Angioedema Airway Risk — MFDS Part 1 MCQ

Correct answer: D — The oedema can progress and compromise the upper airway

The correct answer is D. Angioedema involving the tongue and floor of the mouth can enlarge rapidly, narrow the upper airway and progress to complete obstruction. Ramipril suggests ACE-inhibitor-associated angioedema, which may be bradykinin-mediated. The absence of urticaria or wheeze therefore does not make the condition safe or exclude a medication-related cause. Bradykinin-mediated angioedema is not necessarily anaphylaxis and is unlikely to respond to adrenaline, although airway assessment and emergency escalation remain essential. Major oral haemorrhage, permanent hypoglossal nerve injury and acute sepsis from routine salivary duct obstruction are not characteristic immediate consequences. Option B is incorrect because clinically dangerous airway angioedema can occur without the other features of anaphylaxis.

Reference: Medicines and Healthcare products Regulatory Agency. ACE-inhibitors: Be aware of the distinction between bradykinin- and histamine-mediated angioedema, as treatment strategies differ significantly. Drug Safety Update, 16 June 2026. https://www.gov.uk/drug-safety-update/ace-inhibitors-be-aware-of-the-distinction-between-bradykinin-and-histamine-mediated-angioedema-as-treatment-strategies-differ-significantly