Anaphylaxis

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VMRCVM Gen Vet Med class of 2016. Lecture 4.

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Question 1

Question
Anaphylaxis can be defined as:
Answer
  • A systemic hypersensitivity reaction that can cause multi-organ failure and is often an emergency.
  • A severe Type I hypersensitivity reaction.
  • An immune response mediated almost exclusively by IgG and IgM.
  • The inability to breathe due to swollen airways.

Question 2

Question
Generally Type I hypersensitivity reactions require multiple exposures to an agent before occurring.
Answer
  • True
  • False

Question 3

Question
Potentiation of mast cell degranulation is most often attributed to:
Answer
  • Not removing the inciting agent.
  • Patient stress.
  • Histamine release.
  • Organ failure and an inability to compensate.

Question 4

Question
Clinical signs that accompany anaphylaxis may include: (select all that apply)
Answer
  • Pruritis, wheals, or edema on the skin.
  • Bronchodilation.
  • Increased gastric motility.
  • Hypertension.

Question 5

Question
A localized anaphylactic reaction has the potential to progress to a systemic anaphylactic reaction.
Answer
  • True
  • False

Question 6

Question
Which of the following is true?
Answer
  • Dogs are more likely to present with dyspnea, collapse, and excessive mucous production as signs of anaphylaxis than are cats.
  • Cats are more likely present with dyspnea, collapse, and excessive mucous production as signs of anaphylaxis than are dogs.
  • Cats are more likely to present with cutaneous lesions as signs of anaphylaxis than are dogs.
  • More than one of these answer choices is correct.

Question 7

Question
Like anaphylactic reactions, anaphylactoid reactions require previous sensitization, but occur more frequently on the third or fourth exposure than on the second.
Answer
  • True
  • False

Question 8

Question
The difference between localized and systemic anaphylaxis is:
Answer
  • The immunoglobulins involved, as the skin creates a different type of immunoglobulin than does the blood.
  • Where the exposure occurred, for example a bee sting in the skin versus ingesting an allergen.
  • Localized anaphylaxis is characterized by histamine as a mediator of degranulation, whereas localized anaphylaxis relies on serotonin.
  • Localized anaphylaxis tends to be restricted to one location (often the skin), whereas systemic anaphylaxis involves 2 or more organ systems.

Question 9

Question
Why is epinephrine such a key player in the treatment of systemic anaphylaxis?
Answer
  • It reduces mast cell degranulation.
  • It increases heart rate, and the subsequent increased movement of blood through the system pulls fluid from the interstitial spaces and reduces edema.
  • It promotes bronchoconstriction, allowing a patient to slow their breathing and take deeper breaths.
  • It induces peripheral vasodilation, allowing for better tissue perfusion.

Question 10

Question
Which of the following follows appropriate dosing protocol for epinephrine? Select all that apply.
Answer
  • Continuous rate infusion at 0.05 mg/kg/min
  • Intratracheal dose at 0.02-0.04 mg/kg, diluted.
  • IV dose at ~0.05-0.1 mL/10 lbs

Question 11

Question
Dexmethasone:
Answer
  • Is an antihistamine that can be given either orally (1 mg/lb) or IM (1-2 mg/kg).
  • Is an anti-inflammatory that can be given IV (0.1-0.2 mg/kg).
  • Is the name of a complex anaphylactic treatment protocol that involves extensive analgesics, sedatives, antihistamines, and fluids.
  • Is much better at addressing hypotension than is epinephrine.