A 28-year-old woman presents with recurrent episodes of hives, swelling of the lips and eyes, and difficulty breathing after eating certain foods. She has no history of infections or medications. What is the most likely diagnosis? A) Food allergy B) Drug-induced hypersensitivity C) Angioedema due to ACE inhibitors D) Urticaria due to viral infection E) Hereditary angioedema Correct Answer: A) Food allergy Explanation: Food allergies are commonly associated with hives, angioedema (swelling), and respiratory symptoms after eating certain foods (e.g., nuts, shellfish). This is a typical presentation of IgE-mediated hypersensitivity. Drug-induced hypersensitivity (B) can cause rashes and angioedema, but it typically occurs after starting a new medication and is often systemic. Angioedema due to ACE inhibitors (C) presents with swelling of the lips and face, but it is usually non-pruritic and not associated with hives or food triggers. Urticaria due to viral infection (D) can present with hives, but it is more often associated with fever and other systemic symptoms. Hereditary angioedema (E) presents with episodic angioedema but without hives or an allergic trigger, and is often triggered by stress or trauma rather than specific foods. Key Tips for PLAB 1: ✅ Recurrent hives, angioedema, and respiratory symptoms after food intake = Food allergy ✅ Management = Avoidance of triggers, antihistamines, and epinephrine for severe reactions.
