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Rhodes State Unit 7
Hypersensitivity Reaction Types
| Question | Answer |
|---|---|
| How are reactions classified? | according to to source of antigen |
| Why are IgE antibodies produced? | In response to an allergen; Type 1 |
| In first exposure the IgE attach to? | basophils and mast cells |
| During a subsequent exposure to allergen it links to Ige which is bound to the mast cells and basophils causing what to happen? | degranulation of the cells and chemical mediators are released attacking target organs |
| Are chemical mediators short or long acting? Reversible or irreversible? | Short acting and reversible |
| Severity of a type 1 reaction is based on? | the mediators remaining local or systemic |
| A localized type 1 reaction, meaning a cutaneous response is =? | wheal and flare |
| A sytemic reaction type 1 reaction is? | anaphlyaxis |
| WHen does an anaphylaxis reaction occur? | when the mediators are released systemically |
| When is the onset of anaphylaxis reaction occur? | within minutes |
| Why is an anaphylaxis reaction life threatening? | bronchiole constriction |
| What is the initial 2 symptoms of an anaphylaxis reaction? | edema and itching |
| What is the later symptoms of anaphylaxis reactions? | Shock, hypotension, rapid weak pulse, dilated pupils, dyspnea, cyanosis, bronchial edema, respiratory distress, wheezing, tachypnea, stridor and bronchospams |
| What are some allergies known to cause anaphylaxis reactions? | antibiotics, vaccines, iodine dyes, narcotics, shellfish, milk, chocolate, egg whites, snake venom, nuts, latex |
| Atopic type 1 reactions mean? | there is a strong inherited tendency |
| Examples of an atopic reaction type 1 would be? | hay fever, asthma, atopic dermatitis, and urticaria |
| Which is the most common type 1 atopic reaction? | hay fever (allergic rhinitis) |
| What are the primary causes of hayfever? | pollen, dust, mold: airborne substances |
| What are the target areas affected by hayfever? | conjunctiva of the eyes, and the mucosa of the upper respiratory tract |
| What are the symptoms of hayfever? | nasal drainage, sneezing, lacrimation, mucosal swelling w/airway obstruction and pruritis around the eyes, nose, throat and mouth |
| Most ppl w/ asthma have a history of what disorders? | atopic disorders |
| What do chemical mediators produce in an allergic response? | bronchial smooth muscles constriction, excessice secretion of mucus, edema of mucus membrane of the bronchi and decreased lung compliance |
| What are the symptoms of asthma atopic reactions? | wheezing, coughing, tightness of chest, thick sputum |
| What is an atopic dermatitis? | chronic inherited skin disorder that has exacerbations and remissions |
| What causes atopic dermatitis? | environmental allergens that are difficult to identify |
| The skin lesions are more generalized than the? | wheal and flare reactions |
| An assessment one would fine? | generalized edema w/interstitial edema and vesicle formation |
| Urticaria (hives) are a cutaneous reaction against what allergens? | systemic allergens occuring in atopic persons |
| What are characterized by hives? | transient wheals (pink, raised, pruritic, edematous |
| Onset of the hives? | rapidly lasting hours to minutes after the exposure |
| Angioedema is a cutaneous atopic response lesion similar to hives but involves? | deeper layers of the skin |
| What are the areas of involvement with angioedema? | eyelids, lips, tongue, larynx, hands, feet, GI, genitalia |
| Where does the swelling begin with angioedema> | the face and then spreads to the parts of the body |
| What causes the diffuse swelling? | dilation and engorgement of the capillaries secondary to release of histamines |
| A type to reaction is called? | Cytotoxic |
| A type reaction involves the binding of what two antibodies to the cell surface? | IgG binding to the IgM |
| What do the antigen antibody complexes activate? | the complement system which mediates the reaction |
| How is the cellular tissue destroyed in a type 2 reaction? | cytolysis and enhancing phagocytosis |
| What are the target cells that are destroyed? | erythrocytes platelets and leukocytes |
| Type 3 reaction is called? | immune complex reactions |
| Tissue damage occurs secondary to what? | antigen and antibody complexes |
| Antigen antibody complexes are not cleared by the phagocyti system and become deposited where? | tissue and blood vessels |
| What does deposits in the tissue and blood vessels lead to? | inflammation and tissue damage |
| What are the common sites of tissue deposits? | kidneys, skin, joints, bv, and lungs |
| Examples of type 3 are? | systemic lupus erythematous, acute glomerulonephritis, rheumatoid arthritis |
| Type 4 reaction is called? | delayed hypersensitivity reactions |
| type 4 reactions do not involve? | antibodies or complements |
| What do the sensitized tcells attack? | antigens or release cytokines |
| How do cytokines attract macrophages? | with the enzymes they release |
| Once the cytokines attract the macrophages to the area they cause? | tissue damage |
| How long does the delayed hypersensitivity reactions take? | 24-48 hours |
| examples of type 4 reactions? | allergic contact dermatitis, microbial hypersensitivity, and transplant rejection |
| Allergic contact dermatitis occurs when? | the skin is exposed to substances that easily penetrate the skin |
| What forms to the antigen over 7 to 14 days? | memory cells |
| Within 48 hours of the subsequent exposure what does the person develop? | eczematous skin lesions |
| What is obsereved during the acute phase of allergic contact dermatitis? | the skin is erythematous, covered with papules, vesicles and bullae |
| During the chronic phase of allergic contact dermitis what is observed? | the skin appears thick and scaly |
| Examples of allergic contact dermatitis: | poison ivy, metal compounds, rubber compunds, and cosmetics |
| Type 5 reactions are also called? | stimulatory reactions |
| Type 5 reactions involve inappropriate stimulation of a normal cell surface receptor by: | an autoantibody |
| THe autoantibody results in? | a continous "Turned on" state for the cell |
| Example of type 5 | graves disease |
| Diagnostic studies used are: | cbc w/differential, radioallergosobent test, sputum bronchial and nasal secretions, skin tests, intradermal, and food allergies |
| CBC w/differential is checking for? | increased eosinophils in a type 1 and increased IgE in an atopic rx |
| RAST is measuring amounts of what? | igE towards allergen (in vitro) |
| What is the RAST helpful in determining? | reactivity to various foods or drugs in people who have sever anaphylactic rx |
| sputum, bronchial and nasal secretions are tested why? | for eospinophils |
| Where would you preform the skin, prick test? | the arm or back |
| The skin is pricked with a drop of what? | diluted allergen extract |
| A positive reading is indicated with? | red wheal on skin |
| Intradermal studies is where the extract is injected | interdermally in rows |
| A study of food allergies involves a diet of? | elimination and reintroduction 1 food @ a time |
| Once the allergy is established what is the tx? | reduction of exposure, treat the symptoms, desensitizing the pt w/immunotherapy |
| when can anaphylaxis occur? | after repeated exposure to an allergen |
| The focus is on management of? | recognizing s/s, maintain airway, preventing the spread, admin drugs, tx for shock |
| O2 management for anaphylaxis involves? | observing respiration, symptoms monitored, positioning, intubation |
| What position should an anaphlaxis pt be placed in? | high fowlers |
| intubation is required if the pt is? | hypoxic |
| What meds are given to an anaphylaxis pt? | epinephrine, benadryl |
| What does epi cause? | vacoconstriction, increased bp, relaxation of the bronchioles |
| What does benadryl do for anaphylaxis pts? | shorten the duration of ana and prevents relapse for hives and angioedema |
| NI for chronic allergies involve? | recognition and control, check allergies w/admin of meds, alert bracelets |
| What meds are given to chronic allergy pts? | antihistamines, sympathomimetic/decongestants,corticosteriods, antipuritic, and mast cell stabilizing |
| What do antihistamines block therefore effectively treating what? | block the effect of histamine treating the edema and angioedema |
| When should the antihistamine be taken to work best? | when the symptoms first appear |
| Sympathomimetic/Decongestants cause? | vasoconstriction of peripheral blood vessels and relaxation of the bronchial smooth muscle |
| Nasal or orally administered corticosteriods relieve what sx? | allergic rhinitis |
| topical antipuritic drugs protect what? | the skin and provide relief of itching |
| Mast cell stabilizing drugs inhibit the release of histamine after interaction of what antigen? | IgE |
| Mast cells stablizing is used orally, neb, or inhaler for mgt of ? | asthma |
| allergy shots are recommended when? | the allergens cannot be avoided and drug therapy is not working |
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gatesreichard.sn
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