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Adulth HLTH 2 Test 3
Hypersensitivity and Autoimmunity
| Question | Answer |
|---|---|
| What type of hypersensitive reactions is there an increased production of IgE antibodies? | Type I: Rapid Hypersensitivity Reactions |
| What is the most common Type I rapid hypersensitivity reaction? | Results in acute inflammation due to the release of histamine and other vasoactive amines from mast cells and basophils. |
| Anaphylaxis; Allergic asthma; Allergic rhinitis; Environmental allergens such as latex, iodine, bees, foods and drugs are all examples of what type of reaction? | Type I: Rapid Hypersensitivity Reactions |
| You get activation of basophils, eosinophils and mast cells. On a CBC with differential you will see an increase in eosinophils. What type of Hypersensitivity reaction is this? | Type I: Rapid Hypersensitivity Reactions |
| ___ result from increased production of immunoglobulin E or IgE antibodies? | Rapid hypersensitivity reactions result from increased production of immunoglobulin E or IgE antibodies. |
| Allergens of Type I: Rapid Hypersensitivity Reactions may be __, __, __, or ___? | Allergens may be inhaled, ingested, injected or contacted |
| With ___: Reactions may involve skin, eyes, nasopharynx, bronchopulmonary, or gastrointestinal systems? | Type I |
| ___Reactions usually occur within 15 to 30 minutes, but may be delayed up to 10 to 12 hours? | Type I |
| T/F Type I: Rapid Hypersensitivity Reactions to an allergen can rage from irritating to life threatening? | True |
| Feelings of impending doom, weakness, anxiety, or apprehension are all SS of ___? | anaphylaxis |
| Erythema, wheals, hives or angioedema are SS of ___? | Anaphylaxis |
| Brochoconstriction, mucosal edema, excess mucus production-RESPIRATORY FAILURE are all SS of ___? | Anaphylaxis |
| Laryngeal & tongue edema, strider, hoarseness; HYPOtension, dysrythmias, and Cardiac arrest are all signs and symptoms of ___? | Anaphylaxis |
| What is dramatic and life-threatening: rapid, systemic and multi-organ involvement? | Anaphylaxis |
| A person in ___ will have a weak rapid pulse? | Anaphylaxis |
| Most anaphylaxis deaths occur do to ___ & ___? | respiratory and cardiac failure |
| As the process of ___ progresses the client may become light headed, increasingly anxious and confused? | Anaphylaxis: As the process progresses the client may become light headed, increasingly anxious and confused. |
| What is the treatment for Anaphylaxis? | Airway management &/or CPR; Epinephrine (1:1000) 0.3 to 0.5 ml sub-q may repeat q 15 min; Antihistamines: diphenhydramine 25 to 100 mg IV, IM, PO; |
| Prednisone; Oxygen, albuterol; Theophylline; Vasopressors as needed are treatments for ___? | Anaphylaxis |
| If a person is in anaphyalxic shock what is the most important thing for you as a nurse to do? | AIRWAY MANAGEMENT IS MOST IMPORTANT. |
| In Anaphylaxis, vasopressors such as ___ are used to counter act ___? | Vasopressors such as dopamine are used to counter act hypotension. |
| T/F People who have known severe allergies should carry one of these with them at all times and wear a med alert bracelet? | True |
| In the ER H2 inhibitors may be given to a person with ___? | anaphylaxis |
| What are some common Antibiotic Anaphylactic Allergens? | Penicillin, cephalosporins, tetracycline, sulfonamides, amphotericin B etc |
| Adrenocorticotropic hormone, insulin; Allergen extracts, muscle relaxants, vaccines, local anesthetics (lidocaine); Whole blood or blood products; Radiocontrast medium (iodine); & Opiates are some common ____? | Anaphylactic Allergens |
| What are some food anaphylactic allergens that are common? | shellfish, eggs, nuts, grains |
| What are some common environmental anaphylactic allergens? | Pollens; Insects and animals: bees, venom are some common |
| T/F The best thing to do is be aware of your allergens and avoid them. This can be difficult, especially with food allergies. You really have to read the labels. Nut allergies are on the increase. | True |
| In Type I hypersensitivity Antigen specific IgE is formed after ___? | Antigen specific IgE is formed after the first exposure to allergen. |
| Upon re-exposure the allergen binds to two adjacent IgE molecules on the surface of a basophil or mast cell causing them to degranulate or release vasoactive amines in what type? | Type I |
| ___ is the life threatening end of the spectrum? For most of us Type I hypersensitivity reactions are in the category of hay fever or allergic rhinitis that is triggered by airborne allergens. | Anaphylaxis |
| What is the most common vasoactive amine? | The most common vasoactive amine is histamine, a shortacting biochemical |
| ____ causes capillary leak, nasal & conjuctival mucous secretion, & itching, often with redness? | Histamine |
| ____ is a continuing response due to inflammation from infiltration of white blood cells, leukatrines and prostaglandins & Affects 10 to 20% of the American population? | Histamine |
| What does the nose look like with allergic rhinitis? | Boggy, pale and swollen mucosa |
| Nasal drainage in allergic rhinitis causes throat irritation by___? | “post nasal drip”. |
| In ____ the SS are: Itchy watery eyes, nose blowing and stuffiness are what you see. Ears may feel full and the person feel “foggy”? | Allergic rhinitis |
| T/F The literature says 20% have allergic rhinitis, but according to the teacher it is Overreported. | False the Teacher believes it is underreported by just talking to her friends and family |
| ____ is not usually life threatening, but can complicate other respiratory diseases like asthma? | Allergic Rhinitis |
| Allergic rhinitis occurs ____ between men and women? | equally |
| What are some things a Dr will ask when talking about the History of Allergic Rhinitis? | Symptoms & chronicity; Trigger factors; Response to treatment; Comorbid conditions; Family Hx; Environmental and work exposures; Effects on quality of life. |
| What do we want to know about a pt that has allergic rhinitis? | We want to know when things started and are they seasonal or year round; Has anything specific been identified as an allergen previously; What have they tried in the past & how did it work? |
| What are some common allergens for allergic rhinitis? | dust mites and cockroaches; molds, dust or pollen; animals and pets. |
| T/F All parts of a cockroach including their feces can be an allergen? | True |
| T/F Many times patients come into the hospital for other more serious things and get their allergey meds at the same time? | false they don’t get their allergy medications which makes them miserable. |
| What are some comorbid conditions with allergic rhinitis? | Asthma or COPD |
| About ___% of people with allergies have one parent with them? | As the book says about 50% of people with allergies have one parent with them. |
| Is it important to find out how allergies are impacting their life? | Yes, You want to know how this is impacting their life. |
| In looking at people with allergies you may see them have what is called ____? | allergic shiners or dark circles around the eyes. |
| What is the Type I : Allergy Testing test? | Scratch testing: Reveals immediate hypersensitivity reactions. |
| When will you get the results in scratch testing? | Results in 15-20 min |
| Prior to doing a scratch testing you want to discontinue antihistamines and steroids for how long? | Discontinue antihistamines and steroids for 5 days prior to testing. |
| When doing a scratch test it is important to have emergency resuscitation equipment available. Why? | Pt might go into Anaphylaxis shock |
| T/F All Type I hypersensitivity reactions are allergic rhinitis? | FALSE, Remember that not all type I hypersensitivity reactions are allergic rhinitis. Anaphylaxis falls under this category. |
| What is scratch testing? | Small amount of different allergens are placed on the skin and then tiny scratches are made through them. You then wait and watch for a reaction. |
| Is scratch testing different than patch testing? | Yes |
| T/F Scratch testing will identify all allergens? | False This may not identify all allergens, but may give a clue to categories. |
| In Scratch testing how is the severity of the reaction determined? | The severity of the reaction is determined by the size of the wheal. |
| T/F After a scratch testing, topical antihistamines and steroids may be applied to help decrease irritation/itching. Also oral antihistamines may be given. | True |
| What is one of the major draw backs to antihistamines? | One of their major draw backs is drowsiness and dry mouth. |
| In Type I hypersensitivity reactions what will the lab test show? | On lab tests you will see a rise in eosinophils as high as 12% (normal 1-2%). You may also see in increase in the white count and neutrophils. |
| A ___ scan may be ordered if there is chronic sinusitis as a complication? | A CT scan may be ordered if there is chronic sinusitis as a complication. |
| In what ____ foreign antigen attaches to self cells? | Type II: Cytotoxic Reactions |
| In ___ Special auto-antibodies attack self cells, bind and form immune complexes? | Type II: Cytotoxic Reactions |
| In ___Self cell destroyed along with attached antigen? | Type II: cytotoxic Reactions |
| What are some examples of Type II: Cytotoxic Reactions? | Examples: thrombocytopenic purpura, hemolytic transfusion reactions, drug-induced hemolytic anemia, Goodpasture’s. |
| What is the treatment for Type II: Cytotoxic Reactions? | Treatment: Remove offending drug or blood product, plasmapherisis to remove antibodies |
| Hemolytic transfusion reactions occur when someone is given the wrong type of blood. What type of reaction is this? | Type II: Cytotoxic Reactions |
| In what type of reaction is there an aggregation of antigens, IgG and IgM antibodies? | Type III: Immune Complex Reactions |
| Antigens form in the blood and are deposited in small blood vessels, skin, joints and kidneys in what type of reaction? | Type III: Immune Complex Reactions |
| What type of reaction triggers inflammatory reactions? | Type III: Immune Complex Reactions |
| In what type of reaction does the reaction occur in hours to days? | Type III: Immune Complex Reactions |
| A lot of the diseases we have discussed previously have symptoms that result from immune complexes. Name some of these diseases? | Some of these are Rheumatoid arthritis, Lupus, vasculitis, nephritis, arthritis, and sub acute bacterial endocarditis. |
| ___ testing is often reserved for contact dermatitis and other manifestations of type IV: delayed hypersensitivity reactions? | patch testing |
| Type IV: Delayed Hypersensitivity reactions include? | type IV reactions include contact dermatitis, poison ivy skin rashes, local response to insect stings, tissue transplant rejections, and sarcoidosis. |
| In what type of reaction is the reactive cell is the T-lymphocyte (T-cell)? | Type IV: Delayed Hypersensitivity Reactions |
| In ___ antibodies and complement are not involved? | Type IV: Delayed Hypersensitivity reactions |
| In type ___ the response typically occurs hours to days after the exposure? | Type IV: Delayed hypersensitivity reactions |
| A type ___ reaction consists of a local collection of lymphocytes and macrophages, causing edema, induration, ischemia, and tissue damage at the site? | Type IV: Delayed Hypersensitivity Reaction |
| What type of reaction is a TB test? | Type IV: Delayed Hypersensitivity Reaction |
| Is Diphenhydramine (Benadryl) useful for a Type IV: Delayed Hypersensitivity Reaction? What is? | No it is minimal benefit because histamine is not the main mediator. Corticosteroids or other anti-inflammatory agents can reduce the discomfort and help resolve the reaction more quickly. |
| What is Patch testing? | Test chemicals are applied to intact skin under occlusive tape patches. After the patches are removed, the skin areas in contact w/ chemical are inspected closely for the presence of localized redness, swelling, & blisters. |
| T/F For a positive patch test result to have clinical relevance, the client must have a history of exposure to substances containing the allergen? | true |
| In a patch test it causes a delayed hypersensitivity reaction that develops in ___ to ___ hrs? | 48-96 hours therefore the initial reading is not performed until two days after application |
| In a patch test when does systemic corticosteroids or antihistamines discontinued prior to the test? | 48 hrs before the test |
| If a potential allergen is identified in a patch test what is given to the pt? | a list of items containing that chemical so they can avoid it. |
| In Type V: Stimulatory Reactions the humoral antibody inappropriately activates a ____? | Receptor site |
| Target organ or tissue is continually “turned on” as in Grave’s disease in what type of reaction? | Type V: Stimulatory Reaction |
| What is the treatment for Type V: Stimulatory reaction? | Treatment: remove enough tissue to allow normal response and/or use immunosuppressant drugs. |
Created by:
cgwayland
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