Farnsworth Worthington Year Question & Answer Guide (With Explanation)
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Original Question
Farnsworth P. Worthington, IV, a 71-year-old beekeeper, was stung by a honeybee 24 hours ago while working in his apiary. Within two to three minutes following the sting, he noticed a slightly red, raised area on his arm. Mr. Worthington states he has experienced numerous bee stings over his 39-year career as a beekeeper, typically resulting in mild localized reactions. He experienced no shortness of breath, wheezing, rapid heart rate, or other symptoms such as swelling of the lips, lightheadedness, nausea, or swelling. Today, he presents to the clinic with low-grade fever (99.7ºF [37.6ºC]). Since yesterday’s sting, a 4 cm diameter area of redness, tenderness, and induration with a central 1.1 cm area of necrosis and ulceration has developed. He has never experienced this type of reaction to a bee sting. C3: 190 mg/dL (nl80-178 mg/dL); C4: 55mg/dL (nl 12-42 mg/dL) Based on the information provided, what is your diagnosis? Given the patient’s history of frequent bee stings, what immunological mechanisms could explain the development of the current lesion as described? Be specific. (Type I, Type II, Type III, Type IV) How does this response differ from a life-threatening hypersensitivity reaction to a bee sting? Analyze the significance of the elevated serum complement levels (C3 and C4) in the context of this patient’s presentation.
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