Anaphylaxis and Diabetis Flashcards
Which medication would be the best choice for reducing the bronchospasm and laryngeal edema associated with anaphylaxis?
A. Solu-Medrol
B. Oxygen
C. Albuterol
D. Dexamethasone
C.
Albuterol
The first medication administered to a patient experiencing an anaphylactic reaction should be:
A. epinephrine 1:10,000 0.5 mg IV
B. epinephrine 1:1,000 0.3 mg IV
C. high-flow oxygen
D. diphenhydramine 25-50 mg IV
C.
High-flow oxygen
_____ is a potentially life-threatening condition involving the head, neck, face, and upper airway.
A. Hives
B. Wheals
C. Urticaria
D. Angioedema
D.
Angioedema
Which medication is best for improving hypotension secondary to anaphylactic shock?
A. Hydrocortisone
B. Oxygen
C. Diphenhydramine
D. Epinephrine
D.
Epinephrine
Your patient is a 46-year-old male who is unconscious on his front lawn after being stung by a bee. You note angioneurotic edema. HR= 132, BP= 76/40, RR= 24 and shallow. You should first:
A. Assist ventilations with 100% oxygen via a BVM
B. start an IV of NS wide open and administer epinephrine 1:10,000 IV
C. intubate the patient
D. administer epinephrine 1:1,000 SQ
A.
Assist ventilations with 100% oxygen via a BVM
Your patient is a 31-year-old female complaining of dizziness breathing after being stung by a bee. You note that she is extremely anxious, and your physical examination reveals a rapidly developing urticarial to her shoulders, neck, and face. While you are performing your PE and interview, your partner has administered oxygen via a nonrebreather, initiated IV access, placed the patient on the cardiac monitor, and administered epinephrine SQ and diphenhydramine IV. Despite this, you also note that her voice is quickly becoming more hoarse and that she has developed expiratory wheezes in all lung fields. HR= 128, BP= 100/70, RR= 20, SaO2= 99%. What should be your major concern at this point, and what is the most appropriate treatment?
A. Laryngeal edema leading to total airway occlusion; intubate
B. Increased bronchospasm leading to respiratory arrest; administer albuterol via nebulizer
C. Increased bronchospasm leading to respiratory arrest; administer epinephrine IV
D. Hypotension leading to cardiovascular collapse; administer fluids wide open and initiate a dopamine infusion
A.
Laryngeal edema leading to total airway occlusion; intubate
Which of the following signs indicates aggressive airway maintenance in a patient experiencing an anaphylactic reaction?
A. Expiratory wheezing
B. Generalized rash
C. Urticaria
D. Stridor
D.
Stridor
Your patient is a 60-year-old male who is conscious and alert, sitting on a toilet. He appears to be in moderate distress and complains of nausea and diarrhea. The patient states that her is allergic to eggs and accidentally are pancakes make with eggs this morning. He describes a 4-hour history of severe diarrhea and vomiting. HR= 124, BP= 92/60, RR= 16, SaO2 = 98%. The physical examination reveals no urticarial or angioedema; his shin is cool and clammy, and his lung sounds are clear. Based on these findings, what should be your greatest concern?
A. Cardiac arrest due to ventricular dysrhythmia
B. None; there is no immediate life threat, because this is largely a matter of discomfort
C. Respiratory failure
D. Acute dehydration and cardiovascular collapse
D.
Acute dehydration and cardiovascular collapse
Your patient is a conscious and alert 22-year-old female who was stung by a hornet. She states that she has “allergies to bee stings” and has been told that she could die if stung Your physical examination reveals a 1-cm-diameter, red, edematous area where she was stung on the left forearm. Her skin is warm and dry, and her lung sounds are clear and equal bilaterally. HR = 112 and regular, BP= 122/82, RR= 12 and regular, SaO2 =98%. The most appropriate treatment for this patient would include:
A. BLS transport to the nearest facility
B. 100% oxygen via nonrebreather mask 15 lpm, cardiac monitor, IV of NS 1-2L, epinephrine 1:1,000 0.3mg SQ diphenhydramine 25mg IV, transport
C. 100% oxygen via nonrebreather mask 15 lpm, cardiac monitor, IV of NS KVO, epinephrine 1:1,000 0.3mg SQ diphenhydramine 25mg IV, transport
D. 100% oxygen via nonrebreather mask, cardiac monitor, IV of NS KVO, transport
D.
100% oxygen via nonrebreather mask, cardiac monitor, IV of NS KVO,
You are called to the home of a 28-year-old male who is complaining of hoarseness, a scratchy sensation in the back of hid throat, and palpitations. The symptoms began about 30 minutes ago and have grown steadily worse ever since the patient ingested prescribed penicillin 1 hour ago. Patient management should include all of the following EXCEPT:
A. IV of NS KVO
B. epinephrine 1:1000 0.3 mg SQ
C. administration of an IV beta-blocker
D. supplemental oxygen via nonrebreather mask
C.
administration of an IV beta-blocker
Which treatment would best halt the urticarial associated with an allergic reaction?
A. Epinephrine SQ and diphenhydramine IM
B. Solu-Medrol IV
C. Oxygen via nonrebreather mask 15 lpm
D. Dopamine IV infusion and albuterol via nebulizer
A.
Epinephrine SQ and diphenhydramine IM
Which of the following statements about antihistamine use in anaphylaxis treatment is TRUE?
A. Blocking of H1 receptors results in mild vasoconstriction, while the blocking of H2 receptors resulted in bronchodilation
B. Antihistamine block H1 and H2 receptors and prevent further release of histamine from B and T cells.
C. Antihistamines block histamine receptors and reduce histamine release from mast cells and basophils
D. Antihistamines displace histamine and then block histamine receptors
A
Blocking of H1 receptors results in mild vasoconstriction, while the blocking of H2 receptors resulted in bronchodilation
Which of the following statements about vasopressors use in anaphylaxis treatment is TRUE?
A. A norepinephrine infusion encourages a net movement of plasma from the intravascular space to the vascular space, raising blood pressure.
B. An epinephrine infusion can correct the peripheral vasodilation that occurs secondary to SRS-A release by basophils and mast cells
C. A norepinephrine infusion can correct the peripheral vasodilation that occurs secondary to SRS-A release by basophils and mast cells
D. A dopamine infusion can correct the peripheral vasodilation that occurs secondary to histamine release by basophils and mast cells
D.
A dopamine infusion can correct the peripheral vasodilation that occurs secondary to histamine release by basophils and mast cells
An allergen’s most common route of entry in an anaphylactic reaction is:
A. ingestion
B. injection
C. inhalation
D. absorption
B.
injection
________ is considered an ominous sign late in anaphylaxis
A. Taachycardia
B. Bradycardia
C. Hypertension
D. Hypotension
B
Bradycardia
Epinephrine administration results in all of the following EXCEPT:
A. increased peripheral vasoconstriction
B. hypotension
C. increased contractile force
D. tachycardia
B.
Hypotension
Which of the following treatment regimens for anaphylaxis lists the medications in the correct order of administration following oxygen?
A. epinephrine, dexamethasone, diphenhydramine
B. Diphenhydramine, epinephrine, dexamethasone
C. Epinephrine, diphenhydramine, dexamethasone
D. Dexamethasone, diphenhydramine, epinephrine
C.
Epinephrine, diphenhydramine, dexamethasone
Which sign associated with an allergic reaction should concern a caregiver the most?
A. Wheezing
B. GI distress
C. Urticaria (Hives)
D. Warm flushed skin
A.
Wheezing
Your patient is a 36-year-old female, conscious and alert, sitting at her desk complaining of a rash and itchiness after taking ibuprofen, Physical examination reveals warm and dry skin, urticarial on her chest and back, lung sounds that are clear and equal bilaterally. HR=100, BP=132/78, RR=14, SaO2=98%. Which of the following is the most appropriate treatment for this patient?
A. Oxygen via nonrebreather mask 10 lpm, cardiac monitor, IV of NS KVO, 25 mg diphenhydramine IV, transport
B. Oxygen via nonrebreather mask 10 lpm, cardiac monitor, IV of NS KVO, 0.3 mg epinephrine SQ, 25mg diphenhydramine IV, Albuterol 2.5 mg via nebulizer, transport
C. BLS transport to the nearest facility
D. Oxygen via nasal cannula 4 lpm, cardiac monitor, IV of NS KVO, 5 mg epinephrine IV, 25 mg diphenhydramine IV, transport
A
Oxygen via nonrebreather mask 10 lpm, cardiac monitor, IV of NS KVO, 25 mg diphenhydramine IV, transport
Which of the following medications of treating allergic reactions and anaphylaxis also relieves the abdominal cramping associated with both?
A. Epinephrine
B. Dopamine
C. Diphenhydramine (Benydryl)
D. Ranitidine
C.
Diphenhydramine (Benydryl)
The two most common causes of fatal anaphylaxis are ____ and ____.
A. hymenoptera stings, tree nuts
B. shellfish, tree nut
C. shellfish, sulfa drugs
D. hymenoptera stings, injected penicillin
D
hymenoptera stings, injected penicillin
All of the following medications should be used in the initial treatment of hypotension is patients with anaphylactic shock EXCEPT:
A. diphenhydramine
B. dopamine
C. epinephrine
D. Solu-Medrol
D.
Solu-Medrol
Approximately _____ deaths are attributed annually to anaphylaxis in the United States.
A. 800-1,000
B. 25-40
C. 400-800
D. 100-500
C.
400-800
Your patient is a 72-year-old male with a history of cardiovascular disease. He presents with a mild allergic reaction induced by exposure to pet dander. Which of the following medications should you consider NOT administering to this patient unles absolutely needed?
A. Oxygen 15 lpm via nonrebreather mask
B. Promethazine
C. Epinephrine 1:1,000 SQ
D. Diphenhydramine IV
C.
Epinephrine 1:1,000 SQ
Diphenhydramine is administered in anaphylaxis because it:
A. blocks histamine receptors
B. reduces histamine release from mast cells and basophils
C. possibly reduces peripheral vasodilation
D. all of the above
D.
all of the above
Your patient is experiencing profuse hives, itching, dyspnea, coughing, tachycardia, and dizziness after eating seafood 5 minutes ago. You might also expect to see all of the following signs EXCEPT:
A. hypertension
B. bronchospasm
C. laryngeal edema
D. cyanosis
A.
Hypertension
Which of the following statements about corticosteroid use in anaphylaxis treatment is TRUE:
A. Corticosteroids stabilize mast cell and basophil membranes preventing degranulation and histamine release
B. Corticosteroids can reduce the inflammation associated with anaphylaxis
C. Corticosteroids can help reverse bronchospasm associated with anaphylaxis
D. Administration of high-dose corticosteroids results in peripheral vasoconstriction
C.
Corticosteroids can help reverse bronchospasm associated with anaphylaxis
Which of the following best explains the process of osmotic diuresis associated with hyperglycemia?
A. Decreased insulin levels result in decreased ADH secretion
B. Glucose in the urine raises osmotic pressure inside the kidney tubule, drawing water into the tubule from the surrounding tissues
C. Glucose in the urine lowers osmotic pressure inside the kidney tubule, preventing water reabsorption
D. Elevated blood glucose levels result in increased ADH secretion
B.
Glucose in the urine raises osmotic pressure inside the kidney tubule, drawing water into the tubule from the surrounding tissues
Your patient is a 56-year-old male who is conscious and exhibits slurred speech; irritability; and cool. clammy skin. Blood glucose is 54 mg/dL. Proper treatment for this patient could include all of the following EXCEPT:
A. administration of oral glucose if the patient is able to swallow
B. 5-10 mg of glucagon IM
C. IV f NS
D. consideration of D50 IV if the patient cannot follow simple commands
B.
5-10 mg of glucagon IM
A 22-year-old male, unconscious after a motor vehicle collision, is being cared by a BLS crew. He is fully immobilized, and ventilation are being provided by bag-valve-mask with an oropharyngeal airway in place. Witness report that the patient’s vehicle was traveling on the highway at about 55 mile per hour, then swerved for no apparent reason and drove off the shoulder, rolling over once before coming to rest on its wheels. The patient was initially found in the driver’s seat with his seat belt on. Physical exam reveals some minor abrasions to the patient’s face and shoulders; the airway is clear; the chest, abdomen, extremities, and pelvis are atruamatic; bilateral breath sounds are clear and equal. The BLS crew is achieving adequate ventilation with the BVM. HR=112 and regular, BP=132/90, RR=12 and regular, blood glucose=42 mg/dL. Which of the following is the most appropriate initial treatment of this patient?
A. Continue BLS ventilations, cardiac monitor, IV of NS KVO, 50% dextrose IV, reassess
B. Intubate, cardiac monitor, IV of NS KVO, 50% dextrose IV, reassess
C. Continue BLS ventilations, glucagon 0.5mg IM, reassess
D. Intubate, initiate transport, cardiac monitor and IV access while en route to trauma center
A.
Continue BLS ventilations, cardiac monitor, IV of NS KVO, 50% dextrose IV, reassess
