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In anaphylatic shock, what 3 Tx are given and their mechanisms?
- Antihistamine - histamines in anaphylaxis causes vasodilatation
- Adrenaline - vasoconstrictor effect
- Glucocorticoids - increases heart strength, stabilises lysosomes in cells (prevent enzyme release), aid in glucose metabolism of damaged cells
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Describe the pathogenesis of anaphylatic shock.
- Type I hypersensitivity response
- Immunogens (antigen + protein) stimulate CD4+ T cells of TH2 type
- Cytokine release (IgE and eiosinophils production)
- Histamines causing vasodilatation, bronchospasms, mucus
- Other mediators - leukotrienes, prostaglandin, mast cells
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What are the common allergic and non-allergic causes of anaphylaxis? Give 2 examples.
Allergic (fast, igE-activation) e.g. antibiotics, NSAIDS, insect bites, latex
Non-allergic (slow,longer, mast cell degranuation) e.g. heparin, radiological contrasts, exercise
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Name the 6 types of shock.
- CHONAS:
- Cardiogenic
- Hypovolaemic
- Obstructive
- Neurogenic
- Anaphylatic
- Septic
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Name 6 organs affected by shock and which ones are irreversible damages?
- Kidney
- GIT - haemorrhagic gastroenterpathy
- Lungs - ARDS
- Liver - central tubular necrosis
- Brain (irreversible) -infarction, hypoxic encephalopathy
- Heart (irreversible) -MI
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Name 3 sources of specimens to collectedfrom a case of suspected septic shock.
- IV line culture e.g. catheter
- Blood culture
- Urine culture + analysis
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What empirical therapy would you recommend in a pt with suspected septic shock w/o infection source?
Di/flucloxacillin + Gentamycin
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