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NUR 325 > E3 Hypersensitivity > Flashcards

E3 Hypersensitivity Flashcards

1
Q

Hypersensitivity is a ______ immune response that is _____

A

normal
inappropriately triggered or excessive or produces undesired effects on the body

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1
Q

Hypersensitivity type I, II, III = mediated by

A

B cell Plasma cell antibodies

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2
Q

Hypersensitivity type IV = mediated by

A

T-cells

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3
Q

Type I Key characteristics

A

-Immediate response (15-20 mins)
-Reaction occurs after being sensitized to an antigen
-Environmental (pets dander, bee stings)
-Foods (nuts, seafood, eggs)
-Medications (penicillin, contrast dye)

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4
Q

Type 1 Key cells involved:

A
  1. B lymphocytes
  2. IgE
  3. Mast cells (granulocyte)
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5
Q

Talk through the Type 1 pathogenesis

A
  1. The B cell becomes activated after 1st exposure
  2. the Activated B plasma cell makes larges amounts of IgE
  3. IgE antibodies attach to mast cells
  4. Next time person is exposed to the allergen it binds to the IgE antibodies triggering the release of chemical mediators from the mast cell
  5. Get physical response: Anaphylactic shock, atopic dermatitis, angioedema, Rhinitis, asthma, N/V/D, cramping
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6
Q

Chemical mediators from mast cells cause what mediator activity? (4)

A
  1. Potent vasodilation: stuffy nose, lower BP, Wheals on skin
  2. Increased vascular permeability (Edema, Runny nose)
  3. Bronchial smooth muscle contraction (Breathing difficulties, wheezing)
  4. Stimulates irritant receptors (Itching aka pruritis)
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7
Q

What is Type I Atopic reactions?

A

-Localized
-Inherited tendency to becomes sensitive to allergens
Ex. Allergic rhinitis, asthma, urticaria

-Most common triggers: pollen, dust, animal dander, mold

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8
Q

What is Type I Anaphylaxis reaction?

A

-Systemic release of chemical mediators
-Life threatening: Bronchial constriction, vascular collapse, airway obstruction

-Most common triggers: Meds, Bee stings, Nuts

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9
Q

What causes a Type II reaction?

A

-Exposure to antigen or foreign tissue/cells
-Antigens are located on cell surface
-Like giving somebody the wrong blood type or transplant pts or Erythroblastosis fetalis (RH factor)

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10
Q

Key characteristics of Type II reactions?

A
  1. Antigens stimulate antibody production
  2. Antibodies recognize and attach to cell surface antigens (Antigen-Antibody complex)
  3. Direct destruction of targeted cells that contain the antigen (Cell lysis & phagocytosis)
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11
Q

Immune cells involved in Type II reactions?

A
  1. IgG & IgM
  2. Complement (fix foreign cells & lyse it)
  3. WBCs
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12
Q

What is the major problem with type II reactions?

A

The debri & clumping in small vessels reduces blood supply blocking supply to small vessels

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13
Q

Type II Manifestations Transfusion Reaction

A

-Fever, chills, flushing
-Increase HR & BP
-Chest pain or back pain
-N/V
-Restlessness & Anxiety
-Headache

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14
Q

What is Type III reaction?

A

-Autoimmune attack (Rhematoid arthritis)
-Low grade infection (bacteria or viruses
-Inhaled antigens from molds or contaminated plants

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15
Q

Key characteristics of Type III reations?

A
  1. Antigen-Antibody complexs form
  2. These are deposited into tissues
  3. Inflammatory response causes tissue damage
16
Q

Key immune cells involved in type III

A
  1. IgG & IgM clump w/ antigens
  2. Complement
  3. Neutrophils & Mast cells
17
Q

Clinical manifestations of Type III depends on _____

A

where the complexes are deposited in the tissue
1. Rheumatoid arthritis (Primarily the joints)
2. Glomerulonephritis (kidney failure)
3. Systemic lupus erythematosus (skin & many organs)

18
Q

What is the main difference between Type II & III?

A

Type II-reactions occur on the cell surface and result in direct cell death or malfunction

Type III- Immune complexes are deposited into tissues and the resulting INFLAMMATION destroys the tissue

19
Q

What is Type IV Hypersensitivity?

A

-Plant oils (Poison Ivy)
-Tuberculin antigen (Positive TB skin test)
-Jellyfish sting
-Allergic reaction to jewelry
-Gluten (Crohns disease)
-Organ transplant or skin graft
-Adhesives

20
Q

Key characteristics of Type IV?

A

-Delayed hypersensitivity response 48-72 hrs)
-No antibody involvement

21
Q

Key Immune cells of Type IV?

A
  1. T cells
  2. Cytokines
  3. Mast cells & macrophages
22
Q

Steps of a Type IV response?

A
  1. Small, incomplete antigen, Hapten penetrates the skin
  2. Hapten combines with human protein (APC) to form complete antigen
  3. APC alerts T cells of antigen
  4. T cells attack the antigen via:
    -Direct attack of the T cells
    -Release of cytokines (inflammation)
    -Macrophages (cell destruction)
23
Q

Type IV contact dermatitis manifestations

A

Redness, edema, itching, blisters

24
Q

Type IV Tuberculin hypersensitivity

A

Redness, Induration, Inflammation

25
Q

Antihistamines

A

Suppress histamine mediator activity

26
Q

Immunosuppressants (including corticosteroids)

A

Suppresses cell-mediated immunity
-Anti-inflammatory

27
Q

Epinephrine MOA

A

Halts mediatory activity from mast cells

28
Q

Classification of Epinephrine

A

Vasopressor
Bronchodilator
Anti-asthmatic
Vasoconstrictor

29
Q

Indication of Epinephrine

A

Severe allergic reaction
Cardiac arrest
Severe asthmatic attack

30
Q

Major side effects of epinephrine

A

Angina
Arrhythmias
Hypertension
Tachycardia
Nervousness
Restlessness
Tremor

31
Q

Route of epinephrine

A

All EXCEPT PO
Overdose can be FATAL

32
Q

Nursing considerations for epinephrine

A

-Monitor vitals closely
-Monitor for reversal of symptoms
-Overdose can be fatal: heart attack
-Have coworker recheck dose
-Contact clinician directly after taking this

NUR 325 (21 decks)

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