Anaphylaxis 💉

Question 1

Anaphylaxis

Answer 1

Acute life-threatening systemic reaction that results from the sudden release of mediators from mast cells and basophils
🦠🫧

Question 2

Most common trigger of anaphylaxis […]

Answer 2

1 .. Food

#2 .. Medications

Question 3

Other causes of anaphylaxis ..
(6)

Answer 3

🩻 Radiographic contrast
🐝 Stinging insect
🧤 Latex (spina bifida, bladder exstrophy)
💉 Vaccine & immunotherpy
🏃🏻‍♂️ Exercise (food / drug -co trigger)
❓ Idiopathic

Question 4

Presentation:

Answer 4

🫳🏻 90% Cutaneous-mucosal:
Flushing, urticaria, pruritus, angioedema
🫁 70% Respiratory:
Laryngeal edema, bronchospasm,
wheezing, dyspnea, hypoxemia
💩 45% GT:
N & V, Diarrhea, abd pain
🫀 45% Circulatory:
Hypotension, Tachycardia, syncope

Question 5

The absence of […] symptoms argues against anaphylaxis but cannot completely rule it out

Answer 5

Cutaneous

Question 6

Allergic reactions that are IgE-mediated differs from non IgE-mediated by:

Answer 6

IgE mediated » rapid “ minutes - 2hr”
non IgE mediated » slow “ 2hr - 24 hr”

Question 7

Examples of Non IgE mediated allergic reactions

Answer 7

• Celiac disease
• FPIES
• Food poisoning (fish & shellfish)

Question 8

What test may help confirm the diagnosis of anaphylaxis ?

Answer 8

Tryptase level taken within 6 h

Question 9

[…] is the mainstay of short-term treatment for anaphylaxis

Answer 9

Epinephrine
1:1000 dilution (0.01 mg/kg)

Question 10

Management of Anaphylaxis:

Answer 10

1. ABC , stop exposure to allergen
2. Epinephrine (1:1000) 0.01 mg IM q 5 min
3. Anti-histamines (H1: Diphenhydramine, H2: Rantidine)
4. Epinephrine (1:10000) 0.01 g IV q 5 min
5. Nebulized Salbutamol
   Neubized Epinephrine (1:1000)
6. Hydrocortisone 5mg/kg IV q6h

Question 11

What is the role of corticosteroid in anaphylaxis management?

Answer 11

Prevention of recurrent or protracted anaphylaxis

Question 12

Symptoms may recure up to […] hours after initial recovery

Answer 12

72
“Biphasic anaphylaxis”

Question 13

Patient should be observed for at least […] hours after initial attack

Answer 13

24

Question 14

Continue antihistamines for […] hrs

Answer 14

24-48 hrs after resolution of symptoms

Question 15

All patients at risk of anaphylaxis must carry […]

Answer 15

💉Epi pens
<30 kg : dose 0.15 mg
+30 kg : dose 0.3 mg

Question 16

Can patients with Penicillin allergy given cephalosporin ?

Answer 16

✅ Non IgE-mediated » GI, headache, non urticarial non pruritic rash
❌ IgE-mediated » urticaria, anaphylaxis
🔅Third generation cephalosporins are safe