Q1. Least correct option in management of angioedema
A 57-year-old man presents with sudden onset of lip and tongue swelling. He denies any known allergies and reports no recent food ingestion. He is taking ramipril for hypertension. On assessment:
- No urticaria
- No dyspnoea
- Normal vitals
Which of the following is the least correct management step?
Q2. Most appropriate immediate management
A 24-year-old woman is brought to the emergency department by paramedics. She developed sudden onset of throat tightness, difficulty breathing, and widespread urticaria approximately 5 minutes after eating prawns at a restaurant. She has a known shellfish allergy and carries an adrenaline auto-injector, which she did not use. On arrival, she is anxious and breathless.
Her vital signs are:
- HR: 112 bpm
- BP: 88/54 mmHg
- SpO₂: 94% on room air
- RR: 28
- Temp: 36.8°C
Airway: hoarse voice and mild stridor
Breathing: widespread wheeze
Circulation: cool peripheries, delayed capillary refill
Skin: generalised erythema and urticaria
What is the most appropriate immediate management?
Q3. Which of the following is FALSE regarding anaphylaxis
A 30-year-old man presents following a syncopal episode while dining at a restaurant. He felt light-headed, itchy, and noticed swelling of his lips and tongue after eating a dessert containing nuts.
His past history includes asthma and eczema. On examination, he is alert but hypotensive (BP 86/48 mmHg), with urticaria on the chest and neck. You suspect anaphylaxis and treat accordingly.
Regarding the diagnosis and investigation of anaphylaxis, which of the following statements is FALSE?
