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Allergic urticaria — DipIMC MCQ

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ModerateMedical EmergenciesAllergic urticariaDipIMC

A 46-year-old woman has urticaria after antibiotics but no airway symptoms, no wheeze, normal voice, oxygen saturations 98% and blood pressure 128/78. What is the most appropriate drug/dose?

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

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Correct answer: B — Non-sedating antihistamine with observation and safety-netting

Isolated urticaria without airway, breathing or circulation features is an allergic reaction rather than anaphylaxis. Antihistamine and observation are appropriate while watching for progression. Adrenaline is reserved for anaphylaxis features and should not be used reflexively for every rash. The pearl is that over-treatment can also cause harm, but reassessment is crucial.

Reference: Resuscitation Council UK Anaphylaxis Guidance 2021; JRCALC Guidelines 2025