ANAPHYLAXIS

Question 1

How many % of anaphylactic episodes is uniphasic and biphasic?

Answer 1

a. 80-90% uniphasic

b. 10-20% biphasic

Question 2

Most common presentations of anaphylaxis (>90% of cases)

Answer 2

Cutaneous manifestation

Question 3

Severe hymenoptera-induced anaphylaxis can be a presenting feature of what underlying condition?

Answer 3

Systemic mastocytosis

Question 4

What is the mechanism involved when a repeated exposure to an allergen induces anaphylaxis?

Answer 4

IgE – mediated (usually with antibiotics and chemotherapy)

Question 5

Paclitaxel-induced anaphylaxis: IgE or non-IgE-mediated?

Answer 5

Non-IgE

Question 6

Radiocontrast-induced anaphylaxis: IgE or non-IgE-mediated?

Answer 6

Non-IgE

Question 7

Vancomycin-induced anaphylaxis: IgE or non-IgE-mediated?

Answer 7

Non-IgE

Question 8

Opiates-induced anaphylaxis: IgE or non-IgE-mediated?

Answer 8

Non-IgE

Question 9

NSAIDs-induced anaphylaxis: IgE or non-IgE-mediated?

Answer 9

Non-IgE

Question 10

Onset of symptoms and signs of anaphylaxis occurs within seconds to minutes after the trigger, except for:

Answer 10

Delayed anaphylaxis to meats in alpha-gal sensitized patients

Question 11

Most obvious biomarker of anaphylaxis:

Answer 11

Histamine (but with extremely short half-life)

Question 12

More practical and useful biomarker of anaphylaxis

Answer 12

Serum tryptase

Question 13

Treatment of anaphylaxis and dose:

Answer 13

Epinephrine – 0.3-0.5 mL of 1:1000 (1 mg/mL) IM with repeated doses at 5-20 min intervals as needed for a severe reaction

Question 14

Body posture that may lead to “empty heart syndrome” in anaphylaxis

Answer 14

Upright or sitting posture

Question 15

Recommended body position before receiving epinephrine in anaphylaxis

Answer 15

Supine position

Question 16

Simplest, most straightforward approach to long-term management of a patient with a history of anaphylaxis

Answer 16

Avoidance

Question 17

Study stating that early introduction of peanut protein to the diet of high-risk infants can prevent development of most (80% or more) peanut allergy

Answer 17

Learning Early About Peanut Allergy (LEAP) study

Question 18

Premedication regimens for radiocontrast allergy with doses and timing (2):

Answer 18

a. Prednisone 0.5 mg/kg at 13, 6, and 1 h prior to contrast administration
b. Diphenhydramine – 25 mg 1 h prior to contrast

Question 19

Management of flushing reactions from vancomycin (2):

Answer 19

a. Antihistamine premedication

b. Downtitrate infusion rate