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13 Cards in this Set

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  • Back

Common causes of Allergic Rxns:

Nuts, fish, & shellfish (fatalities)

milk, soy wheat, eggs (children)


Pt comes in w/ large, itchy, red, irregular shaped spots (hives) on leg. Spots appeared about an hour ago & are starting to go down (transient).




Tx: antihistamines

Pt presents w/ swollen lips. She recently started taking ACE inhibitors for hypertension.




Tx: take off ACE (switch), give EPI, antihistamines, or glucocorticoids (although not very helpful)

If the previous patient also has stomach pain, what do you suspect?

how do you confirm?


Hereditary Angioedema (HAE)

Confirm w/ :

family history --> one parent will also have HAE (autosomal dominant)

& C1-esterase Inhibitor levels --> will be low (deficiency)

Tx: IV Fresh Frozen Plasma (FFP) & Commercial C1-INH )if available)

Pt comes into ER complaining of difficulty breathing & itchy hives. PE reveals severe hypotension (or shock), flushing, & urticaria (or angioedema). Dx?



Tx: Maintain ABCs & give epinephrine

may also give antihistamines, glucosteroids

Hospitalize pt 24 hrs & discharge w/ injectible EPI

In a stable patient, what can you test to possibly prevent further rxn?

Skin Testing--> can be used to determine cause of IgE mediated allergies to suspected substances (Food, pets, etc)

__________bites cause central necrosis in fatty areas, these appear about 2-8 hours after bite & spread slowly, d/t release of cytotoxic venom that destroys cells.


Brown Recluse Spider Bite

Tx: usually observe, tx wound, give tetanus

(not much you can do)

_______ bites cause abdominal pain (not tender to palpation but does appear boardlike), muscle spasms, leg cramps, & hypertension, d/t release of neurotoxic venom.

(Pt likely has visible bite mark)


Black Widow bite

Tx: wound tx, tetanus prophylaxis, IV diazepam or Lorazepam (for muscle spasms), Lactrodectus Antivenom (in severe cases, child or elder)

*monitor for 2 hrs & send home

If a pregnant women is bitten by a black widow, what may occur?


abruptio placenta or fetal demise

tx: antivenom

___________ cause sharp burning pain at the site, mydriasis, nystagmus, hypersalivation, restlessness, dysphagia, followed by pruritis, erythema, & possible respiratory or cardiovacular failure (arrhythmia), d/t neurotoxic venom that causes over-excitation. Pt says it fells like an "electric current"


Scorpion (Centruroides exilicauda) sting

Tx: IV valium (muscle spasms & convusions) & supportive therapy, if very severe (esp children) give Antivenom (very expensive)

_______bites cause severe pain, swelling that progresses proximally, numbness, muscle twitching, rapid pulse, visual disturbances, followed by necrosis of skin, pulmonary edema & internal hemorrhage.

It is very important to tx early!


Rattlesnake bite

Tx: Antivenom (croFab), blood transfusion (hemorrage)

Also do lab coagulation study

(use compression bandages until antivenom given)

Rattlesnake venom causes ___________ leading to hemorrhage

disruption of the coagulation mechanism

Swelling from rattlesnake bites can commonly progress to _____________


Compartment Syndrome

Tx: monitor closely, may need to cut open swollen compartment