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1 free EMT practice questions: Allergic Reaction & Anaphylaxis

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Question 1 of 1

A patient develops hives, facial swelling, and wheezing within minutes of a bee sting. Which of the following best explains why this presentation is recognized as anaphylaxis rather than a localized allergic reaction?

Show the answer and rationale

Correct answer · More than one body system (skin and respiratory) is involved after exposure

This patient is in anaphylaxis. Within minutes of the bee sting, the patient has hives and facial swelling in the skin and wheezing in the lungs. Anaphylaxis is an allergic reaction that involves two or more body systems after an exposure. A reaction that compromises the airway, the breathing, or the circulation on its own also counts. In anaphylaxis, mast cells release histamine and other chemicals into the bloodstream. Those chemicals do not stay at the sting site. They cause hives and swelling in the skin and tighten the airways in the lungs at the same time. That's why this patient is wheezing. A reaction in more than one system tells you to give epinephrine right away and get ready for the airway to swell. A local reaction only needs watching and an antihistamine.

Why the others are wrong

Any swelling after an insect sting is by definition anaphylaxis: A local reaction gives you redness, swelling, and itching right at the sting site, with nothing anywhere else on the body. Swelling at the sting site alone is not anaphylaxis. This patient's swelling is in the face, and the patient is also wheezing.

Wheezing alone is sufficient regardless of any other findings: Wheezing by itself can come from asthma or another breathing problem. A wheeze with nothing else does not separate anaphylaxis from asthma. This patient also has hives and facial swelling, so the wheezing is one part of a reaction in more than one system.

Anaphylaxis requires the patient to already have a known bee allergy: A known bee allergy makes you more suspicious, but anaphylaxis can happen on the first sting a person ever gets. Nothing in the question says this patient has a known allergy. The hives and the wheezing happening together are what make this anaphylaxis.

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