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Stage 3 Human Diseases > HD16 Allergic Diseases > Flashcards

HD16 Allergic Diseases Flashcards

1
Q

What are the allergic response symptoms that you may see that are sever and potentially lifethreatening?
2) What should you do after dealing with the crisis?

A

1) breathing difficulties, swelling and itching, urticaria/ hives, incontinance, diarrhoea, cramps
2) refer to appropriate specialists for further investigation

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2
Q

What is hypersensitivity?

A

Immune mediated antigen-specific reaction that are inappropriate or excessive and result in harm to the host.

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3
Q

What 2 ways can hypersensitivity be mediated?

A

Antibody mediated

T cell mediated

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4
Q

What 3 things can hypersensitivity be against?

A

Environmental agents
Self antigens
Infectious agents e.g. hep B, leprosy (tuberculoid reactions)

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5
Q

Whats the other name of a type 1 hypersensitivity?

A

immediate mediated (IgE)

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6
Q

Whats the other name of a type 2 hypersensitivity?

A

antibody mediated

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7
Q

Whats the other name of a type 3 hypersensitivity?

A

immune complex mediated

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8
Q

Whats the other name of a type 4 hypersensitivity?

A

T cell mediated (delayed)

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9
Q

Whats the other name of a T cell mediated hypersensitivity?

A

type 4

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10
Q

Whats the other name of a immune complex mediated hypersensitivity?

A

type 3

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11
Q

Whats the other name of a antibody mediated mediated hypersensitivity?

A

type 2

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12
Q

Whats the other name of a immediate mediated hypersensitivity?

A

type 1

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13
Q

What type of antibody is involved in type 1 hypersensitivity?

A

IgE

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14
Q

What antibodies are involved in type 2 hypersensitivity?

A

IgM , IgG

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15
Q

What antibodies are involved in type 3 hypersensitivity reactions?
2) Anything else involved?

A

1) IgM and IgG

2) extracellular matrix antigens

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16
Q

what is involved in type 4 hypersensitivities?

A

CD4 + T cells (delayed- type hypersentivity)

CD8+ CTLs (T cell mediated cytolysis)

17
Q

Describe the mechanisms of tissue injury and disease through type 1 hypersensitivity?

A

mast cells and their mediators (vasoactive amines, lipid mediators and cytokines)

18
Q

Describe the mechanisms of tissue injury and disease through type 2 hypersensitivity?

A

so the antibody binds to an intrinsic (self) or extrinsic (come from pencillin or virus) antigen on a host cell e.g. RBC=

1) opsonisation and phagocytosis of cells
2) complement and Fc receptor mediated recruitment and activation of leukocytes (neutrophils, macrophages)
3) abnormalities in cellular functions e.g. hormone receptor signalling

19
Q

Describe the mechanisms of tissue injury and disease through type 3 hypersensitivity?

A

complement and Fc receptor mediated recruitment and activation of leukocytes
(this one is similiar to type 2, but misses out a few of the responses due to not involving extracellular matrix antigens)

20
Q

Describe the mechanisms of tissue injury and disease through type 4hypersensitivity?

A
  1. CD4+ T cell= macrophage activation, cytokine-mediated inflammation
    2, CD8+ CTLs = direct target cell killing, cytokine mediated inflammation
21
Q

What is the hygiene hypothesis

A

Decreased infection
Increased immunisation
Leads to preferential switch from type 1 profile to type 2 profile

22
Q

What is atopy?

A

Atopy refers to the genetic tendency to develop allergic diseases such as allergic rhinitis, asthma and atopic dermatitis (eczema)

23
Q

In type 1 hypersensitivity. IgE mediated degranulation of mast cells and basophils.
What is released?

A

Release of histamine, heparin, lysosomal enzymes and proteases

24
Q

What are the clinical consequences caused by increased cappillary permeability with hypersensitivity reactions?

A

Tissue oedema, urticaria, itching, rhinitis
Laryngeal oedema: (Airway obstruction,,
Respiratory distress
Stridor)
Fluid leakage from vascular space (Hypovolemic shock)

25
Q

What are the clinical consequences caused by smooth muscle contraction with hypersensitivity reactions?

A

Bronchospasm: (Respiratory distress, cough)
GI tract spasm: (Nausea, vomiting & Cramps, diarrhoea)
Bladder spasm (Urinary urgency/incontinence)

26
Q

What investigations are undertaken to diagnosis hypersensitivity to a particular antigen?

A
  1. skin prick tests
  2. blood tests (specific IgE)
  3. challenge tests (to overcome false positives and negative results: could be given oral/iv (double blind placebo controlled)
27
Q

What is the definition of anaphylaxis?

A

Severe allergic reaction with 1 or both of:-
Breathing difficulties
hypotension

28
Q

What do u if a patient is in anaphylaxis, (especially if skin changes are present)

A

oxygen

29
Q

following anaphylaxis and treatment with oxygen, what would you do if this then occured:
Stridor, wheeze, respiratory distress or clinical signs of shock

A

Adrenaline 1:1000 2,3 solution; 0.5ml (0.5mg) intramuscular

30
Q

patient has anaphylaxis, oxygen administered then , wheezing occurs then Adrenaline 1:1000 2,3 solution; 0.5ml (0.5mg) administered intramuscularly:
2) what do you do if this doesn’t help?

A

Repeat asministering adrenaline in 5 mins if no clinical improvement
2) Antihistamine (chlorpheniramine) 10-20mg IM or slow IV

31
Q

For all severe or recurrent reactions and patients with asthma give ………..

A

For all severe or recurrent reactions and patients with asthma give hydrocortisone 100-500mg IM or slow IV

32
Q

If clinical manifestations of shock do not respond to drug treatment give …..

A

1-2L of fluid IV4. Rapid infusion or one repeat dose may be necessary.

33
Q

What are the 3 things used to treat type 1 reactions?

A

antihistamines e.g. Cetirizine
steroids e.g. Prednisolone, hydrocortisone
bronchodilators e.g. salbutamol

Stage 3 Human Diseases (10 decks)

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