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Pediatrics > Anaphylaxis > Flashcards

Anaphylaxis Flashcards

1
Q

What is a hypersensitivity reaction?

A

Inappropriate response to harmless molecule

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2
Q

Type 1 hypersensitivity

  • interval between reaction:
  • effector cells:
  • target\antigen:
  • examples:
A
  • <30 min to 2\12hours
  • IgE
  • pollen\food\venom\ drugs
  • anaphylaxis, uticaria, rhinitis, asthma
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3
Q

Type 2 hypersensitivity

  • interval between reaction:
  • effector cells:
  • target\antigen:
  • examples:
A
  • variable
  • IgG, IgM, IgA
  • RBC & platelet
  • Rh incompatiability, thrombocytopnia, goodpasture syndrome
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4
Q

Type 3 hypersensitivity

  • interval between reaction:
  • effector cells:
  • target\antigen:
  • examples:
A
  • 1 to 3 weeks after exposure
  • complement
  • vessels, spleen, kidney, lung
  • serum sickness, hypersensitivity pneumonitis
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5
Q

Type 4 hypersensitivity

  • interval between reaction:
  • effector cells:
  • target\antigen:
  • examples:
A
  • 2 to 7 days after exposure
  • t-cell lymphocyte
  • MTB - chemicalls
  • contact dermaitits, tb skin reaction, graft vs host disease
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6
Q

allergic rhinitis and allergic asthma have a combination of

A

Type 1 and type 4 hypersensitivity reactions

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7
Q

Autoimmunity is associated with which type of hypersensitivity reaction

A

Type 2

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8
Q

What is goodpasture syndrome?

A

IgG and IgA response against proteins in the BM of kidney + lung

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9
Q

Wnich of the hypersensitivity reactions is more sever and associated with systemic disease

A

Type 3

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10
Q

Name a drug that causes

  • type 2:
  • type 3:
  • type 4:
A
  • quinidine
  • cefaclor
  • neomycin
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11
Q

What is the prototype of

  • type 1
  • type 4
A
  • anaphylaxis

- ivy posioning

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12
Q

Differentiate bteween type 2 and type3

A
  • antigens on specific structure

- antigens and antibodies all over the body

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13
Q

Mysthenia gravis is which type of antibody?

A

Type 2

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14
Q

What is the MOA in type 3

A

Complexes swim in the circulation and go to ceratain organs (joint synovium, kidney glomeruli, lung aleveoli)

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15
Q

How to treat type 4 hypersensitivity

A

Avoid trigger - steroidal topical treatment

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16
Q

MOA of type 4 hypersensitivty

A

Allergen on the skin > APC Tcells identify > inflammatory cascade > itching and erythemia

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17
Q

What is anaphylaxis

A

Multiorgan system reaction from chemical mediators of (mast cells) + (basophils)

18
Q

What is the cause, effector, the mediator in type 1 hypersensitivity?

A
  • allergen
  • IgE on mast cell
  • histamine
19
Q

What are the effects of histamine in anaphylaxis shock?

A
  • respiratory: bronchospasm & increased mucus secretion > SOB, tightness, wheeze, stridor, hoarseness, cough
  • GI: abdo pain, diarrhea
  • CNS: lightheadidness, loss of concisousness, headache, anxiety
  • vasodilation: Edema
  • ithciness\rash
20
Q

When to consider patient having anaphylaxis “symptoms wise”

A

Two systems are affected

  • SOB
  • diarrhea
21
Q

What are the most common in patient and outpatient causes of anaphylaxis?

A
  • food: outpatient

- drug: inpatient

22
Q

Name non-immunological causes of anaphylaxis?

A

Exercise

Direct mast cell degranulation

23
Q

What is the best treatment of anaphylaxis?

A

Prevention

  • avoid trigger
  • patient education
  • self administration of epinephrine
24
Q

What are the medications used in mild to moderate anaphylaxis?

A

Antihistamine (diphenhydramine)

25
Q

What medications to use in severe symptoms “trouble breathing or swallowing

A

Epinephrine “CVS\respiratory”

26
Q

ABCD in anaphylaxis should be along with:

A

Epinephrine

27
Q

In a patient with cardiac arrest who you’ve aldready adminsterd IV epinephrine and required another dose, what will you give

A

IM epinephrine

28
Q

What is the role of epinephrine

A

Vasoconstrictor (Alpha 1 agonist)

  • increase BP
  • decrease edema
29
Q

What is the second line for anaphylaxis?

A

Antihistamine (diphenhydramine)

30
Q

In a patient with cardiac arrest who you’ve aldready adminsterd IV epinephrine and required another dose, what will you give

A

IM epinephrine

31
Q

What is the second line for anaphylaxis?

A

Antihistamine (diphenhydramine)

32
Q

Why is rantidine usually raken? (H2 antagonist)

A

To enhance effect oH1 antagonist

33
Q

What to do for patient with respiratory distress in anaphylaxis?

A

Give b2 adrenergic agonist

“Salbutamol and slameterol”

34
Q

How to administer salbutamol in anaphylaxis?

A

5-10 puffs every 20 minutes until symptoms of wheezing or respiratory distress

35
Q

How to prevent the recurrance of anaphylactic symptoms after an initial remission?

A

Give corticosteroid

36
Q

What is biphasic anaphylaxis

A

Initial remission > 8 to 72 hours anaphylactic symptoms

37
Q

What is protracted anaphylaxis

A

Presistance of symptoms for hours\days despite treatment

38
Q

Who should get an epipen?

A

1- at risk of anaphylaxis
2- not responding to treatment
3- altered conciousness during allergic reaction
4- living in remote area

39
Q

When to give epipen 0.3 mg

A

When then weigth is >25 kg

40
Q

When to give epipen 0.15

A

When the weight is 15-25 kg

41
Q

Where to give the dose of epipen?

A

Mid outer part of thigh

Pediatrics (41 decks)

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