Term
| type I hypersensitivity: process, main mediator, classification of reaction |
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Definition
process; exposure
IgE mediated
anaphylactic |
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Term
| what is a type 1 reaction dependen ton |
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Definition
genetics
sensitization, antigen induced mediator release in target organs |
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Term
| what are the systemic manifestations of type 1 |
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Definition
| conjunctivitis, angioedema, allergic rhinitis, anaphylactic laryngeal edema, ocular allergy, shock, allergic bronchopulmonary aspergillosis, asthma, GI edema, urticarial, intestinal edema, angioedema, anaphylaxis |
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Term
| what is allergic rhinitis, how is it tested |
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Definition
inflammation, edema, and weeping of the nasal mucosa
skin testing, physical findings |
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Term
| allergic rhinitis symptoms |
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Definition
Nasal congestion, puritis, rhinitis, paroxysms of sneezing
Nasal puritis and grimacing in younger children
Disturbed sleep and snoring, morning dryness, fatuige
Sinusitis
Allergic shiners or dark circles beneath ees
Dennie’s lines on inner canthus to lower lid in arc
Allergic salute: children wiping nose due to itching
Nasal crease on lower third of nose due to allergic salute
Open mouth and gasping habits
Pale, edematous, inferior nasal turbinate |
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Term
| anaphylactic laryngeal edema: type of hypersensitivity, symptoms |
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Definition
o Type 1 hypersensitivity
o Subglottic obstruction
o Tightness in upper chest, stridor, dyspnea, retractios
o Immediate onset
o Wheezing, vomiting, shock |
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Term
| anaphylactic laryngeal edema: cause, treatment |
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Definition
cause: bee sting, drug, food
treatment: epi, steroids, volume expansion, pressor agents, antihistamines, O2 |
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Term
| symptoms of ocular allergy |
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Definition
ocular angioedema: eyelids very swollen and shut
allergic cobble stoning: conjunctiva, granular appearance due to edema and hyperplasia of papillae |
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Term
| allergic bronchopulmonary aspergillosis symptoms |
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Definition
| frequently asymptomatic, areas of consilitation |
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Term
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Definition
urticarial lesions: well demarcated borders, redness, elevation occasional confluence
anginoedema of lips
most commonly due to physical forces (demographism) |
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Term
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Definition
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Term
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Definition
immediate hypersensitivity
cardiovascular collapse
respiratory compormise
cutaneous (urtical) and GI symptoms |
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Term
| management of anaphylaxis |
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Definition
Airway, breathing (100% O2), circulation (IV)
epinepherineL 0.01 mL/kg subcutaneous every 15 min to max 0.5 mL
albuterol: nebulized 0.05 to 0.15 mg/kg in 3 mL NS for every 15 min as needed
H1 antihistamine (diphenhydramine): 1-2 mg/kg IM or oral
Corticosteroids: prevent late phase response. Methylprednisolone 2 mg/kg IV bolus, 2 mg/kg per day IV or IM divided into 6 hours
Discharge with epi pen >30 kg or epi pen junior <30 kg with instructions |
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Term
| immediate type 1 hypersensitivity: timing, cause, mediators, effect |
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Definition
<30 min
IgE targeted pollen, food, drugs, insect venom
mediators: histamine, ET, NCF, hydrolyase, kallikerin, heparin
smooth muscle contraction, vascular leaking, flush hypotension, mucous secretion, puritis, anaphylaxis, allergic rhinitis, allergic asthma, urticarial |
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Term
| late phase type 1 timing, cause, mediators, effets |
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Definition
2-12 hours
igE targeted pollen food drugs venom
mediators: leukotrienes, PAF, PGD2, LTB4, LTC4-D4
infiltration with eosinophils and neutrophils destorus fibrin
anaphylaxis, allergic rhinitis, allergic asthma, erticarial, tissue destruction |
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Term
| type II hypersensitivity:aka, timing, cause, mediators, results |
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Definition
cytotoxic
variable time
igM/IgG targets RBC or lung tissue
complement mediator
immune hemolytic anemia, Rh hemolytic disease, goodpasture syndrome |
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Term
| type III hypersensitivity: aka, timing, cause, mediator, results |
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Definition
o Immune complexes
4-8 hours until reaction
Antigen and antibody targets vascular endothelium
Complement anaphylatoxin mediators
Serum sickness, poststerpococcal glomerulonephritis |
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Term
| type IV hypersensitivity: aka, cause, mediator, results |
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Definition
o Delayed type
24-48 hours until reaction
Lymphocytes target mycobacterium Tb or chemicals
Lymphokine mediator
Contact dermatitis, Tb skin test reaction |
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Term
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Definition
• Trendelenburg position: Pt head at 30 deg angle below feed
• NS: 20 mL/kg IV rapidly. Repeat bolus as necessicary
• Epi: 0.9 mL/kg IV over 205 minutes while epi or dopamine infusion is being prepared
o Dopamine 5020 mcg/kg/min
o If epi is 1:1000 then a 20 mg kid gets 0.2 mL
o If epi is 1:10,000 then a 20 mg kid gets 10 x 0.2 mLtype |
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