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Anaphylaxis — SCE Acute Medicine MCQ

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ModerateAcute Rheumatological and Dermatological EmergenciesAnaphylaxisSCE Acute Medicine

A 63-year-old man presents with rash, allergic features, visual symptoms or systemic inflammation. Relevant history includes recent drug exposure, autoimmune disease or allergen exposure. On assessment, skin, mucosal or vascular findings suggest systemic disease. Investigations show wheeze, stridor, urticaria and shock after antibiotic exposure. What is the most important immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Give intramuscular adrenaline 500 micrograms

The key discriminator is that wheeze, stridor, urticaria and shock after antibiotic exposure, which makes Give intramuscular adrenaline 500 micrograms the single best answer. Perform synchronised cardioversion is less appropriate because it does not address the dominant acute risk in the vignette; Call for urgent surgical source control would fit a different presentation or later stage of care. Protect the airway and support ventilation and Give hypertonic saline bolus are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: Resuscitation Council UK anaphylaxis guideline