6.10 Latex Allergy (& 6.10 Quiz)

2633: How long after exposure to latex will an allergic reaction typically develop in sensitized individuals?

A key difference between latex allergies and sensitivity to other allergens is that the onset of symptoms from latex allergy do not begin until about 30 minutes after exposure compared to the 5-10 minutes for other allergies.

Which demographic is most likely to experience a type I hypersensitivity reaction under anesthesia? A. Adult female B. Adult male C. Adolescent female D. Adolescent male

A. Adult female

You suspect an anaphylactic reaction to an intravenous drug in an intubated, anesthetized patient. Your first action should be to A. administer 100% oxygen B. administer cortisol intravenously C. administer an intravenous antihistamine D. administer an inhaled bronchodilator

A. administer 100% oxygen

Massive degranulation of mast cells and basophils in an IgE-mediated chain reaction is consistent with A. anaphylaxis B. septic shock C. cell-mediated immunity D. hypovolemic shock

A. anaphylaxis

Nonimmunologic histamine release A. is not dependent upon mu-receptors B. is dependent upon basophil activation C. does not involve mast cell activation D. requires the release of complement

A. is not dependent upon mu-receptors

Nonimmune anaphylactic reactions are the result of A. mediator release from mast cells B. mediation by IgA antibodies C. mediation by IgG antibodies D. mediation by IgE antibodies

A. mediator release from mast cells

The mainstays for treating hypotension in patients suffering from anaphylaxis are (select two) A: epinephrine B: diphenhydramine C: volume expansion with crystalloids D: administration of packed red blood cells

A: epinephrine C: volume expansion with crystalloids The principle treatment for hypotension due to anaphylaxis is epinephrine and volume expansion. The increased capillary permeability associated with anaphylaxis can result in 40% of the intravascular volume moving into the interstitial space.

2347: What food allergies are associated with an increased risk for having an allergic reaction to latex?

Allergies to tropical fruits such as bananas, mangos, peaches, avocados, kiwi, passion fruit, celery, buckwheat, papaya, and chestnuts are associated with an increased incidence of concomitant latex allergy.

Which of the following are associated with an anaphylactic reaction? A: Degranulation of T cells B. Complement activation C. Prostaglandin inhibition D. Leukotriene receptor antagonism

B. Complement activation The underlying physiology of an anaphylactic reaction involves the degranulation of mast cells and basophils with the release of histamine, leukotrienes, and prostaglandins with activation of the complement system.

Seventy percent of anesthesia-related allergic reactions are A. IgA-mediated type I reactions B. IgE-mediated type I reactions C. IgM-mediated delayed-onset reactions D. IgG-mediated globulin reactions

B. IgE-mediated type I reactions

In cell-mediated immunity, infected cells or antigen-presenting cells expose the antigen to A: B lymphocytes B: T lymphocytes C: macrophages D: dendritic cells

B. T lymphocytes In cell-mediated immunity, the antigen is presented to the T lymphocyte by infected cells or by antigen-presenting cells such as dendritic cells, macrophages, or B lymphocytes.

Side effects of histamine include: A. mediation of type II hypersensitivity reactions B. increased capillary permeability C. reduced heart rate D. bronchoconstriction via stimulation of the H2-receptor

B. increased capillary permeability

Most allergic reactions to intravenous drugs A. are delayed reactions B. occur within 5 minutes of administration C. produce bradycardia and rash D. produce intense vasoconstriction

B. occur within 5 minutes of administration

An anaphylactic reaction to latex is mediated by which antibody? A: IgA B: IgE C: IgG D: IgM

B: IgE Classic anaphylactic reactions such as food and latex allergies are mediated by IgE antibodies. Anaphylactoid reactions differ in that they do not involve IgE antibodies, but are instead mediated by mast cell and basophil activation.

Anaphylactic reactions are related to prior sensitization by exposure to an antigen with production of antigen-specific A: IgA antibodies B: IgE antibodies C: IgG antibodies D: IgM antibodies

B: IgE antibodies Anaphylactic reactions are related to production of antigen-specific IgE antibodies.

Which of the following statements are true regarding latex sensitivity? (select two) A: The onset of the reaction is typically less than 10 minutes B: It has a higher incidence in patients with fruit allergies C: It accounts for about 15% of all intraoperative allergic reactions D: Latex sensitivity is mediated by IgG antibodies

B: It has a higher incidence in patients with fruit allergies C: It accounts for about 15% of all intraoperative allergic reactions A key difference between latex allergies and sensitivity to other allergens is that the onset of symptoms from latex allergy do not begin until about 30 minutes after exposure compared to 5-10 minutes for other allergies. It accounts for approximately 15% of all intraoperative allergic reactions, is mediated by IgE antibodies, and is more common in patients with fruit allergies, spina bifida, a history of multiple surgeries, and healthcare workers.

What food allergies are associated with an increased risk for latex allergy? (select four) A: Peanuts B: Papaya C: Kiwi D: Eggs E: Chicken F: Steak G: Chestnuts H: Avocados

B: Papaya C: Kiwi G: Chestnuts H: Avocados Allergies to tropical fruits such as bananas, mangos, peaches, avocados, kiwi, passion fruit, celery, buckwheat, papaya, and chestnuts are associated with an increased incidence of concomitant latex allergy.

A patient experiencing a possible anaphylactic reaction exhibits wheezing and facial edema. Your principal concern is A: hypotension B: airway edema C: myocardial ischemia due to tachycardia D: urticaria

B: airway edema An anaphylactic reaction can produce urticaria, tachycardia, and severe hypotension. The principal concern in this patient is the severe laryngeal edema that can result. This patient already exhibits two signs of respiratory compromise: bronchospasm and facial edema, which suggests that laryngeal edema is likely.

1590: What protocols should be followed for patients with a history of latex allergy?

Patients with a history of latex allergy warrant a completely latex-free operative environment and should be scheduled as the first case of the day to reduce the risk of latex allergens in the air. Some practitioners advocate the removal of latex stoppers from drug vials to prevent inadvertant injection of latex.

By what immunoglobulin are latex allergies mediated?

Serious reactions to latex are IgE-mediated reactions to polypeptides contained in latex.

1889: What factors are associated with an increased risk for developing latex allergy?

Spina bifida, spinal cord injury, and congenital abnormalities of the genitourinary tract are associated with an increased risk for developing latex allergy. Persons with chronic exposure to latex (healthcare workers and patients who undergo frequent urinary catheterization) are also at increased risk.

What is the definitive treatment for anaphylaxis? A. Diphenhydramine B. Albuterol C. Epinephrine D. Lidocaine

C. Epinephrine

The deposition of fragments of antibodies or complement to foreign cells so that they can be identified and killed by effector cells is known as A. complement activation B. fragmentary cohesion C. opsonization D. a type I reaction

C. opsonization

Which of the following groups are at an increased risk for the development of latex allergy? A: Patients with Trisomy 18 B: Patients with a cephalosporin allergy C: Patients with an allergy to fish D: Patients with genitourinary defects

D. Patients with genitourinary defects Spina bifida, spinal cord injury, and congenital abnormalities of the genitourinary tract are associated with an increased risk for developing latex allergy. Persons with chronic exposure to latex (healthcare workers and patients who undergo frequent urinary catheterization) are also at increased risk.

A patient experiences an anaphylactic reaction to an antibiotic while under anesthesia. The patient remains hypotensive despite epinephrine and hydration. The next appropriate step would be to administer A. phenylephrine B. albumin 5% C. ephedrine D. arginine vasopressin

D. arginine vasopressin