A nurse has received her annual purified protein derivative (PPD). Seventy-two hours after the PPD is administered, she develops a reddened urticarial wheal. This skin reaction is related to:
A) Leukotrienes initiating inflammatory responses
B) Bradykinin increasing permeability
C) Prostaglandins producing smooth muscle contraction
D) Mediating sensitized T cells and macrophages
Ans: D
Chapter: 53
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Caring
Objective: 2
Patient Needs: A-1
Feedback: Type IV hypersensitivity, also known as cellular hypersensitivity, occurs 24 to 72 hours after exposure to an allergen. It is mediated by sensitized T cells and macrophages. Prostaglandins, composed of unsaturated fatty acids, produce smooth muscle contraction, as well as vasodilation and increased capillary permeability. Leukotrienes are chemical mediators that initiate the inflammatory response causing smooth muscle contraction, bronchial constriction, and mucous secretion in the airways. Bradykinin is a polypeptide with the ability to cause increased vascular permeability, vasodilation, hypotension, and contraction of many types of smooth muscle, such as bronchi.
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