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7835 Exam IV > Mod12: Hypersensitivity > Flashcards

Mod12: Hypersensitivity Flashcards

1
Q

Hypersensitivity allergic reactions

Which Type of hypersentitivity reaction is immediate?

A

Type I (immediate)

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2
Q

Hypersensitivity allergic reactions

In which type of Hypersensitivity allergic reaction do antigens crosslink with IgE antibodies?

A

Type I Hypersensitivity allergic reaction

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3
Q

Hypersensitivity allergic reactions

In Type I Hypersensitivity allergic reactions, the realease of with substances is triggered by the cross sensitivity of antigens with IgE antibodies?

A

Inflammatory mediators from mast cells

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4
Q

Hypersensitivity allergic reactions

What are examples of Type I Hypersensitivity allergic reactions?

A

Atopy

(Atopy: heightened immune responses to common allergens)

Urticaria-angioedema

True anaphylaxis!!!

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5
Q

Hypersensitivity allergic reactions - Type I

Which two subcategories is Type I hypersensitivity allergic reactions further subdivided into?

A

Atopic type I

Nonatopic type I

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6
Q

Hypersensitivity allergic reactions - Type I

Type I hypersensitivity allergic reactions that are IgE mediated, an that only affect the skin and respiratory tract are categorized as:

A

Atopic type I hypersensitivity allergic reactions

Include allergic rhinitis, dermatitis, and asthma

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7
Q

Hypersensitivity allergic reactions - Type I

Mild, Nonatopic type I hypersensitivity allergic reactions manifest as:

A

Urticaria

Angioedema

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8
Q

Hypersensitivity allergic reactions - Type I

Severe, Nonatopic type I hypersensitivity allergic reactions manifest as:

A

Anaphylaxis

This is when the IgE antibodies crosslink with the antigens

Massive inflammtory mediators will be released from the mast cells

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9
Q

Hypersensitivity allergic reactions - Hypersensitivity

Cytotoxic reactions are classified as which type of Hypersensitivity allergic reactions?

A

Type II hypersensitivity allergic reactions

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10
Q

Hypersensitivity allergic reactions - Hypersensitivity

Which antibodies mediate Type II (cytotoxic) hypersensitivity allergic reactions?

A

IgG antibodies

IgG bind to antigens on cell surface

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11
Q

Hypersensitivity allergic reactions - Hypersensitivity

In Type II (cytotoxic) hypersensitivity allergic reactions, what happens next after the IgG bind to antigens on cell surface

A

Activate classic complement pathway,

which causes cells Lysis

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12
Q

Hypersensitivity allergic reactions - Hypersensitivity

What are examples of Type II (cytotoxic) hypersensitivity allergic reactions?

A

Hemolytic transfusion reactions

Autoimmune hemolytic anemia

Heparin-induced thrombocytopenia

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13
Q

Hypersensitivity allergic reactions - Hypersensitivity

Which type of Hypersensitivity allergic reactions are immune complex hypersensitivity reactions calssified as:

A

Type III (immune complex) hypersensitivity reactions

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14
Q

Hypersensitivity allergic reactions - Hypersensitivity

In Type III (immune complex) hypersensitivity reactions, which complexes deposit in body tissues?

A

Antigen-antibody (IgG or IgM)

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15
Q

Hypersensitivity allergic reactions - Hypersensitivity

Which antibodies comprise the Antigen-antibody complexes responsible for Type III (immune complex) hypersensitivity reactions?

A

IgG or IgM

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16
Q

Hypersensitivity allergic reactions - Hypersensitivity

In Type III (immune complex) hypersensitivity reactions, what happens after antigen-antibody (IgG or IgM) complexes deposit in tissue?

A

Attract neutrophils to area

Release lysosomal enzymes and toxic products

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17
Q

Hypersensitivity allergic reactions - Hypersensitivity

Which are examples of Type III (immune complex) hypersensitivity reactions?

A

Arthus reaction

Serum sickness

Acute hypersensitivity pneumonitis

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18
Q

Hypersensitivity allergic reactions - Hypersensitivity

Delayed, cell mediated Hypersensitivity allergic reactions are classified as:

A

Type IV (Delayed, cell mediated) hypersensitivity allergic reactions

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19
Q

Hypersensitivity allergic reactions - Hypersensitivity

Which cells mediate Type IV (Delayed, cell mediated) hypersensitivity allergic reactions?

A

CD4+ T lymphocytes

20
Q

Hypersensitivity allergic reactions - Hypersensitivity

How are pt’s sensitized for Type IV hypersensitivity allergic reactions?

A

Prior exposure

21
Q

Hypersensitivity allergic reactions - Hypersensitivity

What are examples of Type IV (Delayed, cell mediated) hypersensitivity allergic reactions?

A

Contact dermatitis

Tuberculin-type hypersensitivity

Chronic hypersensitivity pneumonitis

22
Q

Hypersensitivity allergic reactions - Four point severity scale

On the Four point severity scale, in which grade do hypersensitivity allergic reactions manifest as cutaneous signs, generalized erythema, urticaria, angioedema fall?

A

Grade I

(e.g., poision IV, surface hypersensitivity allergic reactions)

23
Q

Hypersensitivity allergic reactions - Four point severity scale

On the the Four point severity scale, in which grade do hypersensitivity allergic reactions manifest as significant but not life threatening symptoms (e.g., cutaneous signs, hypotension, tachycardia, respiratory difficulty)?

A

Grade II

24
Q

Hypersensitivity allergic reactions - Four point severity scale

In which grade on the four point severity scale do hypersensitivity allergic reactions manifest as Life threatening symptoms (e.g., arrhythmias, bronchospasm, cardiovascular collapse)

A

Grade III

(What to do: look for epi pen, call 911. etc.)

25
Q

Hypersensitivity allergic reactions - Four point severity scale

In which grade on the four point severity scale do hypersensitivity allergic reactions manifest as cardiac and/or respiratory arrest or DEATH

A

Grade IV

26
Q

Anaphylactic vs Anaphylactoid Reactions

True or False: Anaphylactoid are less severe reactions

A

True

27
Q

Anaphylactic vs Anaphylactoid Reactions

What percentage of patients with anaphylactoid reactions will have Grade I reactions?

A

60%

28
Q

Anaphylactic vs Anaphylactoid Reactions

What percentage of patients with anaphylactoid reactions will have Grade II reactions?

A

26%

29
Q

Anaphylactic vs Anaphylactoid Reactions

What percentage of patients with anaphylactoid reactions will have Grade III reactions?

A

15%

30
Q

Anaphylactic vs Anaphylactoid Reactions

True or False: incidence of anaphylactoid reactions decreases as their severity increases

A

True

60% of patients have Grade I reactions

26% of patients have Grade II reactions

15% of patients have Grade III reactions

31
Q

Anaphylactic vs Anaphylactoid Reactions

True or False: Anaphylaxis more common as clinical severity increases

A

True

32
Q

Anaphylactic vs Anaphylactoid Reactions

What percentage of patients with anaphylactic reactions will have Grade I reactions?

A

13%

33
Q

Anaphylactic vs Anaphylactoid Reactions

What percentage of patients with anaphylactic reactions will have Grade II reactions?

A

22%

34
Q

Anaphylactic vs Anaphylactoid Reactions

What percentage of patients with anaphylactic reactions will have Grade III reactions?

A

60%

35
Q

Anaphylactic vs Anaphylactoid Reactions

What percentage of patients with anaphylactic reactions will have Grade IV reactions?

A

2%

36
Q

Anaphylactic vs Anaphylactoid Reactions

What’s the severity Grade of most anaphylactic reactions?

A

Grade III

37
Q

Anaphylactic vs Anaphylactoid Reactions

What causes the significant hypotension and the the tachycardia that we see in Anaphylactic and Anaphylactoid Reactions?

A

Significant Hypotension is from

Profound vasodilatation, leading to:

  • Decreased venous return*
  • Cardiac output falls*
  • Increased heart rate (in response)*
38
Q

Anaphylactic vs Anaphylactoid Reactions

What causes the edema that we see in Anaphylactic and Anaphylactoid Reactions?

A

Acute changes in vascular permeability

Fluid moves into interstitial spaces

39
Q

Anaphylactic vs Anaphylactoid Reactions

Along with the bronchospasm, what other pulmonary manifestation accompany Anaphylactic and Anaphylactoid Reactions?

A

Bronchial hyperactivity

40
Q

Anaphylactic vs Anaphylactoid Reactions

What causes the bronchial edema that we see in Anaphylactic and Anaphylactoid Reactions?

A

The mediators that are being released throughout the body

41
Q

Anaphylactic vs Anaphylactoid Reactions

What causes the alveolar hypoventilation that we see in Anaphylactic and Anaphylactoid Reactions?

A

Bronchospasm closing the airway

Decreased gas exchange

42
Q

Anaphylactic vs Anaphylactoid Reactions

What causes the hypoxemia that we see in Anaphylactic and Anaphylactoid Reactions? What does it lead to?

A

Hypoventilation

Decreased gas exchange

Leads to

Respiratory & metabolic acidosis

Decreased mixed venous O2 saturation

43
Q

Anaphylactic vs Anaphylactoid Reactions

What causes the acute respiratory distress that we see in Anaphylactic and Anaphylactoid Reactions? What does it lead to?

A

Huge V/Q mismatch

Decreased ventilation

44
Q

Anaphylactic vs Anaphylactoid Reactions

What’s the most frequent causes of death in anaphylactic reactions?

A

Laryngeal edema

(Gas exchange becomes so low that it leads to a global hypoxic event)

Cardiovascular collapse

45
Q

Anaphylactic vs Anaphylactoid Reactions

What are anesthesia most important interventions to prevent death from an anaphylactic reaction?

A

Protect the airway

Prevents the laryngeal edema

Treat cardiovascular collapse

7835 Exam IV (21 decks)

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