CHP 26: IMMUNOLOGIC EMERGENCIES

Question 1

what is the protein the body produces in response to an antigen

Answer 1

antibody

Question 2

what is the primary antibody responsible for allergic reactions

Answer 2

IgE

Question 3

what is a biphasic allergic reaction

Answer 3

pt’s symptoms improve and then reappear up to 8 or more hours after incident

Question 4

what is prolonged allergic reaction

Answer 4

continue over 5-32 hours

Question 5

what is an anaphylactoid reaction

Answer 5

response that does not involve IgE antibody mediation

Question 6

which allergy is a contraindication to receiving flu vaccine

Answer 6

eggs

Question 7

what are atopic diseases

Answer 7

diseases related to allergies

Question 8

three categories of allergic reactions

Answer 8

mild: localized and do not spread
moderate: start mild but spread to other parts of body
severe: anaphylactic, systemic

Question 9

what does “shark fin” capno waveform indicate

Answer 9

bronchoconstriction

Question 10

what lung sounds indicate upper airway swelling

Answer 10

stridor

Question 11

what does histamine release cause

Answer 11

vasodilation and decreases inotropic effects of heart

Question 12

what is angioedema

Answer 12

swelling of face and tongue

Question 13

3 types of shock during anaphylaxis and their causes

Answer 13

cardiogenic: decreased cardiac output
hypovolemic: fluids leaking into tissues
neurogenic: inability of blood vessels to constrict

Question 14

what can cause red man syndrome

Answer 14

vancomycin infusions

Question 15

what kind of food poisoning can mimic anaphylactic reactions

Answer 15

scombroid fish poisoning

Question 16

drug of choice for patients with signs of allergic reaction like urticaria but no respiratory distress

Answer 16

diphenhydramine

Question 17

what positioning is associated with increased mortality rate in anaphylactic patients

Answer 17

upright

Question 18

how does administering epinephrine effect the body during anaphylaxis

Answer 18

blood vessel constriction, elevates diastolic BP, increases cardiac contractility, improves inotropy, bronchodilation

Question 19

how much fluids to administer to pt with anaphylactic hypotension

Answer 19

20mL/kg over 15mins

Question 20

what type of diseases are collagen vascular diseases

Answer 20

autoimmune

Question 21

what is lupus

Answer 21

chronic, progressive, multisystem autoimmune disease

inflammation, loss of tissue integrity, permanent damage

pt has flares of symptoms in beginning stages

usually ends in kidney failure, infection, or cardiovascular disease

Question 22

S/S of lupus

Answer 22

rash aggravated by sunlight, joint/muscle aches, pleural issues, pericarditis or AMI, stroke, seizures, renal failure, electrolyte imbalance, UTI, anemia, bloody stools, abdominal cramping

Question 23

what is scleroderma and its two types

Answer 23

autoimmune connective tissue disease that hardens the skin

localized: is on skin or muscles without spreading
systemic: fibrosis to body, blood vessels, joints, and organs

Question 24

S/S of scleroderma

Answer 24

Raynaud phenomenon, aches and pains, decreased joint motion, stiffness of lungs and SOB, dysrhythmias, decreased blood flow to kidneys

Question 25

what is Raynaud phenomenon

Answer 25

pain, blanching, cyanosis, or redness of fingers and toes when stress occurs or when exposed to cold or stress

Question 26

how does transplant heart act different from normal heart

Answer 26

vagus nerve denervation - can't generate anginalike pain so pt with ischemia will present with heart failure symptoms or dysrhythmias instead of angina

Question 27

what medication will transplant heart not respond to

Answer 27

atropine

Question 28

S/S of kidney transplant rejection

Answer 28

fever, tenderness and swelling over implanted kidney

Question 29

what do most patients who receive kidney transplants usually develop

Answer 29

Hep C and liver disease

Question 30

what is a common finding in single-lung transplants

Answer 30

unequal breath sounds

Question 31

S/S of lung transplant rejection

Answer 31

hemothorax, cough, dyspnea, vomiting, fever, crackles, rhonchi, decrease in oxygenation

Question 32

most common rejected or failed organ transplant

Answer 32

pancreas

Question 33

what do patients with pancreatic transplants present with

Answer 33

chronic non-anion gap acidosis because bicarb produced by pancreas drains directly into bladder for secretion