Urticaria Lecture Powerpoint

Question 1

Urticaria definition

Answer 1

Hives, vascular rxn in the upper (papillary) dermis resulting in itchy, red, swollen lesions appearing as wheals

Question 2

Angioedema

Answer 2

Swollen/firm, non pitting edema typically in deeper tissues than the dermis and possibly compromising airways or throat

Question 3

Hereditary angioedema

Answer 3

Due to an esterase inhibitor deficiency leading to persistent episodes of angioedema

Question 4

Acute urticaria and angioedema is most often caused by…

Answer 4

…hypersensitivity rxns

Question 5

Chronic urticaria and angioedema is most often caused by…

Answer 5

…Autoimmune, idiopathic, or physical/environemtal influences

Question 6

Chronic inducible vs chronic spontaneous urticaria

Answer 6

Symptoms triggered by physical stimuli vs no exogenous cause being evident

Question 7

Urticarial vasculitis

Answer 7

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

Question 8

H1 receptors and what do they do upon stimulation

Answer 8

Main type of receptor found on mast cells, they increase capillary vasodilation and pruritis

Question 9

Urticaria 4 pathways and final common pathway

Answer 9

1) IgE mediated
2) non IgE mediated
3) autoimmune
4) Idiopathic

Always ends in mast cell activation and degranulation

Question 10

Non IgE/pseudoallergic rxns and what 5 things can activate it

Answer 10

Direct activation of mast cells by non IgE mechanisms, largely unknown but some foods, dyes, medications, complement, or physical stimuli can impact

Question 11

Autoimmune mediated allergic rxn

Answer 11

Occurs when an autoantibody against IgE binds to the IgE or other receptor on the cell that causes histamine release

Question 12

Immediate evaluation of a patient with urticaria should include these 2 things…

Answer 12

…airway and hemodynamic status

Question 13

Lab evaluation of chronic urticaria

Answer 13

Because 40-50% of chronic urticaria is idiopathic most likely to see normal results

Question 14

If severe or refractory to antihistamine treatment, what drug should be given?

Answer 14

Oral corticosteroids

Question 15

What are the anticholinergic side effects of 1st gen antihistamines?

Answer 15

Sedation, tachycardia, dry mouth, urinary retention

Question 16

H2 blockers are only used effectively as an ___ to H1 blockers

Answer 16

Adjunct

Question 17

Chronic use of oral corticosteroids bad side effects

Answer 17

• osteoperosis
• immunosuppression
• hyperglycemia