Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Immunity > Lecture 4 - Anaphylaxis And Rhinitis > Flashcards

Lecture 4 - Anaphylaxis And Rhinitis Flashcards

1
Q

What is anaphylaxis?

A

Severe life threatening systemic hypersensitivity reaction (rapid)

Potentially life threatening airway, breathing or circulation problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some symptoms of anaphylaxis?

A

Hives
Angiodema
Cough
Stridor
Wheeze
Breathless
Shock
Hypotension
Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the pathogenic mechanism for anaphylaxis?

A

Mast cells get activated (can be IgE mediated or non IgE mediated) and their mediators act

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some upper resp symptoms of anaphylaxis?

A

Rhinorrhea
Sneezing
Angiodema
Stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some resp symptoms of anaphylaxis?

A

Cough
Wheeze
Dyspnea
Bronchoconstriction
Hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some skin symptoms of anaphylaxis?

A

Flushing
Urticaria
Angiodema
Itch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some conditions that often occur with anaphylaxis?

A

Asthma
Allergic rhinitis and eczema
Psychiatric illness
Mastocytosis
CVS disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some factors that amplify anaphylaxis?

A

Exercise
Acute infection
Emotional stress
Dysruption of routine (travel)
Premenstrual status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the diagnosis criteria for anaphylaxis?

A

Any once of the 2 criteria:
Acute onset of an illness with simultaneous involvement of the skin, mucosal tissue or both (generalised hives, puritis, flushing
+
Resp compromise
Reduced BP or symptoms of end organ dysfunction
Severe GI symptoms
Acute hypotension, bronchospasm or laryngeal involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Slide 42 and further information:

Does this patient need an Epi Pen?

A

No difficulty breathing only urticaria and angiodema episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are thee 3 main features you need to manage in anaphylaxis?

A

Airways
Breathing
Circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Slide 48:

Is this anaphylaxis?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the management for Acute anaphylaxis?

A

look for sudden onset of Airway, breathing and circulation problems (can have skin changes)
Call for help
Remove trigger
Keep patient on the floor

IM ADRENALINE
Repeat IM adrenaline after 5mins if not worked
O2
Fluids if not response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What posture should we put a patient in with anaphylaxis?

A

Keep patient sat or lay down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where do you administer IM adrenaline in anaphylaxis?

A

Anterolateral thigh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What dose of IM do under 6yrs receive?

A

150mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What dose of IM adrenaline do over 6yr olds receive in anaphylaxis?

A

300mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What part of the epipen faces the sky, what part of the epipen is in the thigh?

A

Blue = sky
Orange = thigh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What should be done after giving an epipen?

A

May need further adrenaline dosing to maintain optimal dose to resolve symptoms
Adrenaline via needle/syrinnge has better pharmacokinetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why are IV fluids useful in anaphylaxis?

A

Help increase venous return
Dec stroke volume
Inc heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What volume of IV fluids should be given in a child with anaphylaxis?

A

10ml/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why type of IV solution is given as a bolus for anaphylaxis for adults ?

A

500ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is refractory anaphylaxis?

A

Anaphylaxis that doesn’t resolve after 2 doses of intramuscular adrenaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you treat refractory anaphylaxis?

A

IV fluids
Start adrenaline infusion (IV)

Ensure has oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Are anti-histamines and corticosteroids part of the initial emergency management for acute anaphylaxis?

A

Not initial emergency managemtn

Given after stabilisation

26
Q

How to you manage anaphylaxis long term?

A

Risk assessment
Allergen avoidance
Emergency plans

27
Q

What are considered avoidable causes of anaphylaxis and not reliably avoidable?

A

Avoidable = prescription drugs

Not avoidable = foods, stings, latex, idiopathic

28
Q

What should be done if a patient presents with asthma in context with exposure to known allergen?

A

IM adrenaline
Can consider bronchodilators like salbutamol/ipratropium

29
Q

What is the definition of rhinitis?

A

Inflammation of the nasal mucosa
Rhinorrhoea, nasal blockage, congestion, itchiness adn sneezing

30
Q

What is rhinitis including the sinus linings called?

A

Rhinosinusitis

31
Q

What is rhinitis called involving the conjunctivae?

A

Rhino-conjunctivitis

32
Q

What are the different types of rhinitis?

A

Allergic
Infective
Non-allergic

33
Q

What are the different classifications of allergic rhinitis?

A

Intermittent
Persistent
Mild
Moderate-severe

34
Q

What is considered moderate-severe allergic rhinitis?

A

Sleep disturbance
Impairment of daily activities, sport, leisure’s

35
Q

What is considered mild allergic rhinitis?

A

Normal sleep
No impairment of daily activities, sport and leisure

36
Q

What condition is strongly associated withi allergic rhinitis?

A

Asthma

37
Q

What is the pathophysiology of rhinitis?

A

Allergen picked up by dendritic cells and macrophages in nasal epithelial cells
MHC II to TH2
IgE made and binds to mast cells and basophils
Activating the cells
Degranulation occurs with allergen being reintroduced release of mediators

38
Q

What is the pathophysiology of rhinitis?

A

Allergen picked up by dendritic cells and macrophages in nasal epithelial cells
MHC II to TH2
IgE made and binds to mast cells and basophils
Activating the cells
Degranulation occurs with allergen being reintroduced release of mediators

39
Q

What is the pathophysiology of rhinitis?

A

Allergen picked up by dendritic cells and macrophages in nasal epithelial cells
MHC II to TH2
IgE made and binds to mast cells and basophils
Activating the cells
Degranulation occurs with allergen being reintroduced release of mediators

40
Q

What are teh effects of some of the mediators being released in rhinitis?

A

Mucus oedema, mucus hypersecretion

Infiltration of inflammatory cells
Eosinophils
Basophils
Neutrophils

41
Q

What are teh symptoms of rhinitis?

A

Sneezing
Rhinnorrhrea
Nasal obstruction
Nasal itching
Ocular symptoms

42
Q

What is the process of being exposed to house dust mite allergens in rhinitis?

A

Allergen infiltration
Cascade of IgE overproduction by B cells
Th2 proliferation due to increased IL-6
House Dust Mite proteases cleave pulmonary surfactants causing dec lung core acne of allergens

43
Q

What are some comorbidities associated with allergic rhinitis?

A

Asthma
Conjunctivitis
Rhinosinusitis/anosmia
Otitis media with effusion
Throat and laryngeal effects
Sleep problems

44
Q

How do you diagnose allergic rhinitis?

A

Mroe than 2 clinal sympotms for more than an hr on most days

Sneezing
Nasal itching
Rhinorrheao
Nasal obstruction
Snoring, sleep problems
+- conjunctivitis

45
Q

What are some features of a Hx for rhinitis?

A

Seasonal
Indoors/outdorrs location

46
Q

What makes rhinitis mroe likely in Fhx?

A

Fhx of it

47
Q

What are some clinical findings on examination for rhinitis?

A

Allergic salute/horizontal nasal crease
Dennie-Morgan lines
Hypertrophic, pale and boggy ITs
Clear, coloured or purulent secretions

48
Q

What signs are seen on slide 14 for rhinitis?

A
49
Q

What are some differentials for rhinitis?

A

Adenoidal hypertrophy
Acute/chronic sinusitis
Foreign bodies

Acute infectious rhinitis

Look at slide 15

50
Q

What are some investigations done for rhinitis?

A

Skin prick test
ssIgE (serum specific IgE)

51
Q

How is climate change affecting the prevalence of rhinitis?

A

More warming means more pollens likely to be spread around

52
Q

What are the treatments for rhinitis?

A

Prevention of triggers

Saline rinses
Antihistamines
Intranasal steroids
Ipratropium bromide

Surgical intervention
Septoplasty
Turbinate reduction

53
Q

What are some symptomatic therapies in allergic rhinitis?

A

Antihistamines (cetirizine)
Intranasal corticosteroid suppress immune cells infiltration momenta’s on furoate
Intranasal H1 antihistamines + ICS combination therapies
Leucotriene receptor antagonists

54
Q

What is an example of a leukotreine receptor antagonist?

A

Monteleukast

55
Q

How do nasal decongestants work?

A

Agonist at alpha 1 and alpha 2 adrenergic receptors on nasal mucosa reducing mucosal swelling

56
Q

What are some nasal sprays?

A

Sudafed (pseudoephedrine)
Neo-synephrine (phenylephrine)

57
Q

What is the problem with overuse of nasal decongestant?

A

Rhinitis medicamentosa

58
Q

What is rhinitis medicamentosa?

How’s it treated?

A

Condition of rebound congestion upon withdrawal of nasal decongestants

Treated by Intranasal corticosteroid

59
Q

What is the treatment pathway for allergic rhinitis?

A

Antihistamines
Intranasal corticosteroids

60
Q

What are the mechanisms of immune tolerance with rhinitis?

A

Regulatory cells. Induced
Regulatory cells produce IL-10 to suppress the Type 2 inflammatory cells
Induces allergen specific immunogobin class switch

61
Q

How do you take nasal drops?

A

Gently blow/clear nose
Tilt head forward and keep bottle upright and squeeze a fine mist and breathe in slowly then out

Immunity (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions