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Kaplan Qbank USMLE



Author7 Posts
  #1

15 year old boy stung by bee, respiratory difficulties wheeze, tachycardia, and urticaria, dyspnoea, swollen lips. What is the MOST EFFECTIVE initial treatment?

A. Adrenaline iv
B. Hydrocortisone iv
C. Antihistamines iv

  #2

A...

  #3

A...

  #4

yep A

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  #5

why not c ?

  #6

A... coz of immediate action. Anti-H will only oppose new Histamine... you have also got to reverse effect of the H that already have acted on receptors. So Epi will do that.

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  #7

The answer is A
The first line therapy in anaphylaxis, after removal of the allergen, is as any emergency; basic life support, centred on airway, breathing and circulation. In addition to this intravenous fluid support is needed, and 100% oxygen.

Further measures are as follows:
Adrenaline.
Chlorpheniramine.
Hydrocortisone.
IV aminophylline or nebulised salbutamol/terbutaline if the patient is wheezy.

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