Anaphylaxis

Question 1

what is anaphylaxis

Answer 1

acute, multi-system syndrome where there is rapidly developing life-threatening airway and/or breathing and/or circulation problems.

Question 2

what is the pathophysiology

Answer 2

mast cell and basophil derived inflammatory mediators such as histamines are released into circulation leading to bronchospasm, increased capillary permeability and reduced vascular tone. these lead to TISSUE OEDEMA

Question 3

list some common allergens

Answer 3

latex, peanuts, drugs and shellfish

Question 4

presenting signs and symptoms

Answer 4

wheeze, tachypnoea, cyanosis, swollen upper airways (choking sensation), swollen eyes, swollen lips, rhinitis, pruritus, rash, hypotension, tachycardia and bilateral conjuctivitis

Question 5

investigations

Answer 5

diagnosis is based on CLINICAL EXAM

to aid diagnosis you can look at serum tryptase, histamine levels and urinary metabolites

Question 6

what investigations can be done after an attack

Answer 6

allergen skin testing to determine the allergens

IgE immunoassays to determine food-specific IgE

Question 7

management (Not cardiac arrest)

Answer 7

ABCDE,
high flow oxygen
Intramuscular adrenaline
antihistamines
hydrocortisone (STEROID anti-inflammatory)
bronchodilator
monitor BP, ECG and pulse oximetry

Question 8

possible complications of an anaphylactic reaction

Answer 8

shock

shock can lead to organ damage

Question 9

management (cardiac arrest)

Answer 9

CPR and advanced life support