Urticaria Lecture Powerpoint Flashcards
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Urticaria definition
Hives, vascular rxn in the upper (papillary) dermis resulting in itchy, red, swollen lesions appearing as wheals
Angioedema
Swollen/firm, non pitting edema typically in deeper tissues than the dermis and possibly compromising airways or throat
Hereditary angioedema
Due to an esterase inhibitor deficiency leading to persistent episodes of angioedema
Acute urticaria and angioedema is most often caused by…
…hypersensitivity rxns
Chronic urticaria and angioedema is most often caused by…
…Autoimmune, idiopathic, or physical/environemtal influences
Chronic inducible vs chronic spontaneous urticaria
Symptoms triggered by physical stimuli vs no exogenous cause being evident
Urticarial vasculitis
Appears very similar to urticaria but has different etiology, often being accompanied by painful/burning sensation rather than itching, lesions last longer than 24 hrs, often chronic, often present alongside other connective tissue disease
H1 receptors and what do they do upon stimulation
Main type of receptor found on mast cells, they increase capillary vasodilation and pruritis
Urticaria 4 pathways and final common pathway
1) IgE mediated
2) non IgE mediated
3) autoimmune
4) Idiopathic
Always ends in mast cell activation and degranulation
Non IgE/pseudoallergic rxns and what 5 things can activate it
Direct activation of mast cells by non IgE mechanisms, largely unknown but some foods, dyes, medications, complement, or physical stimuli can impact
Autoimmune mediated allergic rxn
Occurs when an autoantibody against IgE binds to the IgE or other receptor on the cell that causes histamine release
Immediate evaluation of a patient with urticaria should include these 2 things…
…airway and hemodynamic status
Lab evaluation of chronic urticaria
Because 40-50% of chronic urticaria is idiopathic most likely to see normal results
If severe or refractory to antihistamine treatment, what drug should be given?
Oral corticosteroids
What are the anticholinergic side effects of 1st gen antihistamines?
Sedation, tachycardia, dry mouth, urinary retention