Not Benadryl
Angioedema
Anaphylaxis
Allergies
Things you forgot from medical school
100
This medication is used to treat GERD but is also given to reduce mucocutaneous symptoms in allergy/anaphylaxis.
Pepcid (famotadine) 40mg PO or IV
*DUC: Zyrtec or Claritin?
100
List 2 types of angioedema
Non-histaminergic:
Hereditary angioedema, Acquired angioedema, ACEi angioedema, idiopathic.
Histaminergic
100
Anaphylaxis is a Type (?) Hypersensitivity.
(Gell and Coombs Classification)
Type I Hypersensitivity Reaction
IgE -mediated
100
Which term describes a clinical illnesses produced by excessive immune responses by a normal immune sys- tem to otherwise innocuous allergens?
Allergy
100
I produce, store, and release histamine! (List 2)
Mast cells
Basophils
200
This medication is commonly used to treat massive PE and ischemic strokes but has the unfortunate side effect of pharyngeal and lingual angioedema.
tissue plasminogen activator (tPA)
200
Which additional exam finding would suggest an IgE/histamine-mediated source of angioedema
Urticaria
200
List 2 of the most common triggers for anaphylaxis
Foods, Medication, Insect envenomations
200
Name of the process of developing an allergy after an initial exposure to an allergen.
Sensitization
200
What percentage of histamine receptors of the skin are H2?
+/- 5%
15%
300
The only treatment shown to decrease hospitalization and death from anaphylaxis.
Epinephrine (IM)
Adult 0.3-0.5mg IM q5min or 1mcg/min gtt
Peds 0.01mg/kg IM q5min or 0.05-1mcg/kg/min gtt
1mg Epi (code cart) into 1L NS = 1mcg/mL
300
Which subtype of non-histaminergic angioedema has an FDA approved treatment?
Hereditary Angioedema
300
When can a clinician make the working diagnosis of anaphylaxis based on a SINGLE sign/symptom?
Hypotension following exposure to a KNOWN allergen.
300
Urticarial rashes are classically described as...
An itchy "wheal and flare"
300
The genetic predisposition to develop allergic disease
Atopy
400
These 2nd generation antihistamines have less sedation than Benadryl and are selective for the abundant H1 receptors in the skin and respiratory mucosa. Give 1 generic name
Zyrtec (cetirizine) 10mq PO QD
Claritin (loratadine) 10mg PO QD
Allegra (fexofenadine) 180mg PO QD
adult dosing
400
A deficiency in this acute phase reactant results in increased bradykinin production, ultimately leading to angioedema.
C1 inhibitor (C1 esterase)
400
What is the risk of severe adverse reactions to radiocontrast media? +/-3%
<1%
400
Likelihood of child having allergies if both parents have allergies? +/- 5%
75%
400
This arm of the immune system is rapid and non-specific.
Innate Immune system
500
The epinephrine didn't work on your anaphylaxis patient with a history of hypertrophic cardiomyopathy. What adjunct medication can be given to help avoid cardiovascular collapse?
Glucagon
1-5mg (adults)
20-30 mcg/kg (peds)
Don't forget the Zofran.
500
Airway emergencies (like those involving severe angioedema) are a common topic of malpractice cases. When this seal barks, who you gonna call? (3 of 4 for points)
Anesthesia (trauma), ENT, Emergency Medicine
General Surgery (trauma)?
500
Incidence of true anaphylaxis to cephalosporin medications in patients with reported penicillin allergy.
(+/-5%)
1-8%
500
What is this physical exam finding?
Dennie-Morgan lines (fold)
Allergic Shinner (discoloration)
500
Type IV hypersensitivity reactions are mediated by stimulation of which immune system responder?
T-cells
"Delayed hypersensitivity reaction"