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Principles2 > Latex > Flashcards

Latex Flashcards

1
Q

is irritation dermatitis immune or non-immune?

A

non-immune

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2
Q

is irritation dermatitis limited to area of direct contact?

A

yes

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3
Q

Type 1 or Type 4: spectrum of IgE reactions?

A

type 1

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4
Q

Type 1 or Type 4: delayed, immune mediated contact dermatitis?

A

type 4

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5
Q

type 4 is mediated by what lymphocytes?

A

T-lymphocytes

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6
Q

does type 4 occur on initial exposure or re-exposure?

A

re-exposure

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7
Q

are antibodies or complement involved with type 4 reactions?

A

no

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8
Q

what 2 compounds mediate type 4 reactions? (H,T)

A

histamine, tryptase

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9
Q

what are the hour ranges for type 4:

  1. onset
  2. peak
  3. duration
A
  1. 18-24 hours
  2. 40-80 hours
  3. 72-96 hours
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10
Q

which reaction type to latex is the most common?

A

type 4

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11
Q

are anaphylactoid reactions mediated by IgE?

A

no

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12
Q

anaphylactic reactions are which type of reaction?

A

type 1

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13
Q

what is the phase called in type 1 after 1st exposure to the antigen? (SP)

A

sensitization phase

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14
Q

what 2 things degranulate in stage one of type 1 reaction?

A

mast cells and basophils

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15
Q

mast cell and basophil degranulation cause what to be released?

A

histamine

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16
Q

stage 2 of type 1 is the release of what 5 compounds? (C,L,E,P,P)

A

cytokines, leukotrienes, eosinophilic chemotactic factor, plt activating factors, prostaglandins

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17
Q

H1 receptor activation:

  1. increases permeability where? (C)
  2. causes the release of what from vascular endothelium? (EDRF)
  3. constriction in what 2 areas of the body? (A,VSM)
A
  1. capillaries
  2. endothelium derived relaxing factor
  3. airway, vascular smooth muscle
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18
Q

H2 receptor activation

  1. increases what 2 secretions?
  2. inhibits the activation of what cells?
  3. vasodilates in what 2 vascular areas? (C,P)
  4. increases what 2 C/V related things?
  5. increases permeability where? (C)
A
  1. gastric acid, mucus
  2. mast cells
  3. coronary, peripheral
  4. chronotropy, inotropy
  5. capillaries
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19
Q

eosinophilic chemotactic factors of anaphylaxis and neutrophilic chemotactic factors are what type of substance in the body? (P)

A

peptides

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20
Q

does serotonin cause bronchoconstriction or bronchodilation?

A

bronchoconstriction

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21
Q

Leukotrienes:

  1. fast or slow reacting substance of anaphylaxis (C4,D4,E4)
  2. bronchodilation or bronchoconstriction?
  3. increased or decreased capillary permeability?
  4. vasodilation or vasoconstriction?
  5. coronary vasoconstriction or vasodilation?
  6. myocardial stimulation or depression?
A
  1. slow reacting
  2. bronchoconstriction
  3. increased
  4. vasodilation
  5. coronary vasoconstriction
  6. depression
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22
Q

what are the 2 type 1 effects of prostaglandin D2? (V,B)

A

vasodilation, bronchoconstriction

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23
Q

what are the 2 type 1 effects of thromboxane B2?

A

pulmonary hypertension, increased capillary permeability

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24
Q

what are the 3 type 1 effects of kinins? (V,B,ICP)

A

vasodilation, bronchoconstriction, increased capillary permeability

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25
Q

what are the 3 type 1 effects of plt-activating factors? (AAAP, SMC, ICP)

A

aggregation and activation of plts, smooth muscle contraction, increased capillary permeability

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26
Q

what are the 2 latex allergy tests for at risk ppl?

A

RAST, AlaSTAT

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27
Q

what are 5 characteristics of at risk pts? (HoAA, MS, M, UA, MA)

A
  1. history of atopy or asthma
  2. multiple surgeries
  3. myelodysplasia
  4. urological anomalies
  5. multiple allergies
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28
Q

what 2 workers are in the at risk group, especially with a history of atopy or asthma? (HCW, RPW)

A

healthcare workers, rubber product workers

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29
Q

what number case should the latex allergies surgery be?

A

first case

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30
Q

the OR should be latex free for at least how many hours?

A

1 hour

31
Q

is the use of non-latex (powder free) glove the most important cutaneous contact precaution?

A

yes

32
Q

intraoperative anaphylaxis symptoms can persist for up to how many hours?

A

36 hours

33
Q

What % goes with these S/S of intraoperative anaphylaxis?

  1. hypotension/CV collapse
  2. rash/urticaria
  3. bronchospasm/wheezing
  4. angioedema and stridor
A
  1. 74%
  2. 70%
  3. 44%
  4. small percent
34
Q

fluid resuscitate intraoperative anaphylaxis with what range of mL/kg?

A

25-50 mL/kg

35
Q

what is the initial drug for intraoperative anaphylaxis?

A

epinephrine

36
Q

what process does epinephrine attenuate to make it the initial drug for intraoperative anaphylaxis? (MC&BD)

A

mast cell and basophil degradation

37
Q

Epinephrine intraoperative anaphylaxis doses:

  1. hypotension (mc/kg, range)
  2. CV collapse (mg)
A
  1. 1-10 mcg/kg

2. 0.1-0.5 mg

38
Q

do antihistamines inhibit anaphylactic reaction or the release of histamine?

A

no

39
Q

do you give an H1 and H2 blocker for secondary treatment?

A

yes

40
Q

diphenhydramine (mg/kg, range)

A

0.5-1 mg/kg

41
Q

for secondary treatment, what is the epinephrine gtt rate? (mcg/kg/min, range)

A

0.05-0.1 mcg/kg/min

42
Q

what are the 2 refractory symptoms that corticosteroids are used for? (B, S)

A

bronchospasms, shock

43
Q

hydrocortisone (mg/kg range)

A

5-10 mg/kg

44
Q

albuterol:

  1. how many puffs via MDI? (range)
  2. how many mL via nebulizer? (range)
A
  1. 4-12 puffs

2. 0.25-1 mL

45
Q

Aminophylline

  1. what is the IVP dose given over 20 minutes? (mg/kg, range)
  2. what is the gtt rate? (mg/kg/hr, range)
A
  1. 5-6 mg/kg

2. 0.5-0.9 mg/kg/hr

46
Q

what is isoproterenol dose rate? (mcg/kg/min, range)

A

0.01-0.02 mcg/kg/min

47
Q

what is NaHCO3 dose range for refractory hypotension? (mEq/kg, range)

A

0.5-1 mEq/kg

48
Q

what is the IVP glucagon dose? (mg)

A

1 mg

49
Q

what is the NE dose range? (mcg/kg/min)

A

0.05-0.1 mcg/kg/min

50
Q

Post anaphylaxis, close observation is needed for a minimum of how many hours?

A

12 hours

51
Q

biphasic anaphylaxis will occur 5-32 hours in what % of pts?

A

20%

52
Q

serum tryptase levels remain elevated what range of hours post anaphylaxis?

A

1-4 hours

53
Q

what meds can be used for refractory bronchospasm? (H, M, I, A, A)

A

hydrocortisone, methylpred, isoproterenol, albuterol, aminophylline

54
Q

what med can be used for refractory hypotension? (G, N, N, E)

A

glucagon, NE, NaHCO3, epi

55
Q

H1, H2, leukotrienes, thromboxane B2, or plt activating factor:

  1. SM contraction
  2. myocardial depression
  3. pulmonary HTN
  4. inhibition of mast cell activation
  5. plt aggregation and activation
  6. coronary constriction
  7. coronary vasodilation
  8. slow reacting substance to anaphylaxis
  9. increased chronotropy and inotropy
  10. increased gastric acid and mucus
  11. release of endothelium derived relaxing factor
A
  1. plt activating factor
  2. leukotrienes
  3. thromboxane B2
  4. H2
  5. plt activating factor
  6. leukotrienes
  7. H2
  8. leukotrienes
  9. H2
  10. H2
  11. H1
56
Q

what 5 compounds cause bronchoconstriction? (Someone HeLP Karen)

A

serotonin, H1, leukotriene, prostaglandin D2, kinins

57
Q

what 5 compounds cause vasodilation? (Hey HeLP Karen)

A

H2, H1, leukotriene, prostaglandin D2, kinin

58
Q

what 6 compounds increase capillary permeability? (Hey HeLP Trap Karen)

A

H2, H1, leukotriene, plt activating factor, thromboxane B2, kinin

59
Q

H1, H2 or both:

  1. increased capillary permeability
  2. vascular SM constriction
  3. coronary vasodilation
  4. peripheral vasodilation
  5. endothelium derived relaxing factor release
  6. increased gastric acid secretion
  7. inhibition of mast cell activation
  8. airway constriction
  9. increased inotropy and chronotropy
  10. increased mucus production
A
  1. both
  2. H1
  3. H2
  4. H2
  5. H1
  6. H2
  7. H2
  8. H1
  9. H2
  10. H2
60
Q

leukotrienes depress and constrict what organ?

A

heart

61
Q

what compound causes pulm htn?

A

thromboxane

62
Q

methylprednisolone q 6 hours (mg/kg, range)

A

1-2 mg/kg

63
Q

Sensitization phase:

  1. upon 1st exposure to the Ag, T-helper cells synthesize what? (L)
  2. this causes B-lymphocytes to synthesize what? (A)
  3. this product binds to receptors on what 2 cells? (M, B)
A
  1. lymphokines
  2. antibodies
  3. mast cells, basophils
64
Q

ranitidine (mg/kg)

A

1 mg/kg

65
Q

what is the minute range onset for intraop anaphylaxis?

A

5-150 minutes

66
Q

suspect intraop anaphylaxis when HR drops how many beats per minute?

A

30

67
Q

suspect intraop anaphylaxis when BP drops greater than how many torr?

A

30

68
Q

for intraop anaphylaxis, up to what % of IV volume can be lost into the interstitial space?

A

40%

69
Q

irritation dermatitis:

  1. gradual or fast onset?
  2. what type of agents cause it? (D/D)
A
  1. gradual

2. defatting/degreasing

70
Q

what 5 chemical additives in latex act as haptens? (ABCTT)

A

amines, benzothiazole, carbamate, thiurams, thiourea derivatives

71
Q

what is formed during Type 1 sensitization phase?

A

IgE antibodies

72
Q

Type 1 reactions:

  1. what happens in stage one?
  2. what happens in stage two?
A
  1. mast cells and basophils degranulate causing histamine to be released
  2. CLEPP is released (cytokines, leukotrienes, eosinophils, prostaglandins, PAF)
73
Q

do you give premedication to pts with latex allergies?

A

no

Principles2 (21 decks)

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