Diagnosis of Anaphylaxis
Anaphylaxis Diagnosis: Book Excerpts
Diagnosis of Anaphylaxis: medical news summaries:
The following medical news items
are relevant to diagnosis and misdiagnosis issues for Anaphylaxis:
Diagnostic Tests for Anaphylaxis: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about diagnostis of Anaphylaxis.
HYPOTENSION AND SHOCK:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The workup of shock must be vigorous with emergency CBC, blood cultures, blood gases, ECG, electrolytes, blood urea nitrogen (BUN), and type and cross-match of blood at the same time vigorous antishock measures are applied. Checking the GI tract for blood loss with a rectal and nasogastric tube can be both diagnostic and therapeutic. To work up chronic hypotension, one should not forget venous pressure and circulation times (to diagnose decreased cardiac output and CHF), serial electrolytes and cortisol levels (to rule out adrenal insufficiency), and sedimentation rate and cultures of various body fluids to exclude a chronic infectious disease (e.g., tuberculosis).
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
Toxic shock syndrome:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Diagnosis is based on several criteria: fever, hypotension, rash that peels after 1 to 2 weeks, and at least 3 organs with signs of dysfunction. In some cases, blood cultures may be positive for S. aureus. Organs with signs of dysfunction may include:
❑GI effects, including vomiting and profuse diarrhea
❑muscular effects, with severe myalgias or a fivefold or greater increase in creatine kinase levels
❑mucous membrane effects such as frank hyperemia
❑renal involvement with elevated blood urea nitrogen or creatinine levels (at least twice the normal levels)
❑liver involvement with elevated bilirubin, aspartate aminotransferase, or alanine aminotransferase levels (at least twice the normal levels)
❑blood involvement with signs of thrombocytopenia and a platelet count of less than 100,000/µl
❑central nervous system effects such as disorientation without focal signs.
Negative results on blood tests for Rocky Mountain spotted fever, leptospirosis, and measles help rule out these disorders.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hypovolemic shock:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
No single symptom or diagnostic test establishes the diagnosis or severity of shock. Characteristic laboratory findings include:
❑ elevated potassium, serum lactate, and blood urea nitrogen levels
❑ increased urine specific gravity (more than 1.020) and urine osmolality
❑ decreased blood pH and partial pressure of arterial oxygen and increased partial pressure of arterial carbon dioxide.
In addition, gastroscopy, aspiration of gastric contents through a nasogastric tube, computed tomography scan, and X-rays identify internal bleeding sites; coagulation studies may detect coagulopathy from DIC. Echocardiography or right-heart catheterization can help differentiate between hypovolemic and cardiogenic shock.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Photosensitivity reactions:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Characteristic skin eruptions in sun-exposed areas and a patient history of recent exposure to light or certain chemicals suggest a photosensitivity reaction. A photopatch test for ultraviolet A and B (UVA and UVB) done while the patient is on the drug may aid diagnosis and identify the causative light wavelength. Other studies must rule out connective tissue disease, such as lupus erythematosus and porphyrias.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Shock:
Differential Overview
(Field Guide to Bedside Diagnosis)
Cardiogenic
❑ Anterior myocardial infarction
❑ Arrhythmia
❑ Dilated cardiomyopathy
❑ Aortic stenosis
❑ Acute mitral regurgitation
Obstructive
❑ Massive pulmonary embolism
❑ Pericardial tamponade
❑ Constrictive pericarditis
❑ Tension pneumothorax
Hypovolemic
❑ Hemorrhage
❑ Fluid depletion
Distributive
❑ Sepsis
❑ Anaphylaxis
❑ Adrenal insufficiency
❑ Neurogenic
Diagnostic Approach
A patient in shock will lie still, paying little attention to events around him. If agitated, he will answer in a weak voice. The pupils are dilated and react slowly to light. The coloration is gray and pale, with marbling of the skin on the back or the hands and legs, and cyanosis of the lips. The pulse is rapid and thready; temperature and blood pressure are low. Emergence of these findings corresponds to a 20% to 25% reduction in volume in low preload shock, a fall in the cardiac index to below 2.5 L/min/M 2 or activation of mediators of the sepsis syndrome.
Clues to the underlying cause should be carefully searched for on physical examination. HEENT exam may reveal dilated or pinpoint pupils, dry conjunctivae, or scleral icterus. In the neck, jugular venous distension, delayed carotid upstroke, carotid bruits, or meningeal signs may be observed. Lung exam may show tachypnea, shallow breaths, rales, unilateral tympany or absent breath sounds. The cardiovascular exam may reveal tachycardia, bradycardia, irregular rhythm, S3 gallop, right or left ventricular heave, murmurs, distant heart sounds, pulsus paradoxus, or rub. On abdominal exam, tenderness, guarding or rebound, high-pitched or absent bowel sounds, distension, pulsatile mass, hepatosplenomegaly, or ascites may be found. Rectal exam can reveal evidence of bleeding (occult positive, melena, or bright red blood) or decreased tone. The extremities can show a swollen calf or unequal pulses or blood pressures between the arms. Neurologic exam could exhibit agitation, confusion, delirium, obtundation, or coma. Finally, skin exam can reveal cool and clammy skin, warm and hyperemic skin, rashes, petechiae, urticaria, or cellulitis.
Prognosis in cardiogenic shock can be accurately stratified by Killip class, using observable clinical criteria:
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
anaphylaxis:
Diagnosis
(Handbook of Diseases)
Anaphylaxis can be diagnosed by the rapid onset of severe respiratory or cardiovascular symptoms after ingestion or injection of a drug, vaccine, diagnostic agent, food, or food additive or after an insect sting. If these symptoms occur without a known allergic stimulus, rule out other possible causes of shock (such as acute myocardial infarction, status asthmaticus, and heart failure).
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Toxic shock syndrome:
Diagnosis
(Handbook of Diseases)
A diagnosis of TSS is based on clinical findings and the presence of at least three of the following:
❑ GI effects, including vomiting and profuse diarrhea
❑ muscular effects, with severe myalgias or a fivefold or greater increase in creatine kinase
❑ mucous membrane effects such as frank hyperemia
❑ renal involvement with elevated blood urea nitrogen or creatinine levels (at least twice the normal levels)
❑ liver involvement with elevated bilirubin, alanine aminotransferase, or aspartate aminotransferase levels (at least twice the normal levels)
❑ blood involvement with signs of thrombocytopenia and a platelet count < 100,000/µl
❑ central nervous system effects such as disorientation without focal signs.
In addition, isolation of S. aureus from vaginal discharge or lesions helps support the diagnosis. Negative results on blood tests for Rocky Mountain spotted fever, leptospirosis, and measles help rule out these disorders.
>
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hypovolemic shock:
Diagnosis
(Handbook of Diseases)
No single symptom or diagnostic test establishes the diagnosis or severity of shock. Characteristic laboratory findings include:
❑ elevated potassium, serum lactate, and blood urea nitrogen levels
❑ increased urine specific gravity (greater than 1.020) and urine osmolality
❑ decreased blood pH and partial pressure of arterial oxygen and increased partial pressure of arterial carbon dioxide.
In addition, gastroscopy, aspiration of gastric contents through a nasogastric tube, and X-rays identify internal bleeding sites; coagulation studies may detect coagulopathy from DIC.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Electric shock:
Diagnosis
(Handbook of Diseases)
Usually, the cause of electrical injuries is either obvious or suspected. An accurate history can define the voltage and length of contact.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Cardiogenic shock:
Diagnosis
(Handbook of Diseases)
❑ Auscultation detects gallop rhythm, faint heart sounds and, possibly, if the shock results from rupture of the ventricular septum or papillary muscles, a holosystolic murmur.
❑ Pulmonary artery pressure monitoring reveals increased pulmonary artery pressure (PAP) and increased pulmonary artery wedge pressure (PAWP), reflecting a rise in left ventricular end-diastolic pressure (preload) and increased resistance to left ventricular emptying (afterload) resulting from ineffective pumping and increased peripheral vascular resistance. Thermodilution technique measures decreased cardiac output.
❑ Invasive arterial pressure monitoring shows hypotension from impaired ventricular ejection.
❑ Arterial blood gas (ABG) levels may show metabolic acidosis and hypoxia.
❑ Electrocardiography may reveal evidence of an AMI, myocardial ischemia, or ventricular aneurysm.
❑ Enzyme levels show elevated creatine kinase (CK-MB, troponin T, or troponin I), lactate dehydrogenase (LD), aspartate aminotransferase, and alanine aminotransferase, which point to an MI or myocardial ischemia and suggest heart failure or shock. CK-MB and LD isoenzyme levels may confirm an AMI.
❑ Echocardiography (color-flow Doppler) shows left ventricular function, valvular disease, aneurysmal dilation, and ventricular septal defects.
Additional tests help identify other conditions that can lead to pump dysfunction and failure, such as cardiac arrhythmias, cardiac tamponade, papillary muscle infarct or rupture, ventricular septal rupture, pulmonary embolus, venous pooling (associated with venodilators and continuous intermittent positive-pressure breathing), and hypovolemia.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
HYPOTENSION AND SHOCK:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The workup of shock must be vigorous with emergency CBC, blood
cultures, blood gases, ECG, electrolytes, blood urea nitrogen (BUN), and
type- and cross-match of blood at the same time that vigorous antishock
measures are applied. Checking the GI tract for blood loss with a rectal and
nasogastric tube can be both diagnostic and therapeutic. To work up chronic
hypotension, one should not forget venous pressure and circulation times (to
diagnose decreased cardiac output and CHF), serial electrolytes and cortisol
levels (to rule out adrenal insufficiency), and sedimentation rate and
cultures of various body fluids (to exclude a chronic infectious disease
[e.g., TB]).
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
Anaphylaxis:
Anaphylaxis - DIAGNOSIS
(The 5-Minute Pediatric Consult)
Decide quickly whether the symptoms the patient is experiencing are consistent with anaphylaxis.
- Phase 1: Initiate therapy for anaphylaxis. This generally includes epinephrine 1:1,000 administered SQ, H1 antihistamines, H2 antihistamines, and rapid volume expansion if necessary.
- Phase 2: Attempt to identify the agent that induced the anaphylactic reaction.
» READ BOOK EXCERPT ONLINE »
Source: The 5-Minute Pediatric Consult, 2008
What is an allergy and what is it that causes some people to suffer from them? Why do allergies flare up during certain times of the year? Learn...
Allergies can leave children feeling sniffly, teary and itchy and take their toll at play and at school. Previously, allergy remedies left children...
When you have watery eyes, a runny nose, congestion and sneezing, how can you tell if it's a cold or an allergy? Find out the difference and the...
Immunotherapy is one of the most effective treatments available to allergy sufferers. Learn how allergy shots work and who should and should not get...
See full list of 8 related videos
» Next page: Signs of Anaphylaxis
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
