Anaphylaxis — RACP Adult Medicine MCQ

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EasyEmergency MedicineAnaphylaxisRACP Adult Medicine

A 22-year-old woman presents with acute shortness of breath, lip swelling, urticaria, and wheeze 5 minutes after eating a prawn dish. Her BP is 82/50 mmHg. What is the first-line treatment?

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Correct answer: B — IM adrenaline 0.5 mg (1:1000)

IM adrenaline (0.5 mg of 1:1000 [1 mg/mL] for adults) into the anterolateral thigh is the first-line treatment for anaphylaxis. It should be administered immediately and can be repeated every 5 minutes if no improvement. IV adrenaline is reserved for refractory cases and should be given as a dilute infusion in a monitored setting. Corticosteroids and antihistamines are adjunctive and should NOT delay adrenaline.

Reference: ASCIA – 2024 – Anaphylaxis Guidelines; eTG – 2025 – Immunology