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Insect sting — local reaction — MCCQE Part 1 MCQ

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EasyAllergic ReactionInsect sting — local reactionMCCQE Part 1

A 45-year-old man is stung by a bee and develops only localised swelling at the sting site, no systemic symptoms. He asks about future risk. Most appropriate advice?

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Correct answer: E — Large local reactions rarely progress to anaphylaxis; prescribe antihistamines, no EpiPen needed

Large local reaction (swelling >10cm): ~5-10% risk of future systemic reaction (lower than commonly feared). No EpiPen needed. Venom immunotherapy reserved for prior systemic reactions. If systemic reaction occurs, then EpiPen + allergy referral.

Reference: CSACI Insect Sting Allergy Guidelines