Podcast
Questions and Answers
What is a common sign of a severe allergic reaction?
What is a common sign of a severe allergic reaction?
- Mild headaches
- Rash and itching
- Slight dizziness
- Facial and laryngeal edema (correct)
In which type of hypersensitivity does the IgG or IgM antibody lead to cell death?
In which type of hypersensitivity does the IgG or IgM antibody lead to cell death?
- Type III – Immune Complex
- Type I – Anaphylactic
- Type IV – Delayed Hypersensitivity
- Type II – Cytotoxic (correct)
What is the primary treatment for mild allergic reactions?
What is the primary treatment for mild allergic reactions?
- Corticosteroids
- Topical antibiotics
- Oral histamine blockers (correct)
- Intravenous epinephrine
What is a critical step in the emergency management of a patient experiencing a severe allergic reaction?
What is a critical step in the emergency management of a patient experiencing a severe allergic reaction?
What is the expected timeframe for the onset of symptoms in Type IV hypersensitivity?
What is the expected timeframe for the onset of symptoms in Type IV hypersensitivity?
Which of the following should be monitored during severe allergic reaction management?
Which of the following should be monitored during severe allergic reaction management?
What is a key characteristic of a Type III hypersensitivity reaction?
What is a key characteristic of a Type III hypersensitivity reaction?
What is a recommended preventive measure for individuals with known allergies?
What is a recommended preventive measure for individuals with known allergies?
What should be administered if there is no improvement seen after the first epinephrine dose for severe allergic reactions?
What should be administered if there is no improvement seen after the first epinephrine dose for severe allergic reactions?
What kind of testing is the most reliable for identifying specific IgE antibodies in patients?
What kind of testing is the most reliable for identifying specific IgE antibodies in patients?
Which of the following symptoms is typically associated with mild allergic reactions?
Which of the following symptoms is typically associated with mild allergic reactions?
What characterizes a Type I hypersensitivity reaction?
What characterizes a Type I hypersensitivity reaction?
What is the recommended first-line treatment for a patient experiencing anaphylaxis?
What is the recommended first-line treatment for a patient experiencing anaphylaxis?
What does a rapid progression of symptoms after allergen exposure typically indicate?
What does a rapid progression of symptoms after allergen exposure typically indicate?
Which of the following symptoms is NOT generally associated with an allergic reaction?
Which of the following symptoms is NOT generally associated with an allergic reaction?
What is the primary physiological response during the first exposure to an allergen?
What is the primary physiological response during the first exposure to an allergen?
How do symptoms of an allergic reaction typically manifest over time?
How do symptoms of an allergic reaction typically manifest over time?
Which of the following factors does NOT influence the severity of an allergic reaction?
Which of the following factors does NOT influence the severity of an allergic reaction?
What is a classic sign of severe allergic reactions affecting the respiratory system?
What is a classic sign of severe allergic reactions affecting the respiratory system?
Which medication is likely to be administered in the case of a severe allergic reaction, aside from epinephrine?
Which medication is likely to be administered in the case of a severe allergic reaction, aside from epinephrine?
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Study Notes
Allergic Reactions Overview
- Allergies represent hypersensitivity to ordinarily harmless substances, affecting 10-30% of the U.S. population.
- Reactions can range from mild symptoms (rashes, sneezing, watery eyes) to severe (anaphylaxis, hypotension).
- Anaphylaxis is characterized by rapid onset of symptoms, often life-threatening.
Types of Hypersensitivity
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Type I – Anaphylactic
- Triggered by IgE (immunoglobulin E).
- Immediate hypersensitivity can lead to systemic Anaphylaxis.
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Type II – Cytotoxic
- Mediated by IgG or IgM antibodies resulting in cell death.
- Response can vary in timing and may occur with blood transfusions.
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Type III – Immune Complex
- Involves IgG or IgM antibodies forming complexes that activate inflammatory response.
- Associated with conditions like rheumatoid arthritis and lupus.
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Type IV – Delayed Hypersensitivity
- Involves T-cells and takes more than 12 hours to develop.
- Chronic inflammation can occur, exemplified by contact dermatitis from metals.
Emergency Management for Allergic Reactions
-
Mild Reaction
- Position the patient comfortably; monitor circulation, airway, and breathing.
- Administer oral antihistamines (e.g. Chlorpheniramine, Diphenhydramine) and document the reaction.
- Observe as mild reactions are often self-limiting.
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Severe Reaction
- Recognize worsening symptoms, including respiratory distress, hypotension, and edema.
- Position the patient supine and ensure airway management.
- Administer intramuscular epinephrine (0.2 mL - 0.5 mL) in the lateral thigh, hold for 10 seconds and massage the site.
- Provide supplemental oxygen and monitor vital signs; replicate epinephrine dose after 5 minutes if no improvement.
Treatment Specifics
- Epinephrine must be administered promptly to prevent fatalities, especially in severe reactions.
- Pediatric and adult auto-injectors should be available; training on their use is crucial.
Prevention Strategies
- Avoid allergens and carry an Epipen for those with known allergies.
- Allergy testing may involve skin prick tests, scratch tests, and lab tests like RAST for specific IgE antibodies.
Allergy Etiologies
- Common allergens include dust, pollen, latex, insect stings, specific foods (e.g., peanuts, tree nuts), and medications (e.g., penicillin).
Physiological Response to Allergens
- Initial exposure sensitizes the immune system, leading to antibody production.
- Subsequent exposures trigger histamine release, resulting in allergic reactions.
Signs and Symptoms of Allergic Reactions
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Mild to Moderate Symptoms:
- Urticaria (hives), pruritus (itching), flushing, conjunctivitis, and rhinitis.
- Angioedema may cause airway obstruction if it affects the throat.
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Severe Symptoms:
- Respiratory (dyspnea) and cardiovascular signs (hypotension, tachycardia) leading to potential cardiovascular collapse.
- Symptoms may progress rapidly, indicating possible anaphylaxis.
Progression and Management of Symptoms
- Early allergic symptoms may self-resolve or improve with antihistamines.
- Each exposure may cause more severe reactions due to the cumulative response of the immune system.
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