Urgent Care Urgent Care for Allergic Reactions and Anaphylaxis 2

Question 1

Which description best characterizes urticaria (hives)?

Accepted Answer

Raised, erythematous, pruritic wheals that blanch with pressure

Answer

Fixed violaceous plaques that do not itch

Answer

Deep subcutaneous tissue swelling without overlying skin changes

Answer

Vesicular lesions filled with clear fluid

Question 2

Angioedema most commonly involves which body areas?

Accepted Answer

Face, lips, tongue, and larynx

Answer

Extremities and trunk symmetrically

Answer

Back and chest wall only

Answer

Scalp and hair follicles

Question 3

A patient presents with generalized urticaria but no throat tightness, wheezing, or hypotension. Which treatment is most appropriate as a first step?

Accepted Answer

Oral H1 antihistamine such as cetirizine or loratadine

Answer

Epinephrine 0.3mg IM immediately

Answer

Systemic corticosteroids IV

Answer

IV fluids and hospital admission

Question 4

What is the primary mechanism of IgE-mediated anaphylaxis?

Accepted Answer

Mast cell and basophil degranulation releasing histamine and other mediators

Answer

Activation of the complement cascade

Answer

T-cell mediated cytotoxic destruction of tissue

Answer

Immune complex deposition triggering vessel inflammation

Question 5

Which vital sign finding is most immediately concerning in a patient presenting with anaphylaxis?

Accepted Answer

Blood pressure of 80/50 mmHg

Answer

Heart rate of 95 beats per minute

Answer

Temperature of 38.2°C

Answer

Respiratory rate of 18 breaths per minute

Question 6

A patient develops facial swelling, throat tightness, and hives within minutes of eating shrimp at a restaurant. What is your immediate action?

Accepted Answer

Administer epinephrine 0.3mg IM and arrange immediate transfer to the ED

Answer

Administer oral diphenhydramine 50mg and observe for 30 minutes

Answer

Apply topical hydrocortisone cream to the hives

Answer

Give oral prednisone 60mg and discharge with an EpiPen prescription

Question 7

An EpiPen auto-injector is available in which epinephrine doses?

Accepted Answer

0.15 mg (junior) or 0.3 mg (standard) depending on the formulation

Answer

1.0 mg as the standard adult dose

Answer

0.5 mg as the only available dose

Answer

0.01 mg designed for pediatric patients