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Clin Med IV Week 3 Quiz > Drug Reactions and Urticaria > Flashcards

Drug Reactions and Urticaria Flashcards

1
Q

Chinese/SE Asian patients may develop SJS/TEN if they have HLA-B* ______ and you give them carbamazepine

A

HLA-B*1502

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2
Q

White/Hispanic people may develop DRESS (Drug Related Eosinophilia with Systemic Symptoms) if they have HLA-B*______ and you give them abacavir

A

HLA-B*5701

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3
Q

Chinese/Taiwanese/Thai patients may develop SJS/TEN if they have HLA-B*_________ and you give them Allopurinol

A

HLA-B*5801

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4
Q

What is this:

Severe form of immune reaction in the skin that leads to a widespread eruption of tender lesions, especially bullae and target lesions. Skin and mucous membranes are involved

A

SJS

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5
Q

Two types of epidermal necrolysis drug reactions

A

SJS

TEN (Toxic Epidermal necrolysis)

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6
Q

If someone has an immediate reaction to a drug (less than 1 hour after taking it), what kind of symptoms might you expect

A

Urticaria

Angioedema

Anaphylaxis

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7
Q

Does allergy testing help us determine if someone will have a drug reaction?

A

No, only works with Penicillin

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8
Q

True or False:

HIV+ patients have higher rates of skin reactions to sulfas

A

True

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9
Q

Morbilliform means:

A

Measles like eruption

Widespread, symmetric erythematous macules and papules on the trunk and extremities

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10
Q

What is the most common type of cutaneous drug eruption

A

Exanthematous

(Limited to the skin

Appear on trunk and spread to extremities in a symmetric fashion

Erythematous macules and infiltrated papules

Pruritus and mild fever possible

Appear >2 days after drug has been started and persists for several days after stopping)

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11
Q

If someone develops an exanthematous drug reaction, can they keep taking the drug that caused it?

A

Yes, as long as the eruption is not too severe and the medication cannot be substituted

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12
Q

How do you treat an exanthematous drug eruption?

A

Topical steroids

Oral antihistamines

Reassurance

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13
Q

What kind of drug reaction is this:

“Characterized by the formation of a SOLITARY erythematous patch or plaque that will recur at the same site with re-exposure to the drug”

A

Fixed drug eruption

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14
Q

difference between SJS and TEN

A

SJS is less than 10% body surface area

TEN is over 30% body surface area

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15
Q

What is it called if someone has necrosis and detachment of the epidermis and mucosal surfaces due to a drug reaction, and it covers 20% of their body surface area?

A

SJS/TEN

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16
Q

True or Fasle:

SJS and TEN are emergencies

A

True

17
Q

Let’s see the drugs at highest risk of causing SJS and TEN

A

Sulfas

Allopurinol

Tetracyclines

Anticonvulsants (carbamazepine, Lamotrigine, phenobarbital, phenytoin)

NSAIDS

(SATAN 😈)

18
Q

True or false:

The first symptom of SJS or TEN is always skin lesions

A

False.

Often preceded by fever, headache, rhinitis, or myalgia by 1-3 days

19
Q

Which is worse with SJS and TEN:

Pain or Itching

A

Pain

20
Q

SJS and TEN lesions evolve to become:

A

Flaccid blisters, which spread with pressure and break easily

21
Q

Can SJS or TEN make you blind

A

Yes

22
Q

If someone has SJS or TEN, do you need to stop all non-life-sustaining drugs

A

Yes

23
Q

If someone has SJS or TEN that involves >25% surface area, they need to be treated where?

A

Burn center

24
Q

HLA-B*1502 is associated with what

A

Southeast Asian patients on carbamazepine

25
Q

HLA-B*5701 is associated with what

A

ALL patients starting abacavir

26
Q

over ____% of patients with SJS or TEN have mucosal involvemnt

A

90

27
Q

Difference between acute and chronic urticaria

A

Acute: less than 6 weeks

Chronic: sx recurring most days for 6 weeks or more

28
Q

Individual urticaria lesions are ________

A

Transient**

Disappear within 24 hours

29
Q

urticaria are mediated by cutaneous ______________ cells

A

Mast

30
Q

Release of ________ and vasodilators mediators causes itching and localized swelling

A

Histamine

31
Q

What is the difference between urticaria and urticarial vasculaitis?

A

Urticarial Vasculitis lasts longer than 24 hours, is painful, and is plaques with blanching halos

Urticarial Vasculitis will leave residual hyperpigmentation or purpura

32
Q

How do you treat urticaria?

A

H1 blocker

H2 blocker

Oral steroids if angioedema or persistent symptoms

33
Q

Which H1 blockers are preferred for treatment of urticaria?

A

2nd generation, especially Cetirizine (Zyrtec) and levocetirizine (Xyzal)

Clin Med IV Week 3 Quiz (1 decks)

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