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NUR 325 Patho > Hypersensitivity > Flashcards

Hypersensitivity Flashcards

1
Q

what is hypersensitivity

A

NORMAL immune response that is:

Inappropriately triggered
OR
Excessive
OR
Produces undesirable effects on the body

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2
Q

what are the basic triggers for hypersensitivity

A

A specific antigen-antibody reaction

OR

A specific antigen-lymphocyte interaction

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3
Q

What are the four types of hypersensitivity

A

Types I, II, III = mediated by ANTIBODIES produced by B cells
Specifically PLASMA cells

Type IV = mediated by T cells (LONGER)

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4
Q

What is Type 1 hypersensitivity

A

IgE mediated reaction

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5
Q

Type 1 key charactersitics

A

Immediate reaction! (15-20 minutes)

This reaction occurs after being sensitized to an antigen

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6
Q

Antigens for Type 1 hypersensitivity

A

Environmental (pet dander, bee stings)
Foods (nuts, seafood, eggs)
Medications (penicillin, contrast dye)

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7
Q

Etiology of type 1

A

1 parent allergic = 30% chance
2 parents allergic = 50% chance

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8
Q

key cells involved in type 1

A

B lymphocytes
IgE (antibody)
Mast cells (granulocyte)

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9
Q

What happens when a person is first exposed to allergen

A

B Cell goes from immature to mature

B cell triggered

B cell transforms to plasma cell and produces antibodies

attaches to mast cells to release chemical mediators which cause reactions

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10
Q

Potent vasodilation
causes

A

Stuffy nose
Lower blood pressure
Wheals on skin

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11
Q

increased vascular permeability causes

A

edema
runny nose

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12
Q

Bronchial smooth muscle constriction causes

A

breathing difficulties
wheezing

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13
Q

Stimulates irritant receptors
causes

A

Itching (pruritis)

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14
Q

Atopic reactions =

A

inherited tendency to become sensitive to allergens

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15
Q

Examples of atopic reactions

A

Allergic rhinitis
Asthma
Urticaria (hives)

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16
Q

What are the most common triggers of atopic reactions? (4)

A

Pollen,
dusts,
molds,
animal dander

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17
Q

What is Type I: Anaphylaxis (Systemic)

A

systemic release of CHEMICAL MEDIATORS

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18
Q

Warnings about Anaphylaxis

A 
Life-threatening– 
Bronchial constriction 
Airway obstruction 
Vascular collapse (shock)
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19
Q

Common triggers of anaphylaxis

A

medications
bee stings
foods

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20
Q

What is Type 2 hypersensitivity

A

Cytotoxic reaction

“WRONG BLOOD”

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21
Q

Etiology of Type 2

A

Exposure to antigen or foreign tissue/cells

Antigens are located on cell surface

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22
Q

Key characteristics of type 2

A

Antigens stimulate antibody production

Antibodies recognize and attach to cell surface antigens

Direct destruction of targeted cells that contain the antigen

  • Cell lysis
  • Phagocytosis
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23
Q

Immune cells involved in type 2

A

Antibodies (IgG & IgM)
Complement
WBC’s (phagocytes)

24
Q

Examples of antigens in type 2

A

Blood

Some of your body’s own cells (with auto-immune conditions such as Diabetes)

Erythroblastosis fetalis

25
Q

type 2 example disorders

A

Blood Transfusion Reaction

Newborn/mother Rh incompatibility

Autoimmune disorders
Hemolytic anemia
Myasthenia Gravis
Graves disease

Certain drug reactions

26
Q

type 2 manifestation transfusion reaction

A

Fever, chills, flushing
↑ HR, ↓ BP
Chest pain or back pain
N/V
Restlessness, anxiety
Headache

27
Q

what is type 3 hypersensitivity

A

Immune Complex Reaction

28
Q

type 3 key characteristics

A

Antigen-antibody COMPLEXES form

These are deposited into tissues

Inflammatory response causes tissue damage

29
Q

etiology of type 3

A

Autoimmune attack (or)

Low grade infection (or)

Inhaled antigens from molds or contaminated plants

30
Q

possible offending antigens in Type 3

A

Your body’s own tissues and/or DNA

Inhaled antigens from mold or contaminated plants

Bacteria or viruses

31
Q

Key immune cells involved in Type 3

A

Antibodies (IgG and IgM) that clump with antigens

Complement

Neutrophils and mast cells

32
Q

Type 3 Clincial manifestations

A

Depend on WHERE the complexes are deposited in the tissue!

Rheumatoid arthritis-
Primarily the joints

Glomerulonephritis-
kidney failure

Systemic lupus erythematosus-
Skin and many organs

33
Q

Difference between Type 2 and Type 3

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

34
Q

Type 4 hypersensitivity

A

Delayed hypersensitivity

35
Q

key characteristics of type 4

A

Delayed hypersensitivity response

NO antibody involvement

36
Q

key immune cells in type 4

A

T cells (NO B cells!)

Cytokines

Mast cells and macrophages

37
Q

etiology of type 4

A

Delayed cellular reaction to an antigen

38
Q

possible antigens in type 4

A

Plant oils
Cosmetics, clothing, dyes, adhesives
Nickel alloys
Tuberculin antigen
Organ transplant or skin graft
Gluten

39
Q

type 4 Pathogenesis

A
  1. Small, incomplete antigen, called a ‘hapten’, penetrates the skin
  2. The hapten combines with human protein to form complete antigen
  3. T cells become aware of antigen
    Antigen processing cell
  4. T cells attack the antigen via:
    Direct attack of the T cells
    Release of cytokines (inflammation)
    Macrophages (cell destruction)
40
Q

Type 4 clinical manifestations

A

Generally peak 48-72 hours
Contact dermatitis
Redness, edema, itching, blisters
Tuberculin hypersensitivity:
Redness, induration, and inflammation

41
Q

4 different types of hypersensitivity

A

Type I
Allergens
IgE on Mast Cells
Mediator release

Type II
IgG & IgM
Antibodies
Attach to cells
Cell lysis

Type III
IgG or IgM – Antibody complexes
Accumulate in tissues
Inflammation

Type IV
Delayed
Tcell activation
Cytokines

42
Q

Treatment options of hypersensitivity include

A

Immunosuppressants
Antihistamines
Epinephrine

43
Q

what does ANTIHISTAMINES do

A

Suppress histamine mediator activity

44
Q

What do Immunosuppressants (including corticosteroids)
do

A

Suppresses cell-mediated immunity

Antiinflammatory

45
Q

what does epinephrine do

A

halts mediator activity

46
Q

epinephrine class

A

Vasopressor, bronchodilator, antiasthmatic, vasoconstrictor

47
Q

indication of epinephrine

A

Severe allergic reactions,
cardiac arrest,
severe asthmatic attack

48
Q

action of epinephrine

A

Inhibits release of mediators from mast cells

49
Q

Major Side/Adverse Effects of Epinephrine

A

CV: Angina, arrhythmias, hypertension, tachycardia

CNS: Nervousness, restlessness, tremor

50
Q

Epinephrine routes

A

All except PO

SQ preferred

51
Q

Dosage of Epinephrine

A

Adults: 0.2 to 1 mg
Peds: 0.01/mg/kg

52
Q

How is epinephrine supplied

A

1 mg in 1 mL vial (1:1000) concentration

53
Q

What do we monitor for in Epinephrine

A

Vital signs closely!

Status for reversal of symptoms

54
Q

Nursing implications for epi dosing

A

Correct dose is crucial
Overdose can be FATAL
Have coworker recheck dose
For subcu use – use TB syringe

55
Q

home use of Epi

A

Teach: take EXACTLY as directed

Contact clinician directly after taking!

NUR 325 Patho (18 decks)

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