A 12-year-old boy with a history of eczema and asthma suddenly experiences breathlessness, nausea, and swelling of the face after eating a chicken skewer at a party. A 999 call is made, and his friends report that his skin is covered in raised red bumps and his lips are turning blue. What is the most appropriate immediate management for this patient?
A 23-year-old woman comes to her doctor after finishing her hepatitis B vaccination series and wants to verify her immunity status. What is the best test to confirm her status?
A 78-year-old woman presents to her general practitioner with a painless lump in her groin that she noticed 2 weeks ago. The lump has grown slightly since she first noticed it. On examination, a hard lump is palpable on her left labia majora and she has left inguinal lymphadenopathy. She has no significant past medical history and no known allergies.
What is the most probable diagnosis?
What is the frequency of the cervical cancer screening program in England for women over 50 years old?
A 32-year-old man experiences severe facial and tongue swelling following administration of the Japanese encephalitis vaccine. He receives 500mcg of intramuscular adrenaline immediately and is placed in a supine position with elevated legs while receiving high-flow oxygen. Despite the initial dose of adrenaline, his facial swelling persists and his blood pressure drops to 82/54 mmHg. How long should the healthcare provider wait before administering a second dose of adrenaline?
A 19-year-old young woman is enjoying a meal at a Chinese restaurant to celebrate her birthday. Despite having a nut allergy, the restaurant has taken precautions to ensure her safety. However, while trying a friend’s chicken dish, she unknowingly ingested peanuts and experiences a severe allergic reaction, including difficulty breathing and facial swelling. Thankfully, her friend has an EpiPen® and administers it before calling for an ambulance. Although her symptoms improve, she remains unwell and struggling to breathe. Her friend remembers that a second EpiPen® can be used if necessary. When is it appropriate to administer the second dose of adrenaline?
A 48-year-old man presents to the emergency department with his spouse. He is experiencing significant swelling of his tongue and lips, rendering him unable to speak. His wife reports that his symptoms have worsened during their wait, and she is unsure of the cause as he has no known allergies. However, she does mention that he was recently prescribed a new medication by his primary care physician.
Which of the following medications is the most probable culprit?
You are summoned to the examination room of a pediatric clinic as a 15-month-old girl has developed a rash and difficulty breathing after receiving a routine vaccination. Upon assessment, she is exhibiting swelling in the mouth and neck area. What is the best initial course of action?
A 20-year-old man is brought to the emergency department after experiencing a possible allergic reaction to seafood he ate at a restaurant. He administered his adrenaline autoinjector and received an additional dose of intramuscular adrenaline from the paramedics.
Upon examination, his temperature is 37.8ºC, heart rate is 130 beats/min, and blood pressure is 88/50 mmHg. He has a respiratory rate of 30 breaths/min and oxygen saturation of 93% on room air.
What is the next course of action in managing this patient?
A 25-year-old man presents to the emergency department after consuming a cake containing hazelnut chocolate spread. He has a known allergy to tree nuts and has previously been hospitalized due to an anaphylactic reaction.
Upon examination, he displays a widespread, confluent erythematous urticarial rash at flexor sites. He is speaking in full sentences and has no signs of oral or peri-oral edema. There is no audible wheeze.
His vital signs indicate a respiratory rate of 22 breaths/min, 98% oxygen saturation in room air, a heart rate of 115 beats/min, and a blood pressure of 97/68 mmHg.
What is the most appropriate initial management for this patient?