Anaphylaxis & Urticaria Flashcards
Anaphylaxis definition:
“Anaphylaxis is a serious systemic hypersensitivity reaction that is usually rapid in onset and may cause death. Severe anaphylaxis is characterized by potentially life-threatening compromise in airway, breathing and/or the circulation, and may occur without typical skin features or circulatory shock being present”
What is Anaphylaxis?
an acute systemic, allergic rxn (immune system is involved)
that’s life-threatening
Will anaphylaxis present the same way all the time?
NO
Will anaphylaxis present the same way all the time in the same pt?
NO
What is key for anaphylaxis?
early recogn. of signs/sx’s is key
Skin signs/sx’s are _____ to be present during anaphylaxis
most likely
(~80% of cases)
What does the word anaphylaxis mean?
excessive protection
What is the pathophys for an immunologic rxn (anaphylaxis)?
- During an initial exposure, an individual will form IgE antibodies to an antigen = allergen (AGAINST the peanuts for ex).
- Subsequently, when the individual is exposed to the antigen, it will bind to the IgE antibodies. This triggers the release of vasoactive and inflammatory mediators (ex: histamine - often associated with inflammation, itching, swelling etc.) from mast cells and basophils.
- This leads to the potential development of urticaria (=hives), angioedema (=swelling of top layers; ex: throat swelling), bronchospasm, hypotension, and gastrointestinal symptoms
- Often signs and symptoms occur with 30 minutes after exposure, but sometimes may not appear for several hours
When do signs & sx’s occur?
Often signs and symptoms occur with 30 minutes after exposure, but sometimes may not appear for several hours
The World Allergy Organization has divided human anaphylaxis into three categories. List the three categories.
- Immunologic;
- Nonimmunologic;
- Idiopathic causes
What is the clinical criteria?
Any ONE of the following two criteria fulfilled
a. ACUTE ONSET OF AN ILLNESS (minutes to several hours) with the involvement of the skin, mucosal tissue or both AND at least one of the following:
* Respiratory compromise (such as: dyspnea, wheeze, bronchospasm, etc)
* Reduced blood pressure or associated symptoms of end-organ dysfunction (such as hypotonia/collapse, syncope, incontinence)
* Severe gastrointestinal symptoms (such as severe crampy abdominal pain, repetitive vomiting), especially after exposure to non-food allergens
b. ACUTE ONSET OF HYPOTENSION OR BRONCHOSPASM OR LARYNGEAL INVOLVEMENT after exposure to a known or highly probable allergen for that patient (minutes to several hours), even without the presence of the typical skin symptoms
What are the 3 different potential patters of anaphylactic rxns?
- Uniphasic
- Biphasic
- Protracted
Uniphasic:
isolated reaction with signs and symptoms usually appearing within 30 minutes of exposure to allergic and spontaneously settles or resolves with treatment, generally within 1 to 2 hours
Biphasic:
anaphylaxis reaction resolves, then symptoms begin again usually within 8 hours of first symptoms. Occurs in up to 20% of patients experiencing anaphylaxis
Protracted:
severe reaction that lasts for an extended time (24 to 32 hours)
How should be anaphylaxis sx’s gen. be treated with?
with epi & then go to hospital to treat further potential outcomes of the rxn
What are the body systems that expresses anaphylaxis signs & symptoms?
- Cutaneous rxns
- Respiratory rxns
- Gastrointestinal rxns
- Cardiovascular
- Other rxns
What are the signs & sx’s of CUTANEOUS rxns seen with anaphylaxis?
- hives or welts, severe itching, flushing or redness of the skin, swelling
What are the signs & sx’s of RESPIRATORY rxns seen with anaphylaxis?
- throat or chest tightness, difficulty breathing, wheeze, cough or swelling of the tongue, lips, uvula/palate, itching of the throat
- nose: itching, congestion, runny and sneezing
What are the signs & sx’s of GASTROINTESTINAL rxns seen with anaphylaxis?
- difficult or painful swallowing, nausea or vomiting, abdominal cramping, diarrhea
What are the signs & sx’s of CARDIOVASCULAR rxns seen with anaphylaxis?
- hypotension, chest pain, dysrhythmias
What are the signs & sx’s OTHER rxns seen with anaphylaxis?
- lightheadedness, dizziness, sweating, feeling of impending doom, uneasiness, headache, confusion, tunnel vision, uterine contractions
What type of signs & sx’s of anaphylaxis do CHILDREN also often show?
Children may have sudden behavioral changes (irritability, stop playing, cling to parent)
What are the TOP 3 signs & sx’s of anaphylaxis?
- Urticaria, angioedema (88%)
- Dyspnea, wheeze (47%)
- Dizziness, syncope, hypotension (33%)
