Internal Medicine

P1: SBT

0521779407-03 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 19:6

120 Anaphylaxis

Anaphylaxis........................................

PAMELA DAFFERN, MD

history & physical

History

■Antigen or substance exposure immediately before the event

➣Antibiotics

➣Medications: insulin, progesterone, protamine, anesthetics

➣Vaccines

➣Latex

➣Blood components or biological products

➣Insect stings

➣Exercise

➣Foods: shellfish, peanuts, fish, nuts

Signs & Symptoms

■Urticaria

■Angioedema

■Flushing

■Pruritus

■Sense of impending doom

■Difficulty swallowing

■Hoarseness

■Inspiratory stridor

■Wheezing

■Chest tightness

■Dyspnea

■Hypotension

■Arrhythmias

■Shock

■Seizures

■Nausea

■Abdominal cramping

■Palpitations

■Lightheadedness

tests

Lab Tests

■Serum tryptase levels obtained w/in 2 hours of an event are elevated

in anaphylaxis but not in other causes of shock or respiratory emer-

gencies