In: Nursing
On a sunny, lazy July afternoon at the family lakeside
cabin, 10 year old Ethan is tossing a slobbery tennis ball to
Daisy, the family’s dog. The dog bounds into the underbrush to
retrieve an arrant throw. When the game is over, Ethan wraps his
arms around Daisy and hugs her. A week later, Ethan wakes up his
mother, Maureen, complaining that he itches. The right side of his
face is red and covered with small bumps. Convinced that Ethan is
just suffering from bug bites, Maureen gives him an antihistamine
to relieve the itching. By morning, though, Ethan is worse- the red
angry rash has spread to his neck and arms, his face is swollen,
and blisters appear. Maureen applies an over the counter anti- itch
cream and tells Ethan not to touch the blisters, but he can’t help
scratching them. Three days after that, Ethan still feels and looks
miserable, and Maureen is really getting worried. Then she notices
pus oozing from his blisters. Panicking, she immediately drives
Ethan to the doctor’s office. As soon as the doctor sees Ethan, she
says, “ Looks like you had a run in with poison ivy. She prescribes
a glucocorticoid ointment for applying to the skin rash and
recommends continuing the antihistamine to control the agonizing
itch.
Q1. What is wrong with Ethan? Did bitting bug cause Ethan’s
discomfort?
Q2. Daisy went into the woods not Ethan, then why Ethan showed
allergic symptoms of poison ivy? Explain in detail?
Q3. Do you think if there is role of T- cells n Ethan’s condition?
Why?
Q4.Why is the inflammatory response to poison ivy( Urushiol/ poison
ivy sap) delayed for at least 12 to 48 hours after exposure?
Q5. What precautions should Ethan would take to avoid inflammatory
response?
1. Ethan is infected with poison ivy. Bug bite didn’t cause
this. It is transmitted from his pet dog which was exposed to the
poison from the Bush.
2. The rash is caused by direct or indirect contact. Indirect
contact is from plant oil that has contaminated pet fur, tools,
clothing or other surfaces. Since his pet went into the woods it
got contaminated with the plant oil and when Ethan wrapped his arms
around Daisy it got transmitted to him.
3. Poison ivy causes allergic contact dermatitis. It is a T cell
mediated immune response. It is also called as delayed
hypersensitivity.
4. The T lymphocytes recognise the poison as foreign substance
after the antigens are eaten and degraded into pieces. The
lymphocytes signals for the inflammatory substances called
cytokines. This activates the macrophages and attack causing severe
tissue damage.
5. The precautions to be taken are cover skin while playing, avoid
exposure to pets, don't allow pets into the woods, bath the pets
often, use protective devices if exposed to the plants.