Allergy Immunology1. Airway swelling, wheeze and hypotension after a sting. What is first-line drug therapy? Select TWO correct statements.Select all that apply.A. Most appropriate: Intramuscular adrenaline in the anterolateral thighB. The following is not the most appropriate next step: Oral cetirizine as the primary ABC drugC. Most appropriate: IV bolus adrenaline 1 mg by the GP as standardD. Most appropriate: Delay drugs until immunology clinic next monthCheck
Allergy Immunology2. After nut anaphylaxis, how many adrenaline autoinjectors should typically be prescribed (MHRA)? The most appropriate action is: One device is always enough national policyTRUE. TrueFALSE. FalseCheck
Allergy Immunology3. Where should an adrenaline autoinjector be taught to fire?A. Buttock as the preferred first siteB. Deltoid onlyC. Anterolateral mid-thigh (through clothing if needed per device instructions)D. Intravenous line in GPCheck
Allergy Immunology4. Chronic tiredness, no allergic history. A patient wants a 'full food IgE panel'. What is the most appropriate response?A. Do not order indiscriminate IgE panels — they generate false positivesB. IgE mix panels are first-line for fatigue (NICE)C. A positive peanut IgE without history always means lifelong avoidance after a panelD. Total IgE alone diagnoses every food allergyCheck
Allergy Immunology5. Which child food-allergy scenario most clearly needs allergy-clinic referral (NICE CG116)?A. A single mild perioral smear of tomato with no other features as mandatory tertiary careB. Anaphylaxis to food, or faltering growth with suspected food allergy, or multiple foods plus uncontrolled asthmaC. Family history of hay fever onlyD. Positive IgE to wheat in a child who eats wheat freely and is wellCheck
Allergy Immunology6. An infant has delayed vomiting and eczema flares 24 hours after cow's milk, negative specific IgE. What pattern is this?A. Impossible, because all food allergy is immediate IgEB. Mandatory adrenaline autoinjector for delayed eczema only as first-lineC. Non-IgE-mediated (delayed) food allergy — dietetic/specialist pathways, not dismissed because IgE is negativeD. Coeliac disease proven by IgECheck
Allergy Immunology7. When coding a drug allergy, what must the record capture? The most appropriate action is: Only the word 'allergy' with no detailTRUE. TrueFALSE. FalseCheck
Allergy Immunology8. A penicillin 'allergy' was GI upset only in 1999, no rash, no airway. What is the most appropriate GP action?A. Delabel as intolerance if the history is clear (NICE NG183); do not send for GP skin testingB. Keep the allergy forever because all diarrhoea is anaphylaxisC. Perform intradermal testing in the treatment room after anaphylaxis training from YouTubeD. Give an unsupervised oral challenge the same day after true anaphylaxis last yearCheck
Allergy Immunology9. The only 'allergy' is that the patient's mother had a rash on amoxicillin. What should you do? The most appropriate action is: Copy the mother's allergy into the child's record as a hard stopTRUE. TrueFALSE. FalseCheck
Allergy Immunology10. Convincing immediate urticaria and wheeze with penicillin 2 years ago. What is the most appropriate community prescribing?A. Give oral penicillin in GP to 'test'B. Delete the allergy so the computer is quieterC. Avoid penicillins; use a non-cross-reactive alternative and record the phenotype; specialist if they need a beta-lactam laterD. Skin test in GP then challenge at receptionCheck