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CH 25 Immunologic Emergencies > Lecture > Flashcards

Lecture Flashcards

1
Q

Define hypersensitivity

A

An exaggerated immune response to a perceived harm

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2
Q

What is an abnormal immune response when exposed to a minor allergan affecting one body system

A

Allergic reaction

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3
Q

Define anaphylaxis

A

In extreme response involving IGE antibody mediation in two or more body systems

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4
Q

Define anaphylactoid reaction

A

Does not involve IGE antibody mediation but presents clinically the same as anaphylaxis

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5
Q

What is a substance that produces an allergic symptoms

A

Allergen

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6
Q

An agent that stimulates the formation of specific antibodies

A

Antigen

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7
Q

What is an antibody?

A

Immunoglobulin protein the body produces in response to an antigen

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8
Q

A specific antibody involved in allergic reactions located on mast cells and basophils

A

IGE antibody

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9
Q

Where are immune system cells located

A

In lymph nodes the blood stream, tissues, spleen and G.I. tract

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10
Q

What are the two types of immune system responses?

A

Innate system response and adaptive system response

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11
Q

Describe an innate immune system response

A

First line of defense
Quick response
Consists of compliment proteins and inflammatory mediators such as mast cells, basophils, macrophage and neutrophils

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12
Q

Describe an adaptive immune system response

A

Can either be Cellular immunity or humoral immunity

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13
Q

What type of immune response is cell mediated where killer T cells attack and destroy invaders and helper T cells assist B cells?

A

Cellular immunity of the adaptive immune response

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14
Q

What is the primary response of Humoral immunity

A

When B cells produce antibodies

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15
Q

What is the role of macrophages?

A

To engulf foreign substances and to recognize invading proteins and design antibodies

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16
Q

What is the main physiology behind an inflammatory response?

A

Increased blood flow and leaky capillaries

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17
Q

What is chemotaxis

A

Part of the immune response that involves chemical mediators

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18
Q

How does the immune response develop sensitivity?

A

Specific antibodies are placed on mast cells and basophils that will recognize and destroy the invader in the future

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19
Q

Where are basophils located?

A

In specific body regions typically lymph nodes

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20
Q

Where are mast cells located?

A

They’re circulated in vulnerable body sites such as connective tissue, G.I. mucosa, and the respiratory tract

21
Q

What do chemical mediators do in an immune system response?

A

Signal several chemicals such as histamine to produce swelling, bronchoconstriction, and vasodilation
Recruit neutrophils and eosinophils
Beneficial if localized, But devastating when systemic

22
Q

What is acquired immunity?

A

Exposure to an antigen through a vaccine and the body develops immunity without becoming ill

23
Q

What is natural immunity?

A

Antibodies are developed and immunity occurs after successfully fighting off a disease

24
Q

What happens during anaphylaxis at the cellular level?

A

An inappropriate immune response by systemic chemical mediator release causing vasodilation, respiratory constriction, G.I. upset and/or systemic hives

25
Q

When should you have a high index of suspicion that an anaphylactic response is occurring?

A

Anytime two or more body systems are involved.

26
Q

Does anaphylaxis occur on the first exposure?

A

No, but an anaphylactoid response does

The immune response does not involve IGE mediators in anaphylaxis

27
Q

Is there a difference between the clinical presentation of an anaphylaxis and anaphylactoid response?

A

NO

28
Q

What are the two types of non-anaphylaxis hypersensitivity disorders?

A

Collagen vascular disease

Acute allergic reactions

29
Q

What is a collagen vascular disease?

A

Autoimmune disorder can be chronic or acute and includes lupus and scleroderma

30
Q

What is an acute allergic reaction?

A

A less extreme immune response that can cause rhinitis, localized hives, sneezing, coughing an increased mucus production

31
Q

Name 4 methods of invasion

A

Ingestion
injection
inhalation
absorption

32
Q

Systems affected by anaphylaxis

A

Skin, respiratory, cardiovascular, gastrointestinal, central nervous system, psychological

33
Q

Common anaphylaxis skin signs

A

Warm, flush, itching, swollen red eyes, face mouth and tongue edema, distal edema, Hives (urticaria)

34
Q

Common anaphylactic respiratory signs

A

Dyspnea, tightness in throat and chest, stridor, hoarseness, wheezing, crackles, cough, sneeze

35
Q

Common anaphylactic signs affecting the cardiovascular system

A

Dysrhythmias, hypotension, tachycardia

36
Q

Common anaphylactic signs affecting the gastrointestinal system

A

Abdominal cramping, nausea, bloating, vomiting, abdominal distention, profuse diarrhea

37
Q

Common anaphylactic signs affecting the central nervous system

A

Headache, dizziness, confusion, anxiety, impending doom, AMS

38
Q

Does anaphylaxis always have a rapid onset?

A

No

39
Q

What is the first line of treatment for an anaphylactic response?

A

Epinephrine

40
Q

What is the epinephrine dose for an anaphylactic response?

A

.3mg 1:1,000 IM q 5min

.3mg 1:10,000 IV can be considered

41
Q

Are there any contraindications for administering epinephrine in an anaphylactic response?

A

No
Be cautious if there is a cardiac Hx, but don’t let it stop you from administering epic if it is needed
Caution with pts. taking TCA’s and MAOI for depression

42
Q

What is the first action you should take if you suspect anaphylaxis

A

A B C’s and then administer .3 mg 1:1,000 epi IM

43
Q

In the presence of a severe anaphylactic response what should be done while an IV is being established?

A

Deliver .3mg 1:1,000 IM followed by .3mg 1:10,000 IV SLOWLY over 5 min, if appropriate

44
Q

What is the concern with giving an IM injection during an anaphylactic response

A

Blood is shunted from the periphery thereby decreasing circulation and slowing the absorption rate

45
Q

What are second line treatments for anaphylaxis?

A 
Albuterol 2.5mg
Benadryl 50mg
Solu-Medrol 125mg
IV fluids (1-2L, consider 2 large bore IV if needed)
Supportive care
Monitor closely for re-dosing
46
Q

What is biphasic anaphylaxis?

A

A repeat of symptoms that can occur 1-72 hours after the initial attack

47
Q

What is the best way to prevent biphasic anaphylaxis?

A

Administering 125mg of Solu-Medrol during the first attack

48
Q

What is the most important thing during an anaphylactic response?

A

Early recognition and treatment

49
Q

What signs and symptoms give you a high index of suspicion that there is an anaphylactic response occurring?

A

Two or more body systems are involved

CH 25 Immunologic Emergencies (2 decks)

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