ECITS

Question 1

Antibodies a.k.a.

Answer 1

Immunoglobulin (Ig)

Question 2

Where are IgE antibodies located

Answer 2

On basophil and mast cells

Question 3

Diseases such as asthma, allergic rhinitis and dermatitis predispose some one to the potential for what type of reaction

Answer 3

anaphylaxis

Question 4

Describe collagen vascular disease

Answer 4

an autoimmune disorder where the body perceives its own tissues and cells to be forgein invaders
Systemic Lupus Erythematosis
Scleroderma
Immune suppression is important in the treatment

Question 5

Why is the suppression of the immune system important to organ transplant patients

Answer 5

So that the body does not recognize the new organ as forgiven and attempt to destroy it.
Infection is the greatest risk to survival for these patients

Question 6

The primary immune response begins with what actions

Answer 6

Macrophages engulfing an invader

Immune cells record the proteins of the invader and manufacture antibodies against it

Question 7

Through the primary response the body develops what

Answer 7

Sensitivity

Question 8

What are the systemic effects of chemical mediators

Answer 8

S&Sy of allergic reactions and anaphylaxis

Question 9

What is the secondary immune response composed of

Answer 9

acquired immunity and natural immunity

Question 10

What does a mild reaction effect

Answer 10

A localized area of the body

Question 11

What does a moderate reaction effect

Answer 11

Begins as a mild reaction but spreads to other areas of the body

Question 12

What is a severe reaction classified as

Answer 12

anaphylaxis, potentially life-threatening

Question 13

Classic presentation of anaphylaxis includes what 2 body systems

Answer 13

respiratory and skin

Question 14

Describe the airway response of an anaphylaxis reaction

Answer 14

Wheezing, stridor due to bronchoconstriction, excessive mucus production and increased edema
Exhalation becomes increasingly difficult

Question 15

Typical cardiovascular signs of anaphylaxis

Answer 15

Vasodilation, tachycardia, hypotension

Shock

Question 16

What may the ETCO2 levels show in an anaphylaxis response

Answer 16

Elevated due to air trapping with shark fin wave forms

Question 17

What position should you place the patient in in an anaphylaxis response

Answer 17

Trendelenburg’s

To maintain cerebral perfusion (shock)

Question 18

Primary chemical mediator

Answer 18

Histamine

Causes vasodilation and capillary permeability

Question 19

How does histamine release typically present in a patient

Answer 19

Vasodilation, hypotension, erythematous, edema, urticaria, smooth muscle contraction (larygospasm, bronchoconstriction, abdominal cramping) and fluid loss

Question 20

Leukotriene release causes what

Answer 20

additional bronchoconstriction, coronary vasoconstriction, and increased vascular permiability, decrease in cardiac contractility and decrease in cardiac output

Question 21

What is pruritus

Answer 21

itching

Question 22

Think of a patient in anaphylaxis as experiencing what 3 types of shock

Answer 22

Cardiogenic
Hypovolemic
Neurogenic

Question 23

Whenever dyspnea is present in conjunction with S&Sy of allergic reaction what is the first line of action

Answer 23

administer .3mg 1:1000 epi IM

Question 24

Considerations in IV access

Answer 24

2 large bore IV’s
administer 1-2L of NS
monitor lung sounds

Question 25

What classification is diphenhydramine and how does it work

Answer 25

Anti-histamine

Does not inhibit histamine release but blocks the H1 and H2 receptor sites

Question 26

In an anaphylaxis response when should diphenhydramine be administered

Answer 26

after epi is on board

Question 27

Why are corticosteroids administered in a severe allergic response

Answer 27

They help prevent a biphasic response

Question 28

Why would glucagon be administered in anaphylaxis

Answer 28

If the pt were on B-blockers and epinepherine was ineffective
It increases cardiac contractility

Question 29

Glucagon dose in anaphylaxis

Answer 29

1-2mg IM/IV q 5 min

Question 30

If patient does not respond to fluid administration what medication may be considered

Answer 30

Dopamine infusion

Question 31

What % of patients will have a reoccurrence of the S&Sy in the next 8 hrs

Answer 31

20%