Anaphylaxis and Allergic Reactions Practice Questions
21 free Anaphylaxis and Allergic Reactions practice questions for the CDA. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
Which drug is considered the first-line treatment for suspected anaphylaxis in a dental office setting?
- A Diphenhydramine, an oral or injectable antihistamine
- B Aspirin taken orally by the patient
- C Epinephrine given intramuscularly
- D An oral corticosteroid tablet swallowed by the patient
Correct answer: Epinephrine given intramuscularly
Epinephrine is the first-line drug for anaphylaxis; it rapidly counteracts airway edema, vasodilation and bronchospasm and should be given intramuscularly as soon as anaphylaxis is suspected.
Where is the recommended site for intramuscular epinephrine injection in an adult experiencing anaphylaxis?
- A The deltoid muscle of the upper arm near the shoulder
- B The mid-anterolateral thigh (vastus lateralis)
- C The gluteal muscle of the buttock, injected deeply
- D The subcutaneous tissue of the anterior abdominal wall
Correct answer: The mid-anterolateral thigh (vastus lateralis)
The mid-anterolateral thigh (vastus lateralis) is recommended for IM epinephrine administration because it ensures rapid absorption and onset of action.
Upon recognition of anaphylaxis in a dental clinic patient, what is the first step after suspecting the reaction?
- A Give the patient an oral antihistamine tablet without delay
- B Immediately administer supplemental oxygen and nothing else
- C Remove the trigger, call EMS, and give epinephrine
- D Wait and observe to see whether the symptoms worsen further
Correct answer: Remove the trigger, call EMS, and give epinephrine
Once anaphylaxis is suspected, the trigger should be removed if possible, EMS called immediately, and epinephrine administered — delay increases risk of deterioration.
Which of these signs would most strongly suggest anaphylaxis rather than a mild allergic reaction in a dental patient?
- A Mild localized itching without any other accompanying symptoms
- B An isolated rash confined only to the backs of both hands
- C Wheezing, throat tightness, hypotension or breathing difficulty
- D Slight redness limited to the local anesthetic injection site only
Correct answer: Wheezing, throat tightness, hypotension or breathing difficulty
Anaphylaxis involves life-threatening airway, breathing or circulatory compromise — symptoms like wheezing, throat tightness, hypotension or breathing difficulty signal severe reaction requiring immediate action.
If the first dose of epinephrine does not reverse anaphylaxis symptoms in a dental office, what is the recommended next action?
- A Give an antihistamine and then wait a full 30 minutes for a response
- B Administer a second IM dose of epinephrine after 5 to 15 minutes
- C Begin chest compressions immediately even though the patient is conscious
- D Switch to oral corticosteroids as the mainstay of continued treatment
Correct answer: Administer a second IM dose of epinephrine after 5 to 15 minutes
If symptoms persist, a second IM dose of epinephrine may be given after 5–15 minutes — repeated dosing is often needed, especially in biphasic or persistent reactions.
Why is intramuscular epinephrine preferred over subcutaneous or intravenous administration in initial management of anaphylaxis in dental clinics without IV access?
- A Because an IM injection is generally less painful than a subcutaneous one
- B IM into the thigh absorbs faster than subcutaneous; IV needs trained staff
- C Because the subcutaneous dose required would be far too high for most adults
- D Because intravenous epinephrine is entirely ineffective against anaphylaxis
Correct answer: IM into the thigh absorbs faster than subcutaneous; IV needs trained staff
IM epinephrine (in the thigh) is absorbed quickly and reliably; subcutaneous absorption may be delayed, and IV epinephrine requires advanced skills and is not first-choice outside hospital settings.
Which of the following should be available in every dental office's emergency kit to manage anaphylaxis according to standard guidelines?
- A Broad-spectrum antibiotics along with several topical steroid creams
- B Epinephrine (ampoules or auto-injector) and oxygen supply
- C Only a supply of oral and injectable antihistamine preparations
- D Only a range of oral analgesic and anti-inflammatory tablets
Correct answer: Epinephrine (ampoules or auto-injector) and oxygen supply
Dental emergency kits should include epinephrine (ampoule or auto-injector) and oxygen supply (with mask or bag-valve-mask) to manage anaphylaxis and support airway, breathing and circulation.
Which of the following reactions during or after dental treatment could precipitate anaphylaxis in susceptible individuals?
- A Use of latex gloves, local anesthetics or antibiotics
- B Slow drilling of the tooth performed entirely without any pain
- C Polishing the teeth using nothing more than a plain pumice paste
- D Use of impression materials specifically chosen to be non-allergenic
Correct answer: Use of latex gloves, local anesthetics or antibiotics
Agents such as latex, local anesthetics or antibiotics are common triggers of hypersensitivity and can precipitate anaphylaxis in susceptible individuals during dental procedures.
In addition to drug therapy, which supportive measure should be initiated immediately in a dental patient suspected of anaphylaxis?
- A Keep the patient upright and walking around to maintain their circulation
- B Lay the patient flat with legs elevated and give high-flow oxygen
- C Offer the patient a glass of water and wait for symptoms to settle
- D Begin a dental procedure to distract the patient from their symptoms
Correct answer: Lay the patient flat with legs elevated and give high-flow oxygen
Laying the patient flat, elevating legs (if not contraindicated), and providing oxygen supports circulation and oxygenation while epinephrine and further treatment are administered.
After stabilizing an anaphylactic reaction in the dental office, what is the next crucial step before ending emergency care?
- A Send the patient home right away if the symptoms appear to improve
- B Observe the patient and arrange hospital transfer for 4 to 6 hours
- C Give only oral antihistamines and then discharge the patient home
- D Resume the dental procedure now that the patient has been stabilized
Correct answer: Observe the patient and arrange hospital transfer for 4 to 6 hours
Even after stabilization, patients should be transported to hospital for observation because of risk of biphasic reactions or delayed recurrence of symptoms.
Which ratio of oxygen flow is generally recommended for a patient receiving oxygen via full-face mask during an allergic reaction in a dental office?
- A 2 to 3 L/min delivered through a simple nasal cannula
- B 4 to 6 L/min through a standard simple face mask
- C 10-15 L/min with bag-valve-mask if apneic
- D No supplemental oxygen at all, as it is not required here
Correct answer: 10-15 L/min with bag-valve-mask if apneic
When a patient is apneic or in respiratory distress, oxygen via bag-valve-mask at 10–15 L/min is recommended; otherwise supplemental oxygen should still be administered.
Which statement about antihistamines and corticosteroids in management of anaphylaxis in dental office is correct?
- A They are first-line agents that can fully replace epinephrine
- B They are optional adjuncts; epinephrine stays first-line and must not be delayed
- C They should always be administered to the patient before any dose of epinephrine is given
- D They are never used at all in the setting of dental emergencies
Correct answer: They are optional adjuncts; epinephrine stays first-line and must not be delayed
Antihistamines or steroids may help with some symptoms or prevent delayed reactions, but they are secondary; epinephrine must be given first without delay.
Which one of the following is a sign of circulatory compromise in anaphylaxis that necessitates immediate epinephrine administration in dental setting?
- A Localized itching only on hands
- B Severe hypotension or sudden collapse
- C Mild rash on arms
- D Slight dizziness that resolves quickly
Correct answer: Severe hypotension or sudden collapse
Severe hypotension or collapse indicates circulatory shock — a life-threatening manifestation of anaphylaxis requiring immediate epinephrine and emergency care.
Why is rapid administration of epinephrine critical in anaphylactic reactions in dental practice?
- A Because a single dose of epinephrine cures the patient's allergies forever
- B Because delay increases risk of fatal anaphylaxis or biphasic reaction
- C Because every other available drug is completely ineffective in anaphylaxis
- D Because it reliably prevents all of the patient's future allergic reactions
Correct answer: Because delay increases risk of fatal anaphylaxis or biphasic reaction
Delayed epinephrine administration is associated with increased morbidity and risk of fatal or biphasic reactions; early epinephrine improves outcomes.
What is a key reason for maintaining two doses of epinephrine (e.g. two auto-injectors) in a dental emergency kit for allergic reactions?
- A Because one auto-injector is reserved solely for treating asthma attacks
- B About one third of cases need a second dose (poor response or biphasic reaction)
- C Because the second injector serves only as a backup for controlling pain
- D Because the very first dose of epinephrine is nearly always completely ineffective
Correct answer: About one third of cases need a second dose (poor response or biphasic reaction)
Studies show that many anaphylaxis cases may need a second dose — and biphasic reactions can occur — so having two doses ensures readiness for recurring or persistent symptoms.
Which of the following patient history details is most relevant to assess before dental procedures to reduce risk of anaphylactic reaction?
- A The patient's personal dietary preferences and daily eating habits
- B Known allergies (latex, anesthetics, antibiotics) and past reactions
- C The patient's complete history of previous dental cavities and fillings
- D How frequently the patient tends to schedule routine dental visits
Correct answer: Known allergies (latex, anesthetics, antibiotics) and past reactions
Identifying known allergies (to latex, anesthetics, antibiotics, etc.) and prior allergic reactions helps anticipate and avoid triggers, reducing risk of anaphylaxis during dental procedures.
If a dental patient develops facial or tongue swelling and difficulty breathing immediately after receiving local anesthesia, what should the dental team suspect and what is the first-aid action?
- A Simple dental anxiety, so the team should just calmly reassure the patient
- B A delayed allergic reaction, so give an antihistamine and send home
- C Possible anaphylaxis: stop, call EMS, give IM epinephrine and oxygen
- D Hypoglycemia, so the team should give the patient a sugary drink
Correct answer: Possible anaphylaxis: stop, call EMS, give IM epinephrine and oxygen
Facial or tongue swelling with respiratory distress shortly after anesthetic points to possible anaphylaxis. Immediate cessation of treatment, EMS call, IM epinephrine and oxygen are indicated.
What is the recommended patient position during initial management of anaphylaxis in a dental office (if no contraindication)?
- A Seated fully upright in the chair to help the patient's breathing
- B Supine with the legs elevated, if tolerated and not vomiting
- C Standing up on their feet to reduce the risk of aspiration
- D Dental chair fully reclined with the patient's head positioned down
Correct answer: Supine with the legs elevated, if tolerated and not vomiting
In anaphylaxis with hypotension or collapse, lying patient supine with legs elevated helps maintain perfusion; standing or upright may worsen circulatory compromise.
After administering epinephrine for anaphylaxis in the dental office, what should be done with the auto-injector or ampoule given to the patient?
- A Discard it immediately into the nearest sharps or waste container
- B Record its use and hand it to EMS or hospital staff
- C Set it aside to reuse on another patient if no reaction occurs
- D Flush the used auto-injector or ampoule down the operatory sink
Correct answer: Record its use and hand it to EMS or hospital staff
The used auto-injector or ampoule should be retained and handed to EMS to inform hospital staff of what was administered — important for ongoing care and medical history.
Which of the following ancillary medications may be included in a dental office emergency kit for mild allergic reactions or after stabilization of anaphylaxis?
- A Oral broad-spectrum antibiotics for post-procedure infection cover
- B Diphenhydramine, an antihistamine
- C Sub-lingual nitroglycerin tablets or metered spray for chest pain
- D Oral glucose gel or tablets kept for hypoglycemic episodes
Correct answer: Diphenhydramine, an antihistamine
Diphenhydramine may be used as adjunct therapy for mild allergic symptoms or post-exposure, although it is not a substitute for epinephrine.
Why must all dental staff be trained and familiar with anaphylaxis recognition and management, even if such events are rare?
- A Because such training is legally required only for dentists, not other staff
- B Because dental materials and drugs essentially never cause allergic reactions
- C Because onset can be sudden and prompt treatment can be lifesaving
- D Because the office's malpractice insurer is the only party demanding it
Correct answer: Because onset can be sudden and prompt treatment can be lifesaving
Anaphylaxis may occur unexpectedly due to anesthetics, latex, antibiotics, or antiseptics. Immediate recognition and prompt management by any available staff can save lives — hence whole-team training is essential.