Lecture 2 allergies and lab values

Question 1

Drug hypersensitivity reaction DHR

opiate-related pruritus, flushing following vancomycin infusion

Answer 1

heterogeneous rxn that clinically resmble an allergy but may or may not be mediated by immune response

Question 2

Drug allergy

Answer 2

immunologically mediated hypersensitivity rxn to drug in sensitized person

type 1 hypersensitivity true drug allergy

Question 3

Type 1

Answer 3

True drug allergy, IgE-mediated, occurs within 1 hr up to 6 hrs

Question 4

Type 1 reactions

Answer 4

anaphylaxis, urticaria, angioedema

Question 5

Type 2

Answer 5

Cytotoxic Ig-G or Ig-M

>72 hrs

Question 6

Type 2 reactions

Answer 6

Hemolytic anemia, thrombocytopenia

Question 7

Type 3

Answer 7

immune complex (antigen-antibody), IgG or IgM complexes form and deposit on blood vessel walls -> inflamation)

>72 hrs to weeks

Question 8

Type 3 reactions

Answer 8

vasculitis, serum sickness, lupus

Question 9

Type 4

Answer 9

T-cell-mediated, antigens activate T-lymphocytes -> release cytokine, recruiment of effector cells

>72 hrs

Question 10

Type 4 reactions

Answer 10

Maculopapular rash, erythema multiforme, Stevens-Johnson Syndrome SJS, Toxic Epidermal Necrolysis TENS

Question 11

Hives

Answer 11

urticaria, multiple raised welts of skin (called wheals) itchy, pink red, well-demarcated border

Question 12

Angioedema

Answer 12

swelling under skin, localized edema affecting face, abdomen, extremeties, genitalia, oropharynx or larynx

Question 13

anaphylaxis

Answer 13

acute, life threatening, multiorgan rxn by release of chemical mediators from mast cells and basophils

wheezing, shortness of breath due to bronchoconstriction, need prompt tr

Question 14

rechallenge considerations

Answer 14

can only rechallenge type 4 if maculopapular rash occured

not SJS or TENS

Question 15

Maculopapular rash

Answer 15

rash with both flat and raised lesions that are seperate or merge

Question 16

SJS TENS

Answer 16

blistering dermatologic emergencies, severe sloughing off of skin and life-threatening

sulfa-drugs, anti-seizure meds

Question 17

pseudoallergy

Answer 17

adverse non-immune response tp drug

Question 18

cross-reactivity

Answer 18

drugs within same classes often have similar chem structures exhibit nearly identical rxn profiles in same patients

allergic to penicillin can be allergic to piperacillin

Question 19

Cross-sensitivity

Answer 19

sensitivity to 1 substance that renders an idv sensitive to other substances of similar chem structure

Question 20

Single Pre-Pen ampule

Answer 20

Benzylpenicilloyl polylysine, major detmerminant

Question 21

Penicillin G dilution

Answer 21

minor determinant

Question 22

Hgb

Answer 22

hemoglobin, protein that carries O2

Question 23

Hct

Answer 23

Hematocrit, % of RBC

gen estimation for Hct = 3x Hgb

Question 24

WBC

Answer 24

white blood cells, leukocytes

Question 25

RBC

Answer 25

red blood cells, erythrocytes

Question 26

MCV

Answer 26

mean corpuscular volume | avg size of RBC, high MCV = large RBC poss vitamin B12 or folic acid def

Question 27

MCH

Answer 27

mean corpuscular hemoglobin

Question 28

MCHC

Answer 28

mean corpuscular hemoglobin concentration | Hgb/HCT

Question 29

PLT

Answer 29

platelet count

Question 30

X>X/X<

Answer 30

WBC>HgB/HCT

Question 31

DVT

Answer 31

deep vein thrombosis or blood clot

Question 32

atelectasis

Answer 32

poor aeration of lungs

Question 33

ANC

Answer 33

absolute neutrophil count

Question 34

Mild neutropenia

Answer 34

ANC< 1500

Question 35

Moderate neutropenia

Answer 35

ANC< 1000

Question 36

Sevre neutropenia

Answer 36

ANC< 500

Question 37

electrolytes

Answer 37

Na+, K+, CL-

Question 38

CO2

Answer 38

serum bicarbonate as mesure of venus CO2

Question 39

BUN

Answer 39

Blood urea nitrogen: results from liver breakdown of proteins in food | kidney excretes it after formation

Question 40

SCr

Answer 40

serum creatinine: degradation of product of normal daily skeletal muscle catabolism | excreted almost entirely via kidney -> marker of renal function

Question 41

Glu

Answer 41

measure of the sugar in blood | from food, glycogenolysis and gluconeogenesis in liver for energy

Question 42

WBC value

Answer 42

4,500 -10,000 | cells/mcL

Question 43

Hemoglobin value

Answer 43

13.5 -16.5 | g/dL

Question 44

Hematocrit

Answer 44

41-50 | %

Question 45

Platelet count

Answer 45

150,000 - 450,000 | cells/ mcL

Question 46

Sodium value

Answer 46

135 -145 | mEq/L

Question 47

Potassium value

Answer 47

3.5 -5.0 | mEq/L

Question 48

Chloride value

Answer 48

98 -107 | mEq/L

Question 49

CO2 value

Answer 49

22-29 | mEq/L

Question 50

BUN value

Answer 50

8 - 25 | mg/dL

Question 51

Creatinine value

Answer 51

0.6 -1.2 | mg/dL

Question 52

Glucose value

Answer 52

70 - 115 | mg/dL