CP 4

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Author:
cathy4xo
ID:
41327
Filename:
CP 4
Updated:
2010-10-11 08:30:55
Tags:
Anaphylaxis
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Description:
Anaphylaxis
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  1. In anaphylatic shock, what 3 Tx are given and their mechanisms?
    • Antihistamine - histamines in anaphylaxis causes vasodilatation
    • Adrenaline - vasoconstrictor effect
    • Glucocorticoids - increases heart strength, stabilises lysosomes in cells (prevent enzyme release), aid in glucose metabolism of damaged cells
  2. Describe the pathogenesis of anaphylatic shock.
    • Type I hypersensitivity response
    • Immunogens (antigen + protein) stimulate CD4+ T cells of TH2 type
    • Cytokine release (IgE and eiosinophils production)
    • Histamines causing vasodilatation, bronchospasms, mucus
    • Other mediators - leukotrienes, prostaglandin, mast cells
  3. What are the common allergic and non-allergic causes of anaphylaxis? Give 2 examples.
    Allergic (fast, igE-activation) e.g. antibiotics, NSAIDS, insect bites, latex

    Non-allergic (slow,longer, mast cell degranuation) e.g. heparin, radiological contrasts, exercise
  4. Name the 6 types of shock.
    • CHONAS:
    • Cardiogenic
    • Hypovolaemic
    • Obstructive
    • Neurogenic
    • Anaphylatic
    • Septic
  5. Name 6 organs affected by shock and which ones are irreversible damages?
    • Kidney
    • GIT - haemorrhagic gastroenterpathy
    • Lungs - ARDS
    • Liver - central tubular necrosis
    • Brain (irreversible) -infarction, hypoxic encephalopathy
    • Heart (irreversible) -MI
  6. Name 3 sources of specimens to collectedfrom a case of suspected septic shock.
    • IV line culture e.g. catheter
    • Blood culture
    • Urine culture + analysis
  7. What empirical therapy would you recommend in a pt with suspected septic shock w/o infection source?
    Di/flucloxacillin + Gentamycin

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