NURS 6501 week 1 Discussion: Alterations in Cellular Processes

NURS 6501 week 1 Discussion: Alterations in Cellular Processes

According to McCance and Huether, genetics play a significant role in hypersensitivity reactions (2019). It has been found that a parent with an allergy is forty percent likely to birth a child with an allergy, and these statistics double if both parents have an allergy (McCance & Huether, 2019). This genetic predisposition results in elevated levels of IgE production and receptors in the atopic individual resulting in a more responsive immune reaction to environmental stimuli, in this case, amoxicillin (McCance & Huether, 2019) NURS 6501 week 1 Discussion: Alterations in Cellular Processes.

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The symptoms described, tongue swelling, difficulty breathing, and wheezing, result from IgE antibodies inappropriately and excessively responding to the ingestion of amoxicillin, resulting in an inflammatory reaction (Justiz-Vaillant, & Zito, 2019). This physiologic response occurs because of the degranulation of mast cells releasing histamine, ultimately creating inflammation and the signs and symptoms described in the case study (Justiz-Vaillant, & Zito, 2019). I believe the response to the amoxicillin has occurred likely due to the overproduction of IgE and potentially previous exposure to the allergen. As described earlier, specific cells involved in this allergic response process include IgE antibodies and mast cells. Additionally, basophils, interleukins, leukotrienes, and prostaglandin are involved, the former being the most significant (Soo, 2018). (Turner et, al., 2017)

If a factor such as gender or genetics had been different within the case study, I am not sure it would have responded differently NURS 6501 week 1 Discussion: Alterations in Cellular Processes. I am compelled to consider the patient’s age relating to the severity of the allergic reaction, morbidity, and mortality. If this were an older adult with a preexisting cardiac condition, the patient would be at higher risk of death from drug anaphylaxis, according to Turner et al.(2017).

 

References

Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls.

Treasure Island, FL: StatPearls Publishing. Retrieved from

https://www.ncbi.nlm.nih.gov/books/NBK513315/

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in

adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Soo, P. (2018). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved 

from https://www.youtube.com/watch?v=Jz0wx1-jTds  

Turner, P. J., Jerschow, E., Umasunthar, T., Lin, R., Campbell, D. E., & Boyle, R. J. (2017).

Fatal Anaphylaxis: Mortality Rate and Risk Factors. The journal of allergy and clinical

immunology. In practice, 5(5), 1169–1178. https://doi.org/10.1016/j.jaip.2017.06.031 NURS 6501 week 1 Discussion: Alterations in Cellular Processes

 

2 months ago
RE: Week1

Week 1 Reply 1

 

Hey

I enjoyed reading your discussion post. The studies on the immediate hypersensitivity reactions also pointed to a familial connection (Wu & Lyons, 2021). This study suggests that parents with drug reactions should be taken into consideration when prescribing medications (Wu & Lyons, 2021). In addition to a genetic component there is also a connection between drugs that carry similar chemical make up (Stone et al., 2014). It is important to be aware of these possibilities when looking potential medications. It helps to understand reaction and reaction types. This is important in order to provide education, in this case, to patient and family. Having this type of education about the different types of reactions, helps families be able to understand what a medical emergency is and how to treat reactions (Justiz et al., 2019).  It is important have these understandings of the various reaction types because it helps understand how patients with various diseases will potentially react to different allergens (Justiz et al., 2019).

References

Justiz Vaillant, A., Vashisht, R., & Zito, P. (2019). Immediate Hypersensitivity Reactions. StatPearlshttps://www.ncbi.nlm.nih.gov/books/NBK513315/

Stone, S. F., Phillips, E. J., Wiese, M. D., Heddle, R. J., & Brown, S. A. (2014). Immediate-type hypersensitivity drug reactions. British Journal of Clinical Pharmacology78(1), 1–13. https://doi.org/10.1111/bcp.12297

Wu, R., & Lyons, J. J. (2021). Hereditary alpha-tryptasemia: A commonly inherited modifier of anaphylaxis. Current Allergy and Asthma Reports21(5). https://doi.org/10.1007/s11882-021-01010-1

2 months ago
RE: Week1

 

Great Post,

I just wanted to add a few more quick notes for your reference. Mainly different organisms cause that infection. Group A beta-hemolytic streptococci account for less than 30% of throat infections, but diagnosing and treating GAS pharyngitis is essential to prevent complications (Center for disease control and prevention, 2018). It is widespread in children, so it is necessary to know that cough and sneeze infected droplets into the air that another person inhales. The definitive diagnosis of strep throat is throat culture or rapid antigen testing, although most people are treated based on clinical signs and symptoms (McCance& Huether, 2019). Amoxicillin is the choice of drugs, and it is imperative that patients complete 10-day course therapy. Parents and providers must teach their children about preventing strep throat because no vaccine prevents strep throat. The best way to keep getting and spreading group A strep is to wash hands often. Cover mouth and nose while sneezing and washing hands. NURS 6501 week 1 Discussion: Alterations in Cellular Processes It is also essential that children with Strep stay home from work, school, or daycare until they have no fever or have taken antibiotics for at least 12 hrs (CDC, 2018).

 

Centers for Disease Control and Prevention. (2018). Group A Streptococcal (GAS) Disease.

Retrieved March 03, 2022, from https://www.cdc.gov/groupastrep/diseases-      hcp/strep- throat.html.

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in        adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

 

2 months ago
RE: Week1

 

Thanks for sharing your post. You are correct that genetics can be the major cause of hypersensitivity reactions NURS 6501 week 1 Discussion: Alterations in Cellular Processes. Also, parent with an allergy is forty percent chance of giving birth to a child with an allergy (McCance & Huether, 2019). This genetic predisposition results in elevated levels of IgE production and receptors in the atopic individual resulting in a more responsive immune reaction to environmental stimuli, in this case, amoxicillin (McCance & Huether, 2019).

In the case scenario, the patient is presenting with tongue swelling, difficulty breathing, and wheezing which has result from IgE antibodies to be inappropriately and excessively responding to the ingestion of amoxicillin, resulting in an inflammatory reaction (Justiz-Vaillant, & Zito, 2019). It is a fact that considering the patient ‘s age before prescribing medication can prevent reactions or death.

References

Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls.

StatPearls Publishing.

https://www.ncbi.nlm.nih.gov/books/NBK513315/

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in 

adults and children (8th ed.). Mosby/Elsevier.

 

Discussion: Alterations in Cellular Processes

Photo Credit: Getty Images

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

To prepare:

  • By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor NURS 6501 week 1 Discussion: Alterations in Cellular Processes.
By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

  • The role genetics plays in the disease.
  • Why the patient is presenting with the specific symptoms described.
  • The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
  • The cells that are involved in this process.
  • How another characteristic (e.g., gender, genetics) would change your response.

 

    The case presented is a 16-year old boy with strep throat. This was suspected based on presenting symptoms of reddened posterior pharynx with white exudate on tonsils, swelling of tonsils, and anterior and posterior cervical adenopathy. This was confirmed by a rapid strep test. All of this presents as a common diagnosis of strep throat, and the healthcare provider prescribed the typical course of treatment. However, the patient experiences an immediate reaction to the medication and needs to be given emergency treatment for his allergic reaction. While there are no known factors that can predict amoxicillin allergy in children, a family history of a drug allergy may indicate a potential allergy (Faitelson et al., 2018). Family history was not presented in the case study; however, it was noted that the patient himself exhibited no known drug allergies, therefore there was no reason to suspect this patient would have an allergic reaction to the amoxicillin. After taking the amoxicillin, the patient is presenting with an immediate hypersensitivity reaction (Justiz-Vaillant & Zito, 2019; McCance & Huether, 2019; Soo, 2018).

Strep throat is caused by streptococcus bacteria, which is spread through droplet contact. Streptococcal pharyngitis has a short incubation period and presents as red, painful throat, swollen and pus-filled tonsils, enlarged cervical lymph nodes, and fever (Thai et al., 2018). The inflammation present in the tonsils is a result of the body’s immune response. The exudate present on the tonsils also results from the body’s immune response, as the pus contains dead cells, tissues, and bacteria as byproducts of phagocytosis (McCance & Huether, 2019; Soo, 2018).

There is a strong genetic link regarding IgE response to antigens or allergens (Soo, 2018). The case study presented no known drug allergies for the patient but does not list family medical history, so this information is not known. Most diseases, even when a genetic component is present, have both genetic and environmental aspects (McCance & Huether, 2019). While females are more susceptible to experiencing autoimmune disorders, the type I immediate hypersensitivity immune reaction presented in this case study does not fall under that category (McCance & Huether, 2019; Soo, 2018). One consideration for genetic factors is the increased serum tryptase levels in those with alpha tryptasemia. Individuals with alpha tryptasemia experience hypersensitive reactions and are often associated with systemic mastocytosis conditions (Macharadze, 2021). This information is not presented in this case study and is therefore unknown at this time.

This patient is experiencing an immediate hypersensitivity reaction to the amoxicillin medication, which is a type I or anaphylactic response (Justiz-Vaillant & Zito, 2019). When the patient ingested the amoxicillin, the body viewed the drug as an antigen. Upon exposure to the antigen, B cells mature into plasma cells, which produce IgE antibodies. These IgE antibodies then bind to specific receptors on mast cells, which then degranulate and release pro-inflammatory mediators, including histamine (Soo, 2018). Histamine causes vasodilation and subsequent hypotension, bronchoconstriction, and increased vascular permeability (McCance & Huether, 2019). The increased vascular permeability allows for fluid to leave the vasculature and enter the interstitial space, resulting in inflammation, which was evidenced by the patient experiencing swelling in his tongue and lips. The production of histamine also resulted in bronchoconstriction, which presented in difficulty breathing and auditory wheezing in the patient (McCance & Huether, 2019; Soo, 2018). The difficulty breathing may have also been exacerbated by an inflammatory response in the throat, as the patient was also experiencing swollen tongue and lips.

References

Faitelson, Y., Boaz, M., & Dalal, I. (2018, July). Asthma, family history of drug allergy, and age predict amoxicillin allergy in children. Journal of Allergy and Clinical Immunology, 6(4), 1363-1367. https://doi.org/10.1016/j.jaip.2017.11.015

Justiz-Vaillant, A. A. & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. StatPearls Publishing.

Machardze, D. S. (2021, December). Mast cells and tryptase. Modern aspects. Medicine Immunology, 23(6), 1271-1284. https://doi.org/10.15789/1563-0625-MCA-2193

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby/Elsevier.

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. https://www.youtube.com/watch?v=Jz0wx1-jTds

Thai, T. N., Dale, A. P., & Ebell, M. H. (2018, June). Signs and symptoms of group A versus non-group A strep throat: A meta-analysis. Family Practice, 35(3), 231-238. https://doi.org/10.1093/fampra/cmx072

2 months ago
RE: Discussion Post

I enjoyed reading your post. You are correct that strep throat/ pharyngitis can be confirmed by a rapid strep test. Most people have allergic reaction to an antibiotic and there are no known factors that can cause allergy in children while using amoxicillin, a family history of a drug allergy may show a potential allergy (Faitelson et al., 2018). Also, since the patient’s chart indicated no known allergy then when cannot presume that the patient will have any reaction to amoxicillin. It can surprising that after administering amoxicillin, then the patient present with an immediate hypersensitivity reaction which is a type I or anaphylactic response (Justiz-Vaillant & Zito, 2019).  Most diseases, even when a genetic component is present, have both genetic and environmental aspects (McCance & Huether, 2019) NURS 6501 week 1 Discussion: Alterations in Cellular Processes.

References

Faitelson, Y., Boaz, M., & Dalal, I. (2018, July). Asthma, family history of drug allergy, and age

predict amoxicillin allergy in children. Journal of Allergy and Clinical Immunology, 6(4),

1363-1367. https://doi.org/10.1016/j.jaip.2017.11.015

Justiz-Vaillant, A. A. & Zito, P. M. (2019). Immediate hypersensitivity reactions.

In StatPearls. StatPearls Publishing.

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in

adults and children (8th ed.). Mosby/Elsevier.

 

2 months ago

Thank you for your response. I also agree that it was strange how quickly and severely the reaction presented. I also find it amazing that this patient was able to reach the age of 16 without having been prescribed amoxicillin prior to this encounter. A lot of out-of-the-norm things in this case study, but that’s what makes it such great learning! We have to be able to think outside of the box and analyze the situation as it’s resented, not how events normally progress.

2 months ago

Hi

Your post is interesting to read. I agree with you that since the 16 year old neither showed evidence of allergy nor family history of allergic reactions to drugs, there should be no reason to suspect that he will develop allergic reaction to amoxicillin. Also, you raised an important point that strep pharyngitis incubation period is short and I believe this is why it is contagious. It is interesting that after destruction of strep bacteria, phagocytosis plays an important role by ingesting the dead cells (McCance, K. 2019) thereby maintaining tissue homeostasis. Good post!

Reference

Center for Disease Control and Prevention (2018) https://www.cdc.gov>clinicians:adult outpatient recommendations/antibiotic use.

McCance, K. & Huether, S. (2019). Pathophysiology: The basis for disease in adults and children (8th ed) Mosby.

2 months ago

Thanks for the response, Pauline! Yes, strep throat is so easily contagious, and that is in part due to its short incubation period. The bacteria is also spread through droplet contact, which among children is difficult to prevent (Centers for Disease Control and Prevention, 2022).

Reference

Centers for Disease Control and Prevention. (2020, January 14). Group A streptococcal disease: Strep throat: All you need to know. https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html#:~:text=Group%20A%20strep%20live%20in,infected%20sores%20on%20their%20skin NURS 6501 week 1 Discussion: Alterations in Cellular Processes.

 

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