Case Study: Mechanisms of Self-Defense – Anna Sanchez 21-year-old female nursing student case study
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Case study 1
Anna Sanchez, A 21-year-old taking a nursing course, complains of congestion of the nose, especially during the night and morning hours, itchy eyes that also appear watery, persistent sneezing, and a tickling cough. She indicates that her symptoms have persisted for 5weeks and to counter them, she has been using Zyrtec, nasal spray, and eye drops.
What assessment questions would be useful to ask Anna about her medical and family history? Why? -The appropriate questions to ask the patients concerning her medical and family would be, timing of the symptoms; whether it worsens at certain times than other times, how often she experiences the symptoms, characteristics of the symptoms she presents with, and whether she has been diagnosed before of conditions that present with almost similar symptoms for her medical history and whether she has close relatives with allergic diseases for family history (Pattanayak et al., 2023).
What evidence suggests that Anna does or does not have an acute severe infection? – The patient is suffering from allergic rhinitis, following her symptoms, but the infection is not an acute severe infection due to the presence of nasal polyps and clear nasal drainage, supported by the absence of purulent discharge and clear lungs.
What type of hypersensitivity reaction is involved with allergic rhinitis? Explain this type of hypersensitivity – Allergic rhinitis is a type 1 hypersensitivity reaction. This type of reaction is triggered by allergens such as pets, in our case, that cause the release of IgE antibodies that bind to mast cells and basophils, releasing inflammatory mediators such as histamine and tryptase. The reaction may either be immediate or delayed.
A skin test indicates that Anna is allergic to cat dander. Two months ago, Anna’s roommate brought home a cat. Why didn’t Anna’s symptoms start when the cat entered the household, rather than 3 weeks later? Anna experienced a delayed type 1 hypersensitivity reaction due to the presentation of symptoms three weeks after exposure to her roommates cat this can be due to several factors such as continuous chronic low-exposure to the cat, presences of underlying co-morbidities such as nasal polyps and sinusitis, and other factors such as patient awareness on allergen- triggered symptoms and her young age (Zulfakri Abdullah & Ferryan Sofyan, 2023).
What class of antibodies bound to the mast cells? – The class of antibodies that bind to mast cells is the IgE class that sensitizes the mast cells, causing inflammatory mediators such as histamine to be released in subsequent encounters with allergens.
What physiological mechanisms caused the redness of Anna’s nasal mucosa? -The physiological mechanisms that caused redness in Anna’s nasal mucosa are vasodilation and increased vascular permeability triggered by inflammatory mediators released by mast cells, such as histamine.
Anna’s skin rash is consistent with atopic dermatitis, which is common in young people with allergies. What type of hypersensitivity reaction causes atopic dermatitis? – Atopic dermatitis is a type 1 hypersensitivity reaction caused by overproduction of IgE antibodies (Eyerich & Ring, 2023).
Why are there a lot of eosinophils in nasal polyps in allergic rhinitis? – The presence of eosinophils in nasal polyps in allergic rhinitis is due to an immune response triggered by helper 2 cells that causes the secretion of Th2 cytokines, which lead to the development of eosinophils and their activation that then migrate from the blood to the nasal tissue (Daungsupawong & Wiwanitkit, 2024).
What mechanisms caused Anna’s clear postnasal drainage? – The mechanism behind the clear postnasal drainage is vasodilation and increased vascular permeability caused by the inflammatory mediators, such as histamine, that have been released by mast cells, causing fluid leakage into the nasal cavity from the permeable vessels. Anna Sanchez 21-year-old female nursing student case study Anna Sanchez 21-year-old female nursing student case study
References
Daungsupawong, H., & Wiwanitkit, V. (2024). Blood and local eosinophil levels in chronic rhinitis: Comment. World Allergy Organization Journal , 17 (11), 100977. https://doi.org/10.1016/j.waojou.2024.100977
Eyerich, K., & Ring, J. (2023). Burden of disease in atopic eczema. Atopic Dermatitis – Eczema , 31-33. https://doi.org/10.1007/978-3-031-12499-0_3
Jurcău, R., & Jurcău, I. (2022). Relationship between post-traumatic stress disorder and oxidative stress – a PubMed approach. Health, Sports & Rehabilitation Medicine , 23 (4), 164-168. https://doi.org/10.26659/pm3.2022.23.4.164
Pattanayak, S., Sheel, S., Kumar, V., & Bhat, V. (2023). Ghee-based balm: A novel and innovative herbal therapy for patients with common cold, nasal congestion, and allergic rhinitis. International Journal of Pharmaceutical Sciences Review and Research , 82 (2). https://doi.org/10.47583/ijpsrr.2023.v82i02.016
Wang, Y., Liu, Z., & Chen, T. (2023). Vaginal microbiota: Potential targets for Vulvovaginal candidiasis infection. https://doi.org/10.2139/ssrn.4660638
Zulfakri Abdullah, M. H., & Ferryan Sofyan. (2023). The relationship between the score for allergic rhinitis and the total nasal symptoms score in individuals with suspected allergic rhinitis. Sumatera Medical Journal , 6 (1). https://doi.org/10.32734/sumej.v6i1.7899
