It's all about Renee
What's the difference between early and late phase reactions?
Early phase = immediate activation of mast cells & basophils to cause vasodilation, congestion, & edema (w/ wheal & flare rxn)
Late phase = infiltration of eosinophils, basophils, neutrophils, & Th2 cells due to chemotactic mediators (maintains chronic inflammation)
When canulating a vein, why should you choose a distal site?
In the event a distal site collapses or is no longer useable, you can move proximally. If you start proximal but need to move distal, then any infusion will leak out of the original proximal entry point.
Define "inter-professional practice".
The understanding of skills and cultural values inherent in each member of a healthcare team. Involves collaboration between doctors, nurses, allied health workers and more to provide the highest quality of care to a patient.
Renee's anaphylaxis may have been triggered by penicillin. What type of adverse drug reaction is this?
Type B = Bizarre
These reactions are idiosyncratic and unpredictable. They are not dose-dependent and often result from hypersensitivity or allergic responses.
Describe the basic molecular mechanism of an IgE-mediated allergic reaction.
1st exposure = sensitization = Allergen trigger Th cell activation of B cell, formation of plasma cells producing allergen specific IgE antibodies --> Ab bind to Fc receptor of mast cells & basophils
2nd exposure = hyperresponsiveness = allergen cross-links to IgE of sensitized mast cells, triggering their degranulation & release of vasoactive amines producing physiological effects
Renee is asthmatic and having an anaphylactic reaction. What do you give her, salbutamol or adrenaline?
Adrenaline - provides immediate response to alleviate the S/S
From the article "Inter-professional teamwork: Professional cultures as barriers", what kind of barriers did they describe?
What's the difference between reflex, situational, and orthostatic syncope?
Reflex syncope = classic vasovagal syncope precipitated by emotional distress or prolonged standing
Situational syncope = syncope occurs during or immediately after specific triggers (e.g. GI stimulation, micturition, post-exercise, cough/sneeze)
Orthostatic syncope = documentation of orthostatic hypotension during active standing test associated w/ syncope or pre-syncope (decrease in SBP <90mmHg or >20mmHg decrease)
If the RAST showed an "equivocal" result for peanuts, what should Renee do to confirm if she's allergic to them or not?
Avoid them and...
Complete the provocation test (gold standard)
- introduce small amounts of food in increasing concentration to gauge a reaction
How does IM adrenaline work?
gradual release into the BVs of the muscle
Alpha agonist - Increase peripheral vascular resistance, reduces vasodilation to decrease fluid leakage reduces hypotension
Beta 1 agonist - Positive inotrope (strength of contraction) & positive chronotrope (rate of contraction)
Beta 2 agonist - Bronchodilator
What do you need to consider when reading graphical data?
Understand the components of the graph. (title, axes, etc.)
Read the important findings in the data (main trends, differences, anomalies, the big picture).
Summarise the graph's main findings.
Draw implications from the data in the graph (possible explanations for the findings).
Give 3 examples of cutaneous adverse drug reactions.
mulopapular rash
urticaria (hives)
Stevens-Johnson Syndrome (detachment of epidermis in <10% BSA)
Toxic Epidermal Necrolysis (detachment of epidermis in >30% BSA)