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A mother brings her three-year-old son into the emergency roomof a local hospital. The boy is crying hysterically. The mothersays that earlier that day the boy was playing in the back yardwith his older sisters. He had gone over to pick a rose off of arosebush when he suddenly started screaming and crying. There is aregion of swelling and redness on his arm and the doctor whoexamines him says that it looks like the boy was stung by a bee. Onphysical examination, he is afebrile, with a heart rate of 102 bpm,blood pressure of 90/62 mm Hg, and respiratory rate of 24 breathsper minute and has difficulty breathing. The doctor says that theboy appears to be having a severe allergic reaction to the sting,and he treats him with SC Epinephrine. The mother asks why herson’s arm is swollen and the Dr. says it is because of fluidaccumulation.

1. Describe the process of inflammation that might have led toswelling? 2. Enumerate the mediators of pain, edema, and redness?3. Describe the vascular and cellular changes during inflammation?4. Mention the type of shock the child is presented with and Whyepinephrine is an ideal choice in this setting and elaborate itsmechanism of action? 5. Plot the Drug response curve (DRC) ofEpinephrine (Agonist) with and without the presence of Beta-blocker(antagonist). 6. What type of hypersensitivity reaction is seen inthis child? This type of hypersensitivity reaction is due to thecrosslinking of which immunoglobulin on mast cell surfaces? 7.Which cytokines promote class switching of B lymphocytes toIgE?