The Immune System Flashcards
What is Anaphylaxis?
Severe Allergic Reaction
Characterised by rapidly developing airway and/or breathing and/or circulation compromise
Associated with Skin and Mucosal changes.
Serious systemic hypersensitivity reaction that is usually rapid in onset and may cause death.
What are examples of Treatments of Anaphylaxis?
Should be based on General Life support principles.
Use ABCDE
Call for Help Early
Treat greater threat to life first
What is meant by Atopic?
Having a predisposition towards developing certain allergic hypersensitivity reactions.
Shows through conditions such as eczema, hay fever, asthma or tendency to anaphylaxis.
Have increased levels of IGE in immune system.
What is Immunoglobulin?
Substance that forms part of the defensive immune system.
What is the Initial Pathophysiology of Anaphylaxis?
Anitgen (Nut, Protein Trigger) enters the body.
Antigen attaches itself to mast and basophil cells.
Body manufactured IgE antibodies and when they bind to mast cells they set of a cascade of allergic reaction.
Body now has a primary response.
Memory is laid down.
Individual now refereed to as being sensitised.
At this point no symptoms are present.
Changes take place at cellular level.
What is the Second stage of Pathophysiology of Anaphylaxis?
Mast cells containing Basophils degenerate and cells rupture.
Major explosion of contents of immune system dumped into blood stream, to all major systems of the body.
Pre-formed mediators, strored in cytoplasm are also released as cells rupture.
Release of chemical mediators cause massive vasodilation and fluid shift. Creates internal vascular environment reflects hypovalaemic shock.
Rapid fluid shift moves into and around key organs such as lung and heart.
Compromised both respiratory system and cardiovascular system.
What is the Actions of the Mediators?
Bronchoconstriction
Peripheral Vasodilation
Mucousal oedema
Increase in mucus production
Increased capillary permeability
What are the Mast and Basophil cells?
Found predominantly in connective tissues in:
Respiratory system
Cardiovascular system
Gastrointestinal system
Skin
How to Diagnose Anaphylaxis?
Sudden onset and Rapid progression of symptoms
Life threatening airway or breathing and or circulation problems
Skin and/or mucosal changes.
What are the Symptoms of Anaphylaxis?
Hoarse Voice
Stridor
Shortness of Breath
Wheeze
Hypoxia
Tachycardia/Hypotension
Decreased Conscious level
Erythema
What is a Histamine?
Causes vasodilation and increased vascular permeability promoting oedema
Stimulated secretion of large amounts of mucus
Causes smooth muscles to contract
Causes increased gastric acid secretion
Causes cardiovascular stimulation
What are the Clinical Manifestations of Anaphylaxis?
A - Potential upper airway obstruction, Swelling, Voice Changes.
B - Dyspnoea, Stridor, Wheeze, Hoarseness, Cough, Bronchospasm
C - Tachycardia, Hypotension, Sign of Shock - ECG Changes, Pale, Clammy
D - Alerted level of consciousness, Confusion, caused by Hypoxia, Agitation
E - Erythema - Patchy red rash, Vomiting, Abdo Pain.
What are the Treatments for Anaphylaxis?
ABCDE
Position Patient
Remove Allergen
High Flow Oxygen
IM Adrenaline (THIGH)
IV Adrenaline
Chlorophenamine (IM or Slow IV) 10mg
Hydrocortisone (IM or Slow IV) 200mg
What are Antihistamine?
Blocks Histamine Receptors
Chlorophenamine 10mg
IV or IM injection
What is Hydrocortisone?
Short acting synthetic steroid
Reduces effects of an allergic response, reducing inflammation and treating urticaria
200mg IM or slow IV.
How to Discharge and Follow up Anaphylaxis?
Monitored for 24 hours
Consider Anti-Histamine and oral steroid therapy for 3 days.
Adrenaline auto injector
Allergy testing
Contact with GP.
Identify Triggers
What is the Immune System?
Adaptive differs from innate.
Adaptive - exhibits memory for invading organisms and toxic substances.
Develops slowly but with great deal of specifity
T and B lymphocytes able to produce immunoglobulins in billion of different combinations. Can target billions of different viruses and microorganisms.
Pathophysiology of Immune System?
Protects body against many diseases, including recent infections, allergy, tumour and autoimmunity.
Immunological Disorders:
Crohn’s disease
Melanoma
Lupus
Asthma
Food or Drug Allergy
Multiple Sclerosis
Pancreatitis
What is Sepsis?
Overwhelming condition that occurs when the Body’s Response to an infection damages its own tissues. Infection present in the body, triggers a chain reaction. Infections that lead to sepsis most often start in the lung, urinary tract, skin or gastrointestinal tract. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.
Therefore Sepsis is a life threatening medical emergency.
What is meant by TIME?
Temperature - High or Low
Infection - Signs and Symptoms of Infection
Mental Decline - Confused, sleepy
Extremely ill - Severe pain, Discomfort and shortness of breath.
What are the Signs of Sepsis?
Tachycardia or Hypotension
Confusion
Disorientation
Shortness of Breath
Clammy or Sweaty skin.
How to Diagnose Sepsis?
Monitoring Patients Vital Signs
Serum Lactate in circulation can be used as Marker for Sepsis reflects cellular dysfunction.
How to Treat Sepsis?
Antibiotics
Intravenous Fluids
Vasopressors - Adrenaline. Extremely low blood pressure.
What are 5 types of Shock?
Anaphylactic Shock
Septic Shock
Hypovolaemic Shock
Neurogenic Shock
Cardiogenic Shock
What are the 4 Stages of Shock?
Decompensated
Compensatory
Progressive
Irreversible
