Day 4 Int Med (4 course) Emergencies in allergology (acute generalized urticaria / Quincke's edema, anaphylactic shock)

A 18 year-old atopic man with recurrent urticaria and collapse during or shortly after physical activity correlates the symptoms to the consumption of pizza with tomatoes, cheese, ham and mushrooms (button mushrooms). Usually he tolerates pizzas of the same brand without any symptoms. Which is the most likely diagnosis for this patient?

A 19-years old boy is looking for you help as he suffers from urticaria since more than a years. He reports that the wheals and flares are persisting long. Marking the lesions with a pen, in fact the wheals do not move within 24 hours. The most likely diagnosis in this patient is

A 22 year old woman was referred to the clinic with a history of three episodes of lip swellings for the last year. There is no obvious trigger for her swellings. The swellings lasted for 2-4 days. She was not on any regular medications apart from oral combined contraceptive for the last year. Her mother had recurrent angioedema since puberty. On examination, she had normal concentration and normal functional activity of C1 inhibitor (C1-INH). Allergy screening tests were not revealing any IgEmediated sensitization. Which is the probable diagnosis in this patient?

A 29 years old female patient is stung by an unknown insect and reacts with asthma and urticaria. Allergolgoic work up reveals both, intradermal tests and specific IGE against honey bee and wasp strongly positive. What is/are the main cause(s) of in vitro double-positivity to honeybee and vespula venoms (specific IgE to both honeybee and Vespula venoms)?

What is the most common cause of chronic hives?

What medications are usually used as the first choice for treatment of hives?

What can individuals with chronic hives expect?

Symptoms of anaphylaxis can occur:

An anaphylactic reaction can be as simple as developing a rash after exposure to an allergen.

Anaphylaxis can occur from eating common foods such as milk, eggs or shellfish.

Which of these are not likely to cause anaphylaxis:

If you had a mild allergic reaction to an allergen in the past, then you are not at risk for a life-threatening reaction in the future.

Epinephrine should be given early in symptoms of anaphylaxis.

Epinephrine should be injected into the:

Antihistamines and corticosteroids are good substitutes for epinephrine in treating anaphylaxis.