Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anaphylaxis, treatment basics, the primary importance of epinephrine, and the utility of adjunctive therapies. Also included are great tips on counseling patients about auto-injectable epinephrine, and a reminder not to panic...even when you inject your own thumb?! ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Full show notes available at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Writer (interview, show notes & CME questions) and cover art: Emi Okamoto MD Infographic by: Emi Okamoto MD Hosts: Matthew Watto MD, FACP; Stuart Brigham MD Editors: Matthew Watto MD, FACP Guest: Olajumoke Fadugba MD Special thanks to Sarah Phoebe Roberts MPH for booking! Time Stamps 00:00 Intro and disclaimer 03:00 Guest one-liner, book recommendation, advice to fellows and trainees 07:15 Case of anaphylaxis with mucocutaneous and GI symptoms 09:05 Anaphylaxis (IgE mediated mast cell action) vs anaphylactoid (non-IgE mediated mast cell activation; e.g. contrast allergy, vancomycin) 12:34 Vancomycin and non-IgE mediated reactions 14:40 Common presentations of anaphylaxis and the three diagnostic criteria 22:09 Biphasic reactions and predicting severity 26:42 Counseling patients on the use of epinephrine 28:35 Stuart’s thumb question 30:00 Adjuvant medications: antihistamines and corticosteroids 33:20 Are there any contraindications to epinephrine use? 34:25 Use of tryptase levels when the diagnosis of anaphylaxis is uncertain 37:10 Outro