Question 9

Describe the immunology and drug treatment of anaphylaxis.

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College Answer

It was expected candidates would detail the process of IgE mediated type I hypersensitivity 
reaction with some discussion of the mediators (Histamine / tryptase and others) and their
consequences. Some detail describing time frame of response and the pre-exposure to 
Antigen (or a similar Antigen) was expected. Drug treatments would include oxygen and fluids 
as well as more specific agents such as adrenaline and steroids. Adrenaline is the mainstay of 
therapy and some comment on its haemodynamic role and prevention of ongoing mast cell 
degranulation was required. 
Better answers noted steroids take time to work and some also discussed the role of histamine 
blocking agents.