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The type of immunity resulting fr a direct attack of a foreign substance by specialized cells of the immune system is known as ______.
Substances produced by B lymphocytes in response to an antigen are called _____.
Antibodies combine w/_____ and ctrl or destroy them preventing infection.
Any substance that is capable, under the appropriate conditions, of inducing a specific immune response is a(n) ____.
The type of immunity that is present at birth and has no relation to a previous exposure to a particular antigen is _____.
The type of immunity that develops over time as a result of exposure to an antigen is _____.
An allergic reaction is best described as an exaggerated, sometimes life threatening response by the immune sys to a foreign substance. T or F
Most anaphylactic reactions are the result of the _____ of a toxic substance.
The antibody most commonly associated with a hypersensitivity reaction is _____.
The primary chemical mediator of an allergic reaction is _____.
All of the following are physiological effects associated w/the release of the chemical mediators of anaphylaxis EXCEPT: (A) Bronchodilation (B) Vasodilation (C)Increased intestinal motility (D)Increased vascular permeability (E)Secretion of gastric acids
Urticaria, a wheal & flare reaction characterized by red raised bumps that appear on the skin, is due too _____.
The 1st line parenteral drug for the management of anaphylaxis is:
The first priority when responding to a pt w/ an anaphylactic reaction is to:
Assure scene safety
Hypotension that is seen in severe anaphylaxis is due to:
What is the beta agonist that will reverse bronchospasm?
What med blocks histamine receptors?
_____ suppresses inflammatory response in an allergic reaction.
_____ is the sympathetic agonist that will improve cardiac output.
A potent vasopressor used to support BP is _____.
What are 5 S&S of allergic reactions shown on the skin?
What are some effects of allergic reactions on the resp system?
- Laryngeal Edema
What are S&S of an allergic reaction seen in the cardiovascular sys?
- Increased HR
- Decreased BP
GI effects of an allergic reaction include:
Nervous sys reactions to an allergic reaction include:
What does albuterol do to help mitigate an allergic reaction?
- Beta Agonist
- Reverses bronchospasm & laryngeal edema
How does diphenhydramine mitigate an allergic reaction?
BY blocking histamine receptors
Dopamine is described as a:
Potent vasopressor to support BP
Describe epi & its effects in an allergic reaction?
- Sympathetic agonist that increases HR, Cardiac contractile force & peripheral vasoconstriction.
- Reverses much of the capillary permeability caused by histamine
What is the effect of methylprednisolone on an allergic reaction?
Suppresses the inflammatory response
_____ is another name for a disease producing agent or invading substance.
The immune response in which the body's immunoglobulins (Igs) attack pathogens is:
What is the order for an humoral response to an invading pathogen or antigen.
- 1. Release if IgG and IgM
- 2. Secondary response
- 3. Development of specific antibodies
- 4. Acquired Immunity
A young child is vaccinated for chicken pox. This type of immunity is known as:
Induced Active Immunity
An unexpected or exaggerated reaction to a particular antigen is termed:
What is the immune sys?
Body sys responsible for combatting infection
An immune response is:
Complex of events within the body that works toward the destruction or inactivation of pathogens, abnormal cells, foreign molecules
What is a pathogen?
A disease producing agent or invading substance
A toxin is any:
Poisonous chemical secreted by bacteria or released following destruction of bacteria
Cellular immunity results from:
A direct attack of a foreign substance by specialized cells of the immune sys
Humoral immunity is the result of an:
Attack of an invading substance by antibodies
What is the principle agent of a chemical attack of an invading substance?
An antibody is also known as an ______.
An antigen is any substance that is capable of:
Inducing a specific immune response
The initial response to an antigen is the:
What is hymenoptera?
Any order of highly specialized insects such as bees & wasos
What is a secondary response?
One that occurs if the body is exposed to the same antigen again and antibodies for that specific antigen are released
Natural immunity (aka ____ ____) is that which is:
- innate immunity
- Genetically predetermined & present at birth
Acquired immunity is that which:
Develops over time & results fr exposure to an antigen
Naturally acquired immunity begins to develop:
After birth & is continually enhanced by exposure to new pathogens & antigens
Induced active immunity is achieved through:
vaccination given to illicit a response resulting in the development of antibodies
Sensitization is defined as:
Initial exposure of a person to an antigen that results in an immune response
A delayed hypersensitivity reaction is defined as:
Reaction that takes place after the elapsed of some time following reexposure to an antigen
An immediate hypersensitivity reaction is defined as:
One that occurs quickly following reexposure to an antigen ie anaphylaxis
An allergen is a substance capable of inducing:
Allergy of specific hypersensitivity
White blood cell that participates in allergic responses
Define mast cell:
Specialized cell containing chemicals that assist in the immune response
Product of mast cells & basophils that cause vasodilation, capillary permeability, bronchoconstriction and contraction of the gut
Angioneurotic edema is marked:
Edema of the skin usually involving head, neck, face & upper airway
Bronchospasm in an allergic reaction is caused by the ____ of substances fr ____ ____ or ____ under the influence of anaphylatoxins.
- Mast cells
The most severe form of allergic reaction is a _____ reaction where antibodies what?
- Type I
- Attach to mast cells or basofil
Define mast cells.
Specialized cells of the immune sys which contain chemicals that assist in immune response
The initial exposure to an antigen that results in an immune response is called _____.
The primary response by immune sys is characterized by what 3 events?
- Initial exposure to an antigen
- Several day response by immune sys
- Release of IgG, IgM antibodies
A secondary response is characterized by what?
Release of specialized memory antibodies specific to the antigen
Systemic reaction of multiple organ systems to antigen induced IgE-mediated immunologic mediator release in previously sensitized individual
An antigen that causes the release of IgE antibodies is called ____.
A histamine is the product of mast cells & basophils that causes 4 things:
- Capillary permeability - angioedema
- Contraction of the gut
When a mast cell degranulates it releases:
- Slow reacting substance of anaphylaxis (SRS-A)
- Eosinophil chemotactic factor (ECF)
What are the 3 basic steps of Anaphylaxis?
- Antigen enters the body (secondary response)
- Attaches to antibodies on mast or basophil cells
- Mast cells degranulate releasing Histamine, Leukotrienes, SRS-A & ECF
What are the 3 types of histamine receptors?
Histamine acts on H1 receptors causing:
- Smooth muscle contraction
- Increased vascular permeability
- Prostaglandin generation
Histamine acts on H2 receptors causing:
- Increased vascular permeability
- Gastric acid secretion
- Stimulation of suppressor lymphocytes
- Decrease PMN enzyme release
- Release of more histamine fr mast & basophil cells
When histamine acts on H3 receptors it causes:
- Inhibition of CNS & PNS neurotransmitter release
- Inhibition of further histamine formation, release
Increases in capillary permeability causes:
- Tissue edema, urticaria(hives), itching
- Laryngeal edema
- Fluid leakage fr vascular space
Laryngeal edema fr increases in capillary permeability can cause:
- Airway obstruction
- Resp Distress
Fluid leakage fr vascular space resulting fr increases in capillary permeability can lead to:
Leukotrienes have the characteristics of:
- Potent Bronchoconstrictors
- Increase Vascular permeability
- Possibility of coronary vasoconstriction
The effects of leukotrienes have a ____ onset & last _____ than those of histamine.
SRS-A stands for & is defined as what?
- Slow Reacting Substances of Anaphylaxis
- A potent bronchoconstrictor & inflammatory agent released by mast cells
- Important mediator of allergic bronchial asthma
ECF stands for and is defined as what?
- Eosinophin Chemotactic Factor
- A substrate released from mast cells & basophils during anaphylaxis which attracts eosinophils.
- A tetrapeptide mediator of immediate hypersensitivity
An Eosinophil is a type of ____ belonging to a subgroup called ____ ____.
- Poltmorphonuclear Leukocytes
Where are Eosinophils produced & what do they do?
- In bone marrow
- Release toxic substances to kill invading toxins
In a nut shell, what do lymphocytes & neutrophils do when a foreign substance enters the body?
Release substances to attract eosinophils which release toxic substances to kill invaders
What are the 3 classifications of allergic reactions?
- Severe (anaphylaxis)
A mild allergic reaction is characterized by:
- Mild bronchoconstriction
- Usually localized
- No SOB, hypotension, hypoperfusion
A moderate allergic reaction is characterized S&S of a mild reaction w/the addition of:
- Angioneurotic edema
- Systemic rather than localized
- NO HYPOTENSION/HYPOPERFUSION
Severe allergic reactions (anaphylaxis) are characterized by S&S from mild & moderate reactions plus:
What is the key to differentiating between anaphylaxis & an allergic reaction?
Recognizing the presence of severe resp diff & hypotension
Resp sys involvement in an allergic reaction may include (7):
- Chest Tightness
- Throat Tightness
Other S&S of Allergic reactions may include:
- Lightheadedness or syncope
- Nasal congestion & sneezing
- Ocular itching & tearing
- Abd pain/cramping w/N/V/D
- Decreased LOC
What are the basic principals of allergic reaction/anaphylaxis mgmt?
- Consider trauma
- Protect airway
- High flow O2 or BVM
- Est IV access
- Be aware of vol depletion due to 3rd spacing
- Admin crystalloid sol @ appropriate rate
- Administer meds
- Monitor & transport
How does Epi work in severe allergic reactions or anaphylaxis?
- Sympathetic agonist - increases HR, contratile force, peripheral vasoconstriction
- Reverses some bronchospasm
- Reverses capillary permeability due to histamine
What is the dose for epi in an allergic reaction or anaphylaxis?
- 0.3-0.5 mg 1:1000 IM
- 0.5-1.0 mg 1:10000 IV
How does diphenhydramine work in anaphylaxis?
By blocking histamine receptors keeping addl histamine fr binding
What is the dosage for diphenhydramine adult & pedi?
- 25-50 mg IV/IM
- 1-2 mg/kg IV/IM
Name 2 commonly used corticosteroids in anaphylaxis.
- Methylprednisolone (solu-medrol)
- Dexamethazone (Decadron)
What vasopressors could we give & why would we give them for anaphylaxis?
- Epi, Norepi, Dopamine
- Given to help support BP & cardiac output
What 3 beta agonists cane we give for anaphylaxis & why?
- Albuterol(ventolin/proventil), Levalbuterol (xopenex), metaproterenol (alupent)
- Used to combat laryngeal edema & bronchospasm