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Deep vein thrombosis — MCCQE Part 1 MCQ

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EasyEdemaDeep vein thrombosisMCCQE Part 1

A 29-year-old woman with confirmed C1-inhibitor-deficient hereditary angioedema develops progressive tongue and throat swelling after dental work. She has no urticaria, wheeze or hypotension. What is the most appropriate immediate management?

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Correct answer: D — Give on-demand C1-inhibitor or icatibant now and secure expert airway care early

Known C1-inhibitor-deficient hereditary angioedema with progressive tongue and throat swelling is a bradykinin-mediated upper-airway emergency. Give effective on-demand therapy immediately, using an available C1-inhibitor product or icatibant according to the patient's plan and local formulary, while arranging monitored expert airway management. Progressive laryngeal involvement may require early intubation or a surgical airway even after medication is given. Antihistamines, corticosteroids and epinephrine are central to mast-cell-mediated anaphylaxis but do not reliably stop HAE; if the mechanism is uncertain or anaphylaxis coexists, treat that possibility concurrently. Tranexamic acid is too slow and is not sole rescue therapy. Repeat complement testing must not delay treatment of a previously confirmed, potentially fatal attack.

Reference: 2025 International/Canadian HAE Guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC13123228/ ; WAO/EAACI HAE Guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC9023902/