مريضة بأنيميا نقص الحديد لم تتحمل الحبوب، وتأخذ أول جرعة حديد وريدي. بعد ٥ دقائق صار عندها حكة وضيق نفس وأزيز، والضغط نزل إلى ٨٤/٥٠. ما أول إجراء؟

A woman intolerant of oral iron receives her first IV iron dose. After 5 minutes she has itch, breathlessness and wheeze, and BP falls to 84/50. What is the first action?

1. Reassure her it is normal anxiety
2. Stop the infusion and treat anaphylaxis
3. Halve the infusion rate
4. Finish the dose with an antipyretic

Answer: B) Stop the infusion and treat anaphylaxis. IV iron rarely causes anaphylaxis; stop immediately and give IM adrenaline, oxygen and fluids per protocol, which is why patients are observed during and after.