Immunisation: anaphylaxis: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Immunisation: anaphylaxis

Sample item

A child develops stridor, wheeze and hypotension 10 minutes after vaccination. What is the immediate drug of choice and dose?

AHydrocortisone IV aloneBAdrenaline 0.01 mg/kg (1:1000, 0.01 ml/kg) intramuscularlyCChlorpheniramine aloneDOral prednisolone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Adrenaline 0.01 mg/kg (1:1000, 0.01 ml/kg) intramuscularly

Anaphylaxis needs immediate intramuscular adrenaline into the anterolateral thigh, repeated every 5 to 15 minutes if needed. Antihistamines and steroids are adjuncts and do not treat shock or airway oedema. Oxygen and fluids are given along with it.

Option by option

A. Hydrocortisone IV alone
Steroids act too slowly.
B. Adrenaline 0.01 mg/kg (1:1000, 0.01 ml/kg) intramuscularly (correct)
Correct. IM adrenaline is life-saving.
C. Chlorpheniramine alone
Antihistamines do not treat shock.
D. Oral prednisolone
Oral drugs are inappropriate in anaphylaxis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Adrenaline 0.01 mg/kg (1:1000, 0.01 ml/kg) intramuscularly. Anaphylaxis needs immediate intramuscular adrenaline into the anterolateral thigh, repeated every 5 to 15 minutes if needed.

Why is "Hydrocortisone IV alone" not the answer?

Steroids act too slowly.

Why is "Chlorpheniramine alone" not the answer?

Antihistamines do not treat shock.

Why is "Oral prednisolone" not the answer?

Oral drugs are inappropriate in anaphylaxis.

What concept does this question test?

It tests Immunisation: anaphylaxis in Pediatrics. Antihistamines and steroids are adjuncts and do not treat shock or airway oedema. Oxygen and fluids are given along with it.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunisation: anaphylaxis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.