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NBME 19 Answers

nbme19/Block 3/Question#46 (5.3 difficulty score)
52 yo man, sudden onset of substernal chest pain
Histamine🔍
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submitted by cassdawg(546),

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