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Hematology/Immunology Part 1 > Anaphylaxis > Flashcards

Anaphylaxis Flashcards

1
Q

What is anaphylaxis?

A

A serious allergic reaction that is rapid in onset and may cause death.

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2
Q

What is the difference between anaphylaxis and an anaphylactoid reaction?

A

Anaphylaxis is an IgE-mediated response, while an anaphylactoid reaction is non-IgE mediated but presents similarly.

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3
Q

What are the key criteria for diagnosing anaphylaxis?

A

Sudden onset involving skin or mucosal symptoms, sudden respiratory symptoms, sudden drop in blood pressure, or sudden gastrointestinal symptoms.

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4
Q

What is the lifetime prevalence of anaphylaxis in the United States?

A

1.6 percent based on strict clinical diagnostic criteria.

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5
Q

What are the most common triggers of anaphylaxis?

A

Food, insect stings and bites, and medications.

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6
Q

How is reduced blood pressure defined in adults during anaphylaxis?

A

Systolic BP less than 90 mmHg or a greater than 30 percent decrease from baseline.

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7
Q

What foods are common triggers of anaphylaxis?

A

Milk, egg, shellfish, finfish, peanut, tree nuts, and soy.

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8
Q

Why is the true global rate of anaphylaxis unknown?

A

Due to under-recognition by patients and caregivers and underdiagnosis by healthcare professionals.

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9
Q

What are some common food triggers of anaphylaxis?

A

Milk, egg, shellfish, finfish, peanut, tree nuts, soy.

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10
Q

Which insects are known to trigger anaphylaxis?

A

Bees, vespid, fire ants, other ants, scorpions, deer & horse flies, mosquitoes.

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11
Q

What are some diagnostic agents that can trigger anaphylaxis?

A

Contrast media, medications, antibiotics, aspirin and other NSAIDs, biological response modifiers, anti-venoms, monoclonal antibodies, blood transfusions, allergen immunotherapy.

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12
Q

Who are at increased risk of anaphylaxis?

A

Healthcare workers, children with spina bifida, patients with multiple surgeries.

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13
Q

What are some physical causes of anaphylaxis?

A

Exercise-induced, cold-induced, heat-induced.

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14
Q

What are the most frequent signs and symptoms of anaphylaxis?

A

Oral pruritus, cutaneous flushing, gastrointestinal nausea, cardiovascular faintness, respiratory congestion.

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15
Q

What characterizes a protracted anaphylactic reaction?

A

It lasts hours to days without resolving completely.

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16
Q

What is the most common cause of death from anaphylaxis?

A

Asphyxiation due to airway obstruction or cardiovascular collapse.

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17
Q

How predictable are the recurrent symptoms in protracted anaphylaxis?

A

The severity is unpredictable.

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18
Q

What is biphasic anaphylaxis?

A

Symptoms recur up to 8 hours later without further exposure to the trigger.

19
Q

What is a protracted course of anaphylaxis?

A

A reaction that lasts hours to days without resolving completely.

20
Q

What percentage of anaphylactic reactions are biphasic?

A

Up to 23%.

21
Q

What should patients be informed about after being discharged following anaphylaxis?

A

The possibility of recurrent symptoms for up to three days.

22
Q

What is the primary treatment for all anaphylactic episodes?

A

Epinephrine.

23
Q

What is the recommended dose of epinephrine for adults and children weighing 30 kg or more during anaphylaxis?

A

0.3 to 0.5 mg intramuscularly in the thigh, repeated every 5 to 10 minutes as necessary.

24
Q

When should serum tryptase be measured in relation to an anaphylactic reaction?

A

Within 15 minutes to 3 hours of the reaction.

25
Q

What is the significance of a positive serum tryptase test?

A

It helps to confirm the clinical diagnosis.

26
Q

How should epinephrine be administered to children weighing less than 30 kg during anaphylaxis?

A

0.01 mg/kg intramuscularly or subcutaneously in the thigh, up to a maximum of 0.3 mg per injection, repeated every 5 to 10 minutes as necessary.

27
Q

What are the rapid progression symptoms of anaphylaxis?

A

Respiratory distress, vomiting, abdominal pain, hypotension, dysrhythmia, and chest pain.

28
Q

What is the first-line treatment for anaphylaxis?

A

Intramuscular epinephrine in the mid-outer thigh, repeated every 5 to 15 minutes as needed.

29
Q

What additional treatments are recommended if symptoms do not respond to epinephrine injections?

A

Prepare IV epinephrine for infusion, place the patient in a recumbent position, provide oxygen, administer normal saline rapid bolus, and consider albuterol for bronchospasm.

30
Q

What adjunctive therapies can be considered during anaphylaxis management?

A

H1 antihistamine (diphenhydramine), H2 antihistamine (ranitidine), and glucocorticoid (methylprednisolone).

31
Q

What monitoring is essential for patients receiving IV fluid resuscitation for severe hypotension or shock?

A

Continuous noninvasive hemodynamic monitoring, pulse oximetry, and urine output monitoring.

32
Q

What should be done immediately after discharge from the ED following anaphylaxis?

A

Fill the epinephrine prescription.

33
Q

What are the 3 R’s of an anaphylaxis emergency action plan?

A

Recognize symptoms early, respond quickly, review the cause.

34
Q

What should be done for patients on beta-blockers who do not respond to epinephrine?

A

Administer glucagon 1 to 5 mg IV over 5 minutes, followed by an infusion of 5 to 15 mcg/minute.

35
Q

What is the common issue regarding the knowledge of epinephrine usage among healthcare professionals and patients?

A

Inadequate knowledge about outpatient use, with many unaware of different dose formulations and proper usage techniques.

36
Q

What are the key steps to take during an anaphylactic reaction?

A

Administer epinephrine, activate EMS (911), and notify emergency contacts.

37
Q

Who is at risk for anaphylaxis?

A

Anyone, especially those allergic to certain foods, insect stings, latex, or medications.

38
Q

What is the recommended dose of epinephrine for adults and children over 30 kg?

A

0.3 to 0.5 mg administered intramuscularly in the thigh, repeated every 5 to 10 minutes as necessary.

39
Q

What should be avoided when searching for the etiology of anaphylaxis?

A

Random screening tests.

40
Q

When can anaphylaxis occur?

A

Within minutes of exposure to an allergen.

41
Q

What are the signs that indicate anaphylaxis?

A

Several symptoms occurring simultaneously, such as itching, hives, difficulty breathing, vomiting, dizziness, or shock.

42
Q

Where can anaphylaxis occur?

A

Anywhere, including home, restaurants, schools, and transportation.

43
Q

Why is follow-up necessary after an anaphylactic episode?

A

To confirm the trigger and implement long-term preventive strategies.

Hematology/Immunology Part 1 (12 decks)

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