input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 7-year-old woman presents shortly after her birthday with red scaly plaques over both ears. Her mother reports that the patient recently received a pair of fashionable silver earrings from her older sister as a birthday present. Physical examination is only significant for erythema and tenderness over the lobules of the ears bilaterally. Her vital signs show a blood pressure of 121/73 mm Hg, heart rate of 72/min, and a respiratory rate of 21/min. Her medical history is non-significant. Of the following options, which is the mechanism of this reaction?   (A) Type I–anaphylactic hypersensitivity reaction   (B) Type III–immune complex-mediated hypersensitivity reaction   (C) Type IV–cell-mediated (delayed) hypersensitivity reaction   (D) Type III and IV–mixed immune complex and cell-mediated hypersensitivity reactions
output: ['(C) Type IV–cell-mediated (delayed) hypersensitivity reaction <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Type I–anaphylactic hypersensitivity reaction  (B) Type III–immune complex-mediated hypersensitivity reaction  (C) Type IV–cell-mediated (delayed) hypersensitivity reaction  (D) Type III and IV–mixed immune complex and cell-mediated hypersensitivity reactions <> possible answers', '  A 7-year-old woman presents shortly after her birthday with red scaly plaques over both ears. Her mother reports that the patient recently received a pair of fashionable silver earrings from her older sister as a birthday present. Physical examination is only significant for erythema and tenderness over the lobules of the ears bilaterally. Her vital signs show a blood pressure of 121/73 mm Hg, heart rate of 72/min, and a respiratory rate of 21/min. Her medical history is non-significant. Of the following options, which is the mechanism of this reaction? <> context']