ANAPHALAXIS FINAL

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medic11
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74773
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ANAPHALAXIS FINAL
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2011-03-23 14:49:15
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ANAPHYLAXIS FINAL
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Anaphylaxis Cards 3/23/11
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  1. The type of immunity resulting fr a direct attack of a foreign substance by specialized cells of the immune system is known as ______.
    Cellular
  2. Substances produced by B lymphocytes in response to an antigen are called _____.
    Antibodies
  3. Antibodies combine w/_____ and ctrl or destroy them preventing infection.
    Antigens
  4. Any substance that is capable, under the appropriate conditions, of inducing a specific immune response is a(n) ____.
    Antigen
  5. The type of immunity that is present at birth and has no relation to a previous exposure to a particular antigen is _____.
    Natural
  6. The type of immunity that develops over time as a result of exposure to an antigen is _____.
    Acquired
  7. An allergic reaction is best described as an exaggerated, sometimes life threatening response by the immune sys to a foreign substance. T or F
    True
  8. Most anaphylactic reactions are the result of the _____ of a toxic substance.
    Injection
  9. The antibody most commonly associated with a hypersensitivity reaction is _____.
    IgE
  10. The primary chemical mediator of an allergic reaction is _____.
    Histamine
  11. 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
    Bronchodilation
  12. Urticaria, a wheal & flare reaction characterized by red raised bumps that appear on the skin, is due too _____.
    Vasoconstriction
  13. The 1st line parenteral drug for the management of anaphylaxis is:
    Epinephrine
  14. The first priority when responding to a pt w/ an anaphylactic reaction is to:
    Assure scene safety
  15. Hypotension that is seen in severe anaphylaxis is due to:
    Vasodilation
  16. What is the beta agonist that will reverse bronchospasm?
    Albuterol
  17. What med blocks histamine receptors?
    Diphenhydramine
  18. _____ suppresses inflammatory response in an allergic reaction.
    Methylprednisolone
  19. _____ is the sympathetic agonist that will improve cardiac output.
    Epinephrine
  20. A potent vasopressor used to support BP is _____.
    Dopamine
  21. What are 5 S&S of allergic reactions shown on the skin?
    • Flushing
    • Itching
    • Hives
    • Swelling
    • Cyanosis
  22. What are some effects of allergic reactions on the resp system?
    • SOB
    • Sneezing
    • Coughing
    • Wheezing
    • Stridor
    • Laryngeal Edema
    • Laryingospasm
    • Bronchospasm
  23. What are S&S of an allergic reaction seen in the cardiovascular sys?
    • Vasodilation
    • Increased HR
    • Decreased BP
  24. GI effects of an allergic reaction include:
    • N/V/D
    • Abd cramping
  25. Nervous sys reactions to an allergic reaction include:
    • Dizziness
    • H/A
    • Convulsions
    • Tearing
  26. What does albuterol do to help mitigate an allergic reaction?
    • Beta Agonist
    • Reverses bronchospasm & laryngeal edema
  27. How does diphenhydramine mitigate an allergic reaction?
    BY blocking histamine receptors
  28. Dopamine is described as a:
    Potent vasopressor to support BP
  29. 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
  30. What is the effect of methylprednisolone on an allergic reaction?
    Suppresses the inflammatory response
  31. _____ is another name for a disease producing agent or invading substance.
    Pathogen
  32. The immune response in which the body's immunoglobulins (Igs) attack pathogens is:
    Humoral Immunity
  33. 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
  34. A young child is vaccinated for chicken pox. This type of immunity is known as:
    Induced Active Immunity
  35. An unexpected or exaggerated reaction to a particular antigen is termed:
    Hypersensativity
  36. What is the immune sys?
    Body sys responsible for combatting infection
  37. An immune response is:
    Complex of events within the body that works toward the destruction or inactivation of pathogens, abnormal cells, foreign molecules
  38. What is a pathogen?
    A disease producing agent or invading substance
  39. A toxin is any:
    Poisonous chemical secreted by bacteria or released following destruction of bacteria
  40. Cellular immunity results from:
    A direct attack of a foreign substance by specialized cells of the immune sys
  41. Humoral immunity is the result of an:
    Attack of an invading substance by antibodies
  42. What is the principle agent of a chemical attack of an invading substance?
    Antibody
  43. An antibody is also known as an ______.
    Immunoglobulin (Ig)
  44. An antigen is any substance that is capable of:
    Inducing a specific immune response
  45. The initial response to an antigen is the:
    Primary response
  46. What is hymenoptera?
    Any order of highly specialized insects such as bees & wasos
  47. 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
  48. Natural immunity (aka ____ ____) is that which is:
    • innate immunity
    • Genetically predetermined & present at birth
  49. Acquired immunity is that which:
    Develops over time & results fr exposure to an antigen
  50. Naturally acquired immunity begins to develop:
    After birth & is continually enhanced by exposure to new pathogens & antigens
  51. Induced active immunity is achieved through:
    vaccination given to illicit a response resulting in the development of antibodies
  52. Sensitization is defined as:
    Initial exposure of a person to an antigen that results in an immune response
  53. A delayed hypersensitivity reaction is defined as:
    Reaction that takes place after the elapsed of some time following reexposure to an antigen
  54. An immediate hypersensitivity reaction is defined as:
    One that occurs quickly following reexposure to an antigen ie anaphylaxis
  55. An allergen is a substance capable of inducing:
    Allergy of specific hypersensitivity
  56. Define Basophil:
    White blood cell that participates in allergic responses
  57. Define mast cell:
    Specialized cell containing chemicals that assist in the immune response
  58. Define histamine:
    Product of mast cells & basophils that cause vasodilation, capillary permeability, bronchoconstriction and contraction of the gut
  59. Angioneurotic edema is marked:
    Edema of the skin usually involving head, neck, face & upper airway
  60. Bronchospasm in an allergic reaction is caused by the ____ of substances fr ____ ____ or ____ under the influence of anaphylatoxins.
    • Degranulation
    • Mast cells
    • Basofils
  61. The most severe form of allergic reaction is a _____ reaction where antibodies what?
    • Type I
    • Attach to mast cells or basofil
  62. Define mast cells.
    Specialized cells of the immune sys which contain chemicals that assist in immune response
  63. The initial exposure to an antigen that results in an immune response is called _____.
    Sensitized
  64. 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
  65. A secondary response is characterized by what?
    Release of specialized memory antibodies specific to the antigen
  66. Define Anaphylaxis.
    Systemic reaction of multiple organ systems to antigen induced IgE-mediated immunologic mediator release in previously sensitized individual
  67. An antigen that causes the release of IgE antibodies is called ____.
    Allergen
  68. A histamine is the product of mast cells & basophils that causes 4 things:
    • Vasodilation
    • Capillary permeability - angioedema
    • Bronchoconstriction
    • Contraction of the gut
  69. When a mast cell degranulates it releases:
    • Histamine
    • Leukotrienes
    • Slow reacting substance of anaphylaxis (SRS-A)
    • Eosinophil chemotactic factor (ECF)
  70. 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
  71. What are the 3 types of histamine receptors?
    • H1
    • H2
    • H3
  72. Histamine acts on H1 receptors causing:
    • Smooth muscle contraction
    • Increased vascular permeability
    • Prostaglandin generation
  73. 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
  74. When histamine acts on H3 receptors it causes:
    • Inhibition of CNS & PNS neurotransmitter release
    • Inhibition of further histamine formation, release
  75. Increases in capillary permeability causes:
    • Tissue edema, urticaria(hives), itching
    • Laryngeal edema
    • Fluid leakage fr vascular space
  76. Laryngeal edema fr increases in capillary permeability can cause:
    • Airway obstruction
    • Resp Distress
    • Stridor
    • Angioedema
  77. Fluid leakage fr vascular space resulting fr increases in capillary permeability can lead to:
    Hypovolemic Shock
  78. Leukotrienes have the characteristics of:
    • Potent Bronchoconstrictors
    • Increase Vascular permeability
    • Possibility of coronary vasoconstriction
  79. The effects of leukotrienes have a ____ onset & last _____ than those of histamine.
    • Slower
    • Longer
  80. 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
  81. 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
  82. An Eosinophil is a type of ____ belonging to a subgroup called ____ ____.
    • WBC
    • Poltmorphonuclear Leukocytes
  83. Where are Eosinophils produced & what do they do?
    • In bone marrow
    • Release toxic substances to kill invading toxins
  84. 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
  85. What are the 3 classifications of allergic reactions?
    • Mild
    • Moderate
    • Severe (anaphylaxis)
  86. A mild allergic reaction is characterized by:
    • Urticaria
    • Erythema
    • Rhinitis
    • Conjunctivitis
    • Mild bronchoconstriction
    • Usually localized
    • No SOB, hypotension, hypoperfusion
  87. A moderate allergic reaction is characterized S&S of a mild reaction w/the addition of:
    • Dyspnea/wheezing
    • Angioneurotic edema
    • Systemic rather than localized
    • NO HYPOTENSION/HYPOPERFUSION
  88. Severe allergic reactions (anaphylaxis) are characterized by S&S from mild & moderate reactions plus:
    Shock/Hypoperfusion
  89. What is the key to differentiating between anaphylaxis & an allergic reaction?
    Recognizing the presence of severe resp diff & hypotension
  90. Resp sys involvement in an allergic reaction may include (7):
    • Cough
    • Chest Tightness
    • Dyspnea
    • Wheezing
    • Throat Tightness
    • Dysphagia
    • Hoarseness
  91. Other S&S of Allergic reactions may include:
    • Lightheadedness or syncope
    • Nasal congestion & sneezing
    • Ocular itching & tearing
    • Abd pain/cramping w/N/V/D
    • Incontinence
    • Decreased LOC
  92. 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
  93. 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
  94. 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
  95. How does diphenhydramine work in anaphylaxis?
    By blocking histamine receptors keeping addl histamine fr binding
  96. What is the dosage for diphenhydramine adult & pedi?
    • 25-50 mg IV/IM
    • 1-2 mg/kg IV/IM
  97. Name 2 commonly used corticosteroids in anaphylaxis.
    • Methylprednisolone (solu-medrol)
    • Dexamethazone (Decadron)
  98. What vasopressors could we give & why would we give them for anaphylaxis?
    • Epi, Norepi, Dopamine
    • Given to help support BP & cardiac output
  99. What 3 beta agonists cane we give for anaphylaxis & why?
    • Albuterol(ventolin/proventil), Levalbuterol (xopenex), metaproterenol (alupent)
    • Used to combat laryngeal edema & bronchospasm

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