مريضة بعد أكل الروبيان صار عندها صفير وتورم الشفتين وهبوط ضغط ٨٠/٥٠. ما أول دواء؟

After eating shrimp, a woman develops wheeze, lip swelling and BP 80/50. What is the first drug?

1. An oral antihistamine, then observation
2. Inhaled salbutamol alone for the wheeze
3. IV steroid alone as the starting treatment
4. Adrenaline 0.5 mg intramuscularly into the thigh

Answer: D) Adrenaline 0.5 mg intramuscularly into the thigh. Anaphylaxis is treated first with IM adrenaline into the anterolateral thigh (0.5 mg of 1 mg/mL in adults), repeated after 5 minutes if needed. Antihistamines and steroids are adjuncts, not substitutes.