Allergy

Cross sensitivity between latex and what fruits are known?

Avacodo, potato, chestnit Kiwi, papaya, banana, and tomatoes.

You thnk your patient is having an allergic reation, or infact, a hemolytic transfusion reation to his receiving PRBCs. What test can you use to verify this

Coombs test. it picks up both antigen-antibody complexes, and the activation of the complement system

Fist line treatment in anaphalactic or anaphalactoid reactions?

Epinephrine!!

Who is more prone to allergic reations, males or females?

Females.

Neuromuscular blockers reactions are probably Ig__mediated

IgE

Those reations that cause Type I reactions are mediated by______________

Ig_ mediated (IgE,IgA etc..)

Which type of allergic reaction occurs 80% of the time. Type A or B?

Type A

What effect does anesthesia itself have on allergic responses?

alters mediator release, possibly delaying early recognition.

Challenge test does what?

directly exposes the Pt. to latex and is observed for reactions

Which test has the greatest chance of anaphalaxis reaction?

intradermal

The number one allergic reaction that's caused by a drug in anesthesia is caused by...

muscle relaxers.

latex anaphalactic reactions can be delayed for how long?

up to an hour.

20 proteins that bind to activated antibodies-effectors of inflammation, initiated by IgG, IgM, plasma or endotoxins, and some drugs. Causes cell destruction, chemotaxis, activation of leucocytes, cell and bacterial lysis.

Complement system.

True or false: the bellow on the Omeda machines are made of latex.

False

True or false: S/S as well as treatment differs between anaphalactic and anaphalactoid reactions.

False. Anaphalactoid reactions are clinically indistinguishable from anaphalaxis and treatments are the same.

True or false: Men react to muscle relaxers more than women

False: women do.

True or false: anaphalactoid reactions can be effectively premedicated

True. (eg. contrast dye)

True or False: Use of premedications prior to contrast dye decreases incidence of anaphalactoid reactions

True. down to 0.9%

T-cells mediate what level reaction

Type 4 reaction

Type of reaction seen in graft versus host and contact dermatitis, Tuberculin immunity, and poison ivy. takes 18-24 hours to develop

Type 4. can progress to type I

A skin prick test is used to detect what type of reaction?

Type I latex allergy

anautoimmune type reaction is a type __ reaction

Type II

Hemolytic transfusion reactions are of what type?

Type II reations

Soluble immune complexes ( aggregations of antigens and IgG, IgM antibodies) form in the blood and are deposited into the tissues (skin, kidneys and joints. This is what type of reaction?

Type III (eg. lupus, RA, serum sickness, protamine-mediated pulmonary vasoconstiction.)

A delayed immune reaction involving T-Lymphocyte activation. This type of reaction is seen in latex allergy.

Type IV

patch test are used to detect which type of reaction?

Type IV

Chemically mediated reaction are

anaphalactoid reactions.

usually happens on second exposure to an antergen

anaphalaxis

A reaction to CT contrast dye is what type of reaction

anaphalctoid

Anaphalaxis can occur on first exposure due to...

cross-reactivity among various substances.

The RAST or radioallergosorbant-blood test is used for...

measures IgE-specific circulating antibodies.

Define anaphalactoid

not mediated by an antigen/antibody reaction

Steroids have two benificial effects when given during an anaphalaxis reaction ...

1. Stabalizes mast cells (takes about 6 hours) 2. The enhance the effectiveness of catecholamines at the cellular level (immediately).

How many types of latex allergies are there

3. Irritant contact dermatitis ( gradual onset over days), Allergic contact dermatitis ( 6-48 hours type IV), Immediate hypersensitivity, type I)

what percent chance is there of a person having an anaphalactoid reaction if the previously had one?

33% chance.

High-grade responders who present with multiple allergies or exaggerated responses are called

Atopic

Most common presenting manifestation

CV collaspe

Which immunoglobulin mediates hemolytic transfusion reactions

IgM

Your patient had a positive skin test of a hypersensitivity nature to PCN. Can you still give Ancef instead?

No! positive skin test: no 1st generation cephlasporins. 2nd and 3rd generations should be OK.

Contact dermatitis is what type of reaction

T-lymphocyte-mediated (white cells). delayed type hypersensitivity (eg. Latex allergy)

Egg allergen, Soy bean oil, metabisulfite preservatives probably also allergic to...

propofol