Question

The First Time’s Not the Problem Steven, an eight-year old boy, is brought to your office Monday morning by his father to have his upper arm checked for a possible infection. Dad is worried because the area of a bee sting on the boy’s arm is getting more red, itchy, and tender. The father gave him some children’s acetaminophen yesterday, which relieved the discomfort somewhat. There is no history of medical problems or allergies, and the child takes no regular medication. The child is otherwise feeling well, and his father tells you he is playing and eating normally. There is no previous history of bee stings, and Steven proudly tells you he “hardly even cried” when he got stung. There is a half-dollar-sized area on his left upper arm that is puffy and red, but there is no streaking or drainage, and the area does not appear to be infected. Steven’s temperature is normal, and his lungs are clear.

Part A

How should you describe this skin reaction to the bee sting? How should you describe this skin reaction to the bee sting?

a. Type IV hypersensitivity reaction

b. Type II hypersensitivity reaction

c. Type III hypersensitivity reaction

d. Type I hypersensitivity reaction

Part Part B

Why did the skin turn red and swell up?

a. Redness and swelling are due to the release of antihistamine during degranulation of mast cells and basophils.

b. Redness and swelling are due to the release of histamine during degranulation of mast cells and basophils.

c. Redness and swelling are due to the release of IgG from plasma cells.

d. Redness and swelling are due to the release of IgE from mast cells.

Part Part C

What is urticaria?

a. purpura

b. hives

c. hemolysis

d. anaphylaxis

Part Part D

Which of the following OTC medications would provide the best relief of symptoms?

a. antihistamines

b. aspirin

c. antibiotics

d. acetaminophen

Part E

This child has had a moderate reaction to his “first” bee sting. If he were to be stung again, the signs/symptoms could be severe and life-threatening due to constriction of airways. What is this systemic reaction called and what would be the treatment of choice?

a. hemolysis; blood transfusions

b. delayed hypersensitivity; acetaminophen

c. purpura; calamine lotion

d. anaphylaxis; epinephrine