CLINICAL ALLERGY-IMMUNOLOGY

This is the perfect season for this topic to be covered....
Pollen, bee stings and lots of outdoor activities.
Of course, as you well know by know...the boards want to know....how much you know.


Q: What is an ANAPHYLACTIC REACTION?


A: It is an immune response... IgE mediated Type I...hypersensitivity reaction.
HINT: Best way to remember...Ig"E" = "E"mergency. This is important on the
boards.



Q: Which laboratory test can be useful in definitely establishing the diagnosis of
Anaphylaxis?


A: SERUM B-TRYPTASE, if drawn within 30 minutes of onset. It will help differentiate
from other similar, but NON-anaphylactic reactions.




Q: Does anaphylaxis have a LATE PHASE?


A: Yes, it tends to be BIPHASIC....thus, it is best to admit the patient to ICU for 24 hours.
As, despite the treatment given in the ER...the patient can experience another bout
of clinical symptoms.




Q: What is the BEST medication to use in patients with anaphylaxis, who are on B-Blockers?


A: GLUCAGON...1 mg...this medication is also useful in REFRACTORY anaphylaxis.




Q: What is an ANAPHYLACTOID REACTION?


A: It is a NON-IgE mediated!!! ...MAST CELL or COMPLEMENT induced reaction.
Clinically indistinquishable from anaphylaxis.




Q: What are most common causes of an ANAPHYLACTOID REACTION?


A: IV CONTRAST or NSAID, ASA administration.




Q: Can a patient who is ASPIRIN sensitive be given NSAIDS?


A: NO....there is a strong degree of CROSS REACTIVITY.




Thanks for your time...we'll continue soon