Your First Patient of the Day Is Complaining of Pain

question 21

Multiple Choice

Your first patient of the day is complaining of pain in the area of his new tattoo. When you examine the tattoo, you note that the area around it is firm, red, and swollen. There is no evidence of pus, and your patient has a normal pulse, and no fever. You tell your patient that you have seen this type of response to a tattoo before, and that it is called a granulomatous reaction. You give him more information on the condition
-Your patient questions why he has developed a granuloma. You explain to him that granulomas 

• A) are formed to recruit macrophages and neutrophils to an area of persistent inflammation such as that observed with a tattoo.
• B) result from activation of complement proteins; once complement C3 is activated, it causes a cascade of activation of C4 - C25. These activated proteins concentrate to form the granuloma.
• C) are immune cells that are normally synthesized to fight virus infections. In your patient's case, these cells were formed in response to ink particles.
• D) are proteins that recognize compounds unique to microbes or tissue damage; in your patient's case, these are made as a result to the tissue damage caused by the tattoo.
• E) are formed as an attempt by the body to wall off and contain persistent antigens - in his case, the red tattoo ink (red ink contains mercury compounds).

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Definitions:

Dysthymic Episode

A period characterized by a persistent mild depression that lasts for at least two years in adults or one year in children and adolescents.

Dissociative Episode

A temporary period of dissociation or disconnection from one's immediate surroundings or self, often seen in disorders like dissociative identity disorder.

Hyperinflationary State

An economic condition marked by an extremely high and typically accelerating rate of inflation, eroding the real value of the local currency.

Compulsion

A strong, usually irresistible urge to perform an act, often repetitively, driven by anxiety or obsessive thoughts.