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NBME 19 Answers

nbme19/Block 3/Question#46 (reveal difficulty score)
52 yo man, sudden onset of substernal chest pain
Histamine ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1780)
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Many opioids (like morphine) are potent histamine releasers, which can cause puritis and anaphylactoid reactions (such as seen in this patient with the facial flushing, drop in blood pressure and corresponding increase in heart rate). Puritis is actually a common side effect of morphine.

Source: First Aid and

https://www.ncbi.nlm.nih.gov/pubmed/22417016

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solidshake  Opioids (morphine), radio contrasts, some antibiotics (vancomycin), and several other medications can trigger IgE independent mast cell degranulation. (Uworld Qid# 11852) +1



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