Hypersensitivity and SLE Overview
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Questions and Answers

A patient presents with wheezing and hives after eating peanuts. What type of hypersensitivity reaction is the patient experiencing?

  • Type II (Cytotoxic hypersensitivity)
  • Type IV (Delayed-type hypersensitivity)
  • Type I (IgE-mediated hypersensitivity) (correct)
  • Type III (Immune complex-mediated hypersensitivity)

Which clinical finding is most specific to diagnosing systemic lupus erythematosus (SLE)?

  • Positive anti-DNA antibody test (correct)
  • Increased erythrocyte sedimentation rate (ESR)
  • Presence of proteinuria
  • Red butterfly rash on the face

A patient is admitted with an acute anaphylactic reaction. Which is the priority medication to administer?

  • Theophylline
  • Steroids
  • Epinephrine (correct)
  • Antihistamines

Which patient is at the highest risk for developing systemic lupus erythematosus (SLE)?

<p>A 25-year-old African American female (A)</p> Signup and view all the answers

What is the most important teaching point for a patient with SLE who is prescribed corticosteroids?

<p>Avoid exposure to sunlight and use sunscreen. (C)</p> Signup and view all the answers

A patient is experiencing hemolysis after receiving a blood transfusion. What is the priority nursing action?

<p>Stop the transfusion immediately. (A)</p> Signup and view all the answers

Which diagnostic test result indicates a positive delayed-type hypersensitivity reaction?

<p>10 mm induration at the site of a tuberculin skin test after 48-72 hours (A)</p> Signup and view all the answers

Which patient is at the highest risk for developing a hypersensitivity reaction?

<p>A patient with a history of seasonal allergies (B)</p> Signup and view all the answers

Which organ system is most commonly affected in systemic lupus erythematosus (SLE)?

<p>Connective tissues (C)</p> Signup and view all the answers

Which laboratory finding is consistent with an exacerbation of SLE?

<p>Proteinuria on urinalysis (A)</p> Signup and view all the answers

A patient with asthma is prescribed a daily antihistamine. What is the primary purpose of this medication?

<p>Block histamine receptors to prevent symptoms (A)</p> Signup and view all the answers

A patient is undergoing desensitization therapy for allergies. What is the expected outcome of this therapy?

<p>Development of tolerance to allergens (C)</p> Signup and view all the answers

What is the hallmark dermatologic manifestation of systemic lupus erythematosus (SLE)?

<p>Red butterfly rash across the cheeks and nose (B)</p> Signup and view all the answers

Which example illustrates a Type IV hypersensitivity reaction?

<p>Rash from poison ivy exposure 72 hours ago (A)</p> Signup and view all the answers

Which statement by a nursing student requires correction regarding risk factors for SLE?

<p>SLE affects men and women equally. (D)</p> Signup and view all the answers

A patient with SLE is prescribed hydroxychloroquine. What is the primary purpose of this medication?

<p>Prevent skin flares (C)</p> Signup and view all the answers

What is the primary immune component involved in a Type II hypersensitivity reaction?

<p>IgG or IgM antibodies (D)</p> Signup and view all the answers

Which nursing diagnosis is a priority for a patient with SLE experiencing fatigue and joint pain?

<p>Impaired Physical Mobility (D)</p> Signup and view all the answers

Which statement best describes autoimmune disorders?

<p>The immune system fails to recognize its own cells. (C)</p> Signup and view all the answers

A patient with SLE is starting immunosuppressive therapy. Which teaching point is most important?

<p>Avoid large crowds and people with infections. (A)</p> Signup and view all the answers

What is the primary consideration for a patient with SLE planning to become pregnant?

<p>Medication adjustments may be needed for fetal safety. (B)</p> Signup and view all the answers

A patient receives a positive purified protein derivative (PPD) test. What does this indicate?

<p>Prior exposure to Mycobacterium tuberculosis (D)</p> Signup and view all the answers

Which finding in a patient with SLE requires immediate attention?

<p>Sudden onset of hematuria (C)</p> Signup and view all the answers

What is a common manifestation of immune complex deposition in Type III hypersensitivity?

<p>Joint inflammation (D)</p> Signup and view all the answers

Which medication is most appropriate for acute severe exacerbations of SLE?

<p>Corticosteroids (C)</p> Signup and view all the answers

Flashcards

Type I Hypersensitivity

An immediate allergic response triggered by IgE antibodies, causing symptoms like wheezing and hives.

Type II Hypersensitivity

Cytotoxic reaction where antibodies attack cells, often seen in blood transfusions.

Type III Hypersensitivity

Immune complex-mediated reaction, where immune complexes form and deposit in tissues, causing inflammation.

Type IV Hypersensitivity

Delayed-type hypersensitivity reaction, involving T-cells and taking hours or days to develop.

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SLE (Systemic Lupus Erythematosus)

An autoimmune disease affecting various organs, particularly connective tissues.

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Anti-DNA antibody

A key diagnostic marker for SLE, rarely found in other conditions.

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Epinephrine

First-line treatment for anaphylaxis, reversing severe symptoms.

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SLE Risk Factors

Predominantly affects women of childbearing age, more common in certain ethnic groups.

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SLE Corticosteroids

Used to manage SLE, but patients should avoid sun exposure and use sunscreen due to photosensitivity.

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Blood Transfusion Reaction

A potential complication in blood transfusions, requiring immediate stopping of the transfusion.

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Positive PPD Test

Indicates previous exposure to Mycobacterium tuberculosis, not an active infection.

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Hematuria in SLE

Sudden onset of hematuria signifies kidney involvement needing immediate medical attention.

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SLE Exacerbation

A worsening of SLE symptoms, often accompanied by indicators like proteinuria.

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Antihistamines (Type I)

Reduce allergic symptoms by blocking histamine receptors.

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Desensitization Therapy

Gradually introduces allergens to build tolerance and reduce hypersensitivity.

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Butterfly Rash

Classic skin manifestation of SLE.

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Poison Ivy Reaction

Example of a delayed hypersensitivity reaction causing a skin rash.

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SLE Pregnancy

Requires medication adjustments to ensure fetal safety during pregnancy.

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Hydroxychloroquine (SLE)

Antimalarial drug used to prevent skin and arthritic SLE flares.

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Type II Antibody

IgG or IgM antibodies attack cells associated with Type II hypersensitivity.

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SLE Fatigue/Joint Pain

Nursing diagnosis of concern in SLE patients affecting mobility.

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Autoimmune Disorder

Immune system attacks the body's own tissues.

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Immunosuppressive Therapy and SLE

Patients should avoid large crowds and infectious exposure to reduce infection risk.

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SLE Kidney Involvement

Kidney involvement in SLE can lead to proteinuria.

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Type III Manifestation

Common manifestation of immune complex deposition in Type III hypersensitivity reactions is joint inflammation.

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SLE Exacerbation Treatment

High-dose corticosteroids are often used to reduce inflammation in severe SLE exacerbations.

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Study Notes

Hypersensitivity Types

  • A patient experiencing wheezing and hives after eating peanuts is exhibiting a Type I (IgE-mediated) hypersensitivity reaction.
  • Type I reactions cause an immediate allergic response, often seen in anaphylaxis or allergic reactions to foods.

Systemic Lupus Erythematosus (SLE)

  • A positive anti-DNA antibody test is highly specific for diagnosing SLE.
  • This test is rarely found in other disorders, making it a key diagnostic marker.
  • Increased erythrocyte sedimentation rate (ESR) is not specific for SLE diagnosis.
  • A red butterfly rash on the face is a common symptom but not diagnostic.
  • Proteinuria may indicate an SLE exacerbation and kidney involvement.

Type I Hypersensitivity Treatment

  • Epinephrine is the immediate priority treatment for an acute anaphylactic reaction.
  • Epinephrine counteracts bronchospasms, vasodilation, and other severe symptoms of a Type I hypersensitivity reaction.

SLE Risk Factors

  • Young African American women are at highest risk for developing SLE.
  • SLE is more prevalent in African American, Hispanic, and Native American populations.
  • SLE predominantly affects women of childbearing age.

Nursing Management in SLE

  • Patients with SLE should be taught to avoid exposure to sunlight and use sunscreen due to photosensitivity.
  • Corticosteroids are used in SLE to reduce inflammation.
  • Corticosteroid use requires teaching on avoiding sunlight and protecting the skin.
  • Patients should be instructed to notify the provider about any side effects.

Type II Hypersensitivity

  • A priority action when a patient experiences hemolysis after a blood transfusion is to immediately stop the transfusion.
  • This stops further destruction of red blood cells and prevents potential life-threatening complications.

Delayed-Type Hypersensitivity

  • A positive reaction to a tuberculin skin test (10 mm induration at the test site after 48-72 hours) indicates a positive delayed-type hypersensitivity reaction.
  • A delayed hypersensitivity reaction is characterized by an induration reaction at the test site after antigen exposure.

Immune System & SLE

  • A history of allergies increases the risk of a hypersensitivity reaction.
  • Patients with SLE commonly have an overreactive immune system, therefore they are predisposed to hypersensitivity reactions.
  • SLE is a chronic autoimmune disease targeting the connective tissues.

Diagnostic Testing in SLE

  • Proteinuria during an SLE exacerbation suggests kidney involvement frequently caused by immune complex deposition in the kidneys.

SLE Management & Interventions

  • Corticosteroids are a typical choice for managing acute severe SLE exacerbations as they reduce both inflammation and immune activity.

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SLE Practice Quiz PDF

Description

Explore the mechanisms, symptoms, and treatments for Type I hypersensitivity and Systemic Lupus Erythematosus (SLE). This quiz covers key diagnostic markers, risk factors, and management strategies, focusing on critical clinical features and interventions. Test your knowledge on identifying and treating these immune responses.

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