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Anaphylaxis — RACP Adult Medicine MCQ

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EasyInfectious DiseasesAnaphylaxisRACP Adult Medicine

A 30-year-old woman with known peanut allergy develops urticaria, tongue swelling, wheeze, and hypotension (BP 75/40 mmHg) within 5 minutes of accidental peanut ingestion. What is the most appropriate first-line treatment?

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Correct answer: A — IM adrenaline 0.5 mg (1:1000) mid-outer thigh

Anaphylaxis with cardiovascular compromise requires immediate IM adrenaline 0.5 mg (1:1000 = 1 mg/mL) into the mid-outer thigh. This is the first-line treatment. Do not delay for other treatments. IM route is preferred over IV (safer, faster absorption from thigh). Can repeat every 5 minutes if no response. Position patient supine with legs elevated. IV adrenaline is reserved for ICU/ED with monitoring.

Reference: ASCIA – 2024 – Anaphylaxis Guidelines; eTG 2024