodges in a vessel wall and activates a complement system.
(e.g: rheumatoid arthritis)

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4
Q

Type 4 Hypersensitivity Reaction

A

Antigen-specific activated T cells - contact dermatitis.

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5
Q

What is a uniphasic reaction?

A

A reaction with rapid onset and symptoms get rapidly worse

Once treated, symptoms don’t return.

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6
Q

What is a biphasic reaction?

A

Mild-severe reactions followed by a period of time when there are no symptoms before increasing symptoms with breathing and blood pressure problems.

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7
Q

What is a biphasic reaction?

A

Mild-severe reactions followed by a period of time when there are no symptoms before increasing symptoms with breathing and blood-pressure problems.

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8
Q

How long should patients be monitored following anaphylaxis?

A

6-12 hours

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9
Q

Symptoms of Anaphylaxis

A
  1. Skin changes - redness and itching.
  2. Mucosal changes - swelling below the skin surface.
  3. Swallowing and breathing difficulties due to swollen mouth, throat or tongue.
    - wheezing
    - tachypnoea (quick breathing)
    - tachycardia
    - hypotension
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10
Q

4 causes of anaphylaxis in the dental practice.

A
  1. Antibiotics
  2. Chlorhexidine
  3. Local Anaesthetic
  4. Iodoform
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11
Q

Airway assessment for anaphylaxis:

A
  1. Swollen tongue.
  2. Difficulty swallowing/speaking.
  3. Throat tightness.
  4. Hoarse voice.
  5. Stridor.
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12
Q

Breathing assessment for anaphylaxis:

A
  1. Difficult or noisy breathing.
  2. Chest tightness.
  3. Persistent coughing.
  4. Wheezing.
  5. Tachypnoea (increased respiratory rate).
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13
Q

Circulation assessment for anaphylaxis:

A
  1. Hypotension
  2. Tachycardia
  3. Pallor (sweaty)
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14
Q

Disability assessment for anaphylaxis:

A
  1. Feeling dizzy or faint.
  2. Confusion
  3. Agitation
  4. Syncope
  5. Loss of consciousness.
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15
Q

Exposure assessment for anaphylaxis:

A
  1. Skin changes or rashes?
  2. Abdominal pain and cramps.
  3. Nausea or vomiting.
  4. Diarrhoea
  5. Sense of impending doom.
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16
Q

How would you manage anaphylaxis in the dental setting?

A

Adrenaline (ASAP)

17
Q

What does adrenaline do in the event of anaphylaxis?

A
  1. Reverses peripheral vasodilation.
  2. Reduces oedema.
  3. Dilates the airways.
  4. Increases myocardial contractility.
  5. Suppresses histamine and leukotriene release.
18
Q

Dose of adrenaline for a person over 12?

A

0.5ml

19
Q

Dose of adrenaline for a child aged 6-12?

A

0.3 ml

20
Q

Dose of adrenaline for a child under 6?

A

0.15 ml

21
Q

How frequently should adrenaline dose be readministered?

A

Every 5 mins until there has been an adequate response.

22
Q

What is the angle of injection?

A

90 degrees

23
Q

Positioning of a patient with anaphylaxis?

A

In a comfortable position - upright may be better for breathing difficulties but those with hypotension will benefit from lying down with legs raised.

24
Q

Resuscitation Council Response to Anaphylaxis

A
  1. Call for help and request emergency drugs and resuscitation kit.
  2. Assess with ABCDE.
  3. Call 999 and state anaphylaxis.
  4. Stop dental procedure, clear airway and remove potential triggers.
  5. Administer oxygen 15 litres through non-rebreathe mask.
  6. Administer adrenaline.
  7. Monitor using ABCDE.
  8. Repeat adrenaline at 5 min intervals.

medical emergencies (4 decks)

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