Question

Copstead: Pathophysiology, 5th Edition

Chapter 10: Alterations in Immune Function

Case Study

Anna Sanchez, a 21-year-old nursing student, comes to her nurse practitioner in December with a five-week history of itchy eyes and nasal congestion with watery nasal discharge. She also complains of a “tickling” cough, especially at night, and she has had episodes of repetitive sneezing. She gets frequent “colds” every spring and fall.

Physical Examination

Vital Signs: Afebrile; respiratory rate, pulse, and blood pressure all normal

Skin: Flaking erythematous rash on the flexor surfaces of both arms

Head, Eyes, Ears, Nose, and Throat: Tender over maxillary sinuses; sclera red and slightly swollen with frequent tearing; outer nares with red irritated skin; internal nares with red, boggy, moist mucosa and one medium-sized polyp on each side; pharynx slightly erythematous with clear postnasal drainage (NOTE: Nasal polyps are common in allergic rhinitis. They are edematous protrusions of the mucosa that are infiltrated with neutrophils, eosinophils, and plasma cells.)

Lungs: Clear to auscultation and percussion

Answer the questions about Anna Sanchez and her condition.

1. What assessment questions would be useful to ask Anna about her medical and family history?

2. What evidence suggests that Anna does not have an acute severe infection?

3. If Anna has allergic rhinitis, what type of hypersensitivity reaction is involved?

4. 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?

5. What class of antibodies bound to the mast cells?

6. What physiological mechanisms caused the redness of Anna’s nasal mucosa?

7. 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?

8. Why are there a lot of eosinophils in nasal polyps in allergic rhinitis?

9. What mechanisms caused Anna’s clear postnasal drainage?

Answer 1

1) Does she experienced this before and family history of asthma or hay fever.

2) this is not acute severe infection because heart functions and lung functions are normal

3 ) Hypersensitivity type 1 Atopic dermatitis : allergy caused by foreign substances like dust, pollen, animal hair etc

4) The Hypersensitivity reaction takes place after 72 hours