Question

. Josh is a 19-year-old man who has been rushed to your emergency room from a local Italian restaurant, where he had become acutely "ill" while eating. On arrival he is pale, cool, & clammy & has a low blood pressure. There is no medic-alert bracelet to be seen. Putting your stethoscope to his chest you find that he has wheezes throughout his lung fields but very poor air intake. A friend who is with him says this has never happened before, & to his knowledge, no one in Josh's family has ever been like this. What are your thoughts on how to proceed?

1

Answer 1

It seems to most likely be an allergic reaction, but it is hard to say for sure. If there was nothing earlier in the day or week that is cause for concern or may be symptoms of something else, then I would lean towards anaphylactic shock.

Answer 2

thanks dear. here are the questions" 1. Someone who is pale, cool, & clammy is not perfusing his peripheral tissue with blood. Explain how/why this happens in (a) trauma cases, and (b) immunological reactions in which biological vasodilators are released.

2. Explain why vasodilation is followed by sweating.

3. Shellfish & nuts are two of the most potent mediators of food allergies. However, reactions as described in this case depend on re-exposure to a previously sensitized individual. Explain.

4. Note that food allergies will often present as nausea, stomach cramps, & diarrhea. Explain.

5. How would you determine the immediate precipitant of this reaction?

6. How should Josh now be treated? Include at least two different drugs of choice during anaphylactic shock such as that being experienced by Josh.

7. Which type of hypersensitivity response is responsible for this reaction?

8. Describe the etiology of this type of a hypersensitivity response. Include in your description each of the following terms: mast cells, histamine, IgE.

9. Many allergic reactions are inconvenient but not life threatening. How do these type of allergic reactions manifest clinically?