NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes

NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations in Cellular Processes

Walden University NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes-Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University  NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes

 

Whether one passes or fails an academic assignment such as the Walden University  NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for  NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes 

 

The introduction for the Walden University  NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for  NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes 

 

After the introduction, move into the main part of the  NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for  NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes 

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for  NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes

The role genetics plays in the disease

Genetics plays a significant role in substance abuse and addiction. Research has consistently shown that genetic factors contribute to an individual’s susceptibility to developing substance use disorders. While genetics alone does not determine whether someone will develop an addiction, it can influence their vulnerability and response to substance use. Naloxone is an opioid blocker and since the patient responded to the medication, he was suffering from an opioid overdose. Agrawal et al., (2012) stated that “The gene encoding the mu-opioid receptor (OPRM1) to which opioids bind to produce their analgesic and rewarding effects is the most widely studied candidate gene for heroin and other opioid addictions”. According to Smith (2022), over half of the differences in how likely people are to develop substance use problems stem from DNA differences. Research suggests alcohol addiction is about 50 percent heritable, while addiction to other drugs is as much as 70 percent heritable.

Why is the patient presenting with the specific symptoms described?

The first symptom mentioned is unresponsiveness which is a result of opioid overdose resulting in respiratory depression, decreased cardiac output, and severe pulmonary edema (McCance & Huether, 2018, p.71). It is an opioid overdose because he responded to Naloxone which is an opioid receptor antagonist as it reverses the effect of the opioid by binding to opioid receptors and blocks the effects of other opioids (Naloxone for Opioid Overdose: Life-Saving Science, 2017). The second symptom is burning pain over his left hip and forearm which revealed a large amount of necrotic tissue over the greater trochanter as well as the forearm, which could most likely have resulted from the impact of a fall post-overdose. This led to ischemia and hypoxia causing cellular injury, which affects the plasma membrane of the cells leading to damage to the organelles leading to ATP depletion, and calcium level alteration and ultimately resulting in tissue necrosis, (McCance & Huether, 2018, pp. 49-51). The third symptom is hyperkalemia which resulted in the ECG reading as explained by this statement “Progressive hyperkalemia may result in ECG changes, including peaked T wave, flattened P wave, prolonged PR interval”, (Teymouri et al., 2022).  Hyperkalemia resulted from cellular injury leading to the direct release of intracellular potassium into the extracellular fluid raising the potassium blood levels.

The physiologic response to the stimulus presented in the scenario and why you think this response occurred.

Unresponsiveness from reduced consciousness due to respiratory depression was the physiologic response to the stimulus and the response occurred because “Opioids induce respiratory depression via activation of μ-opioid receptors at specific sites in the central nervous system including the pre-Bötzinger complex, a respiratory rhythm generating area in the pons” (Boom et al., 2012).  Opioid overdose negatively affects the part of your brain that regulates breathing, resulting in ineffective breathing that could ultimately result in death.

The cells that are involved in this process

Opioids work by activating opioid receptors on nerve cells. “The opioid receptors family consists of three classical receptors: μ, δ and κ opioid receptors, all of which belong to the G-protein coupled receptors (GPCR) family with seven transmembrane domains”, (How Opioid Drugs Activate Receptors, 2018)

How another characteristic (e.g., gender, genetics) would change your response?

 Genetic factors can contribute to interindividual differences in opioid response and metabolism. Specific variations in genes encoding drug-metabolizing enzymes, such as cytochrome P450 (CYP450) enzymes, can affect how opioids are processed and eliminated from the body. Genetic variations in opioid receptors can also influence an individual’s sensitivity to opioids and their overall response to pain relief or side effects, (Smith, 2009).

Research suggests that gender can play a role in how individuals respond to opioids. Generally, women may experience greater sensitivity to opioids and may require lower doses for pain management compared to men. This difference may be attributed to variations in hormonal factors, body composition, and metabolism. However, it’s important to note that individual responses can still vary, and these differences are not absolute, (Smith, 2009).

There are two different aspects to this scenario, addiction, and the result of it.  As far as addiction goes, this has been studied heavily and is known to be heavily correlated with genetics.  Studies have found that 50% of a person’s risk of becoming addicted to a substance is within their genetic makeup (NIDA,2019).    Addiction is known to be both an environmental factor and a susceptibility caused by genetics.  Compartment syndrome, which is what I believe is going on in this scenario has little to do with genetics.  However, there is a study regarding Compartment syndrome and the GYG1 gene mutation that may make people more susceptible to this syndrome.  This gene is involved in muscle energy utilization, a mutation on this gene may put a person at a genetic predisposition to suffering from compartment syndrome more easily than others (Joseph et al., 2020).

This patient suffering an overdose developed in my opinion by compartment syndrome.  I have actually had a few patients in my experience of nursing with amputated limbs due to this.  It is not extremely common, but it happens enough that it is actually referred to as “found down” compartment syndrome.  This is due to pressure tissue injuries from patients either collapsing on an arm or leg or in this case a left hip and forearm and then laying there on that limb for extended periods of time.  So, we have an overdose, which then caused compartment syndrome, which led to hyperkalemia, which led to heart rhythm abnormalities.

Compartment Syndrome occurs from an increase in pressure within a closed osteofacial compartment.  This increase in pressure causes circulation to be impaired.  This often occurs in crush injuries, soft tissue injuries, and fractures (Compartment Syndrome, n.d.).  In this case “found down” compartment syndrome can be both from crushing injuries upon collapse or from impaired bloodflow from laying on the extremity for extended amounts of time.  The hyperkalemia occurs due to “Damage to the skeletal cell membrane, both from direct injury or the loss of energy and dysfunction of the cell membrane pumps, causes calcium and sodium to rush inside the cell, and causes substances such as myoglobin, potassium, uric acid and phosphorus to leak out of the cell (Dahlgren, 2015).  This free floating of the potassium causes it to systemically cause hyperkalemia.  The abnormal heart rhythm of prolonged PR interval and peaked T waves is common with extreme hyperkalemia.  Potassium is responsible for helping to control the electrical signals of the myocardium.

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n this scenario, the patient is an obvious drug user and has suffered an overdose as evidenced by being unresponsive and receiving Narcan that revived him. Naloxone is an opioid antagonist. When given, naloxone attaches to the opioid receptors and reverses and blocks the effects of opioids. A number of patients that receive Narcan, arise mad and fighting, because their “high” has been blocked or ruined. The patient also seems to be presenting with rhabdomyolysis. As he was found lying down for an undetermined amount of time, it is not known if he fell or not, and he has necrotic tissue over his hip and forearm with pain. That likely stems from the possible trauma if it was a fall but also the pressure of him lying on the hard ground for an unknown amount of time.

Rhabdomyolysis occurs when the muscle tissue breaks down rapidly, spilling its contents (myoglobin) into circulation. Myoglobin is difficult for the kidneys to excrete sometimes causing kidney failure. Significant decreases in ATP concentration results in cell death, mostly by necrosis. The reduction of ATP levels causes the sodium-potassium pump and sodium-calcium exchange to fail. This results in cellular swelling and diffusion of K+ out of the cell. Due to the cell membrane damage calcium moves rapidly intracellularly (McCance & Huether, 2019). With reperfusion, WBC’s migrate to the damaged muscle and cause further myolysis and necrosis of muscle fibers and release the muscle breakdown contents such as K+ and myoglobin, CK, PO4, and uric acid and leads to complications of hyperkalemia and hyperphosphatemia. In rhabdo hypocalcemia will present followed by hypercalcemia. This happens because Ca moves into the myocyte during the injury, and then leaks out into the ECF after cell lysis (Stanley, et al., 2017). If the patient has kidney damage, the K+ will not be excreted and hyperkalemia will lead to dysrhythmias see on an EKG noted by taller T-waves and prolongs the PR interval and widening of the QRS complex (McCance & Huether, 2019).

Drug addiction was thought to be just people making poor choices. Through research, it has been formulated that drug addiction is physiological and changes the brain structure, the way it looks, and how it processes information. Our brain is known as the “reward pathway or reward center.” When you have a reward behavior, your brain will release dopamine. As all drugs produce a pleasurable amount of dopamine, addictive drugs cause a flood of dopamine that is 10x higher than the natural reward. As drug use increases, the brain cells adapt, thus causing a decrease in the sensitivity to dopamine. A person with a drug addiction has built a tolerance which decreases the dopamine receptors (25, M, 2022). Drug abusers/ addicts are always chasing that first high.

Genetics play a role in substance abuse, use and addiction. Genes have an influence on the number and type of receptors in a person’s brain. Genes also dictate how quickly one’s body will metabolize drugs and how they respond to drugs and other types of medications. A person’s health is determined by genetics and the environment (US Department of Health and Human Services, 2022). Other characteristics such as gender or race would not change my response. Those factors would have the same repercussions regardless of gender or ethnicity.

Sample Answer 2 for NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes

This paper is being written to explain the pathology of cystic fibrosis. I personally have a friend who has this disease and have learned from her. The topics that will be covered are, how cystic fibrosis is created at a cellular level, genetics role in cystic fibrosis, the reasoning for the symptoms that the patient presented with, the description of the cells involved in cystic fibrosis, and how other characteristics would change the child’s response to cystic fibrosis. In short what I remember from nursing school is that cystic fibrosis is a genetic disorder which is an autosomal recessive gene that is carried by both the mother and the father. The abnormality occurs in chromosome 7 which is where creates an inability to transport small molecules across the cell’s membrane, which in turn, dehydrates the cells of the epithelium and this then creates dry secretion. This is a broad overview of what this disease is, but I will go into further detail below.

 The Role Genetics Plays in the Disease

Genetics play an important role in this disease, according to an article published in Pub

Med titled Cystic fibrosis genetics: from molecular understanding to clinical application states that due to a defective epithelial cell that is defective, this cell is inherited and is an autosomal recessive gene. The genetic information that is in the cell, which is the recipe for the cell to make proteins (Cutting, 2015).  According to Pathophysiology of disease: An introduction to clinical medicine, if a person receives a cystic fibrosis transmembrane conductance regulator gene (CFTCR), or a person can receive two copies of the CFTCR gene. This copy has a mutation of the cystic fibrosis gene, furthermore these two copies of the CFTR gene have stored a mutation which is the on chromosome seven. So, when the recipe is being presented to the cell to be made, the genetic information is then stored into the deoxyribonucleic acid which is known as DNA.  This is part of the twenty-three pairs of chromosomes, but on the seventh chromosome, the cystic fibrosis recipe is stored in that chromosome. In the DNA, where the CFTCR gene recipe lives, if there is one copy of the recipe than the gene will not show up in the person but will be a carrier but if there are two copies of the recipe being stored in the chromosome than the cystic fibrosis gene than the person will have cystic fibrosis (McCance at el., 2019).

 Why the Patient is Presenting with the Specific Symptoms Described

The baby’s symptoms included salty skin, a swollen stomach on occasion, and a failure to gain weight normally. According to an article published in the Journal of Cystic Fibrosis titled Inflammation in cystic fibrosis lung disease: Pathogenesis and therapy, epithelia make up the major organ systems. The sweat glands, liver’s bile duct, and intestines in the gastrointestinal tract are all affected in this patient. The article goes on to explain that the patient suffers from malnutrition and does not grow normally as a result of the loss of pancreatic function. As a result, enzyme replacement is critical for this patient in order to prevent cell clogging caused by an inability to breakdown a key nutrient (Cutting, 2015).

The physiologic response to the stimulus presented in the scenario and why you think this response occurred

After reading different sources, I was able to breakdown the pathology behind this patient’s symptoms. This disease starts with the CFTR gene protein being mutated in the chromosome seven, which there are two copies of the recipe, this mutation causes the decrease of chloride acceptance and ion being transported, then this makes the absorption of water to increase which throws off ciliary from completing the job and there is mucus that is dry, this is what causes the skin to be salty of the baby. The stomach inflammation and swelling that is being experienced, is due to the CFTR gene protein not having the right recipe present to the epithelial cell, this is causing malfunction by changing the reabsorption of the sodium, chloride and potassium in the cell, the recipe tells the cell to keep the sodium, chloride and potassium outside of the cell, this causes a back-up of outside of the cell structure and blocks the cell from absorbing the nutrients especially, proteins, fats and vitamins that are fat soluble.

The Cells that are Involved in this Process

The cells involved in this process begin with epithelial membranes found in the digestive tract, pancreas, airways, and reproductive area. According to an article in Apoptosis Journal, cystic fibrosis is caused by epithelial cell dysfunction, which leads to inflammation and an inability to create homeostasis due to the CFTR gene’s constant inflammation. Furthermore, the epithelial cells fail and undergo apoptosis as a result of the inflammation that occurs in the endoplasmic reticulum (Soleti at el., 2013).

How another characteristic (e.g., gender, genetics) would change your response

For cystic fibrosis, it is important to understand that this would not be a disease if the parents did not carry the gene. The

gene is the CFTR gene mutation, mentioned throughout this paper. According to a study done by Harvard Stem Cell Institute, where a lung cell was isolated to examine the function of the CFTR gene. It was shown in the study that if the ionocytes in the cell are not doing their job because it is expressing CFTR gene in increased levels, then the symptoms are created in the cell (Montoro at el., 2018). This occurs in the form of thick mucus and creates the response in the body that does not allow for the patient to regulate sodium, chloride, and potassium in a normal fashion.

Conclusion

During this journey of studying disease in depth and truly understanding how they work will help in the future of my career. I believe that if screening done at the hospitals before they leave would be beneficial. When parents are informed about the possibility of something occurring and what it means, parents will be empowered and get treatment before or if cystic fibrosis symptoms could show up. Also, encouraging parents to come to their baby checkups, will also allow for the medical staff to ask the right questions and treat the baby early, if they see symptoms. Cystic fibrosis is a challenge some patients may struggle with and it is our job as practitioners to catch things before extreme measures need to be taken.

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.

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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.

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.

Check Out Also: NURS 6501 Week 1 Discussion Alterations in Cellular Processes

Read a selection of your colleagues’ responses.

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By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not

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Total Points: 100

Sample Answer 3 for NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes

The disease highlighted in the scenario is anaphylaxis or anaphylactic shock. The 16-year old boy had an allergic reaction to the amoxicillin 500 mg; he went into anaphylactic shock. Its symptoms include wheezing, stridor, hoarseness, and persistent clearing of the throat (McLendon & Sternard, 2021). Anaphylaxis usually occurs within an hour of exposure and progresses rapidly; it should be treated urgently (McLendon & Sternard, 2021).  

Anaphylaxis is caused by an immunoglobulin E (IgE) mediated process; certain factors such as genetics play a role in exacerbating the release of antibodies against a soluble antigen (Abbas, Moussa, & Akel, 2021). The patient is presenting with these specific symptoms because of a hypersensitive reaction to the amoxicillin 500 mg. The immune system is protecting the body from the drug and this contributes to a release of inflammatory mediators (Abbas, Moussa, & Akel, 2021).  

The physiologic response to the amoxicillin is as follows: allergens are introduced to the body (T-cells) in the sensitization stage; the T-cells cause the B-cells to produce IgE antibodies which then bind to the Fc receptors located on basophils and mast cells; the bound basophil and mast cells IgE antibodies link leading to the degranulation of the cells; this then causes the release of histamines and proteolytic enzymes (Abbas, Moussa, & Akel, 2021). The main cells that are involved in this process are the T-cells, B-cells, mast cells, and basophils.  

The female gender is more susceptible to anaphylaxis and other allergic reactions. This is due to the presence of estrogen. Hox et al. (2015) determined that the mechanisms through which reproductive hormones contribute to an increased risk of anaphylactic shock are not well understood. Different studies have concluded that estrogen and testosterone play a part in inducing IgE antibodies. 

  

References 

Abbas, M., Moussa, M., & Akel, H. (2021). Type I hypersensitivity reaction. In: StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK560561/#!po=2.63158 

Hox, V., Desai, A., Bandara, G., Gilfillan, A. M., Metcalfe, D. D., & Olivera, A. (2015). Estrogen increases the severity of anaphylaxis in female mice through enhanced endothelial nitric oxide synthase expression and nitric oxide production. The Journal of Allergy and Clinical Immunology, 135(3), 729–36.e5. https://doi.org/10.1016/j.jaci.2014.11.003 

McLendon, K., & Sternard, B. T. (2021). Anaphylaxis. In: StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK482124/#!po=2.94118 

Sample Answer 4 for NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes

The 16 year old boy demonstrated severe allergic reaction to the drugs administered. Genetics play a significant role in drug allergy reactions.  Drug allergy occurs as a simultaneous reaction between the drug and the immune system. HLA alleles are the risk factors that aid the development of severe allergic reaction after drug administration (Finberg & Guharoy, 2012).. Identifying people showing severe allergic reactions that could be fatal helps in improving patient care. 

Immediately after taking the drugs the boy complained of swelling of his tongue and lips, difficulty breathing with audible wheezing. This could be as a result of body reaction with the administrated drug which was amoxicillin. It could also be a side effect of the drug taken. Some drugs such as ACE inhibitors are known to produce the common side effect of having a swollen tongue. The boy presented the specific described symptoms due to being hypersensitive to amoxicillin drugs. When the boy was exposed to amoxicillin, which is the specific allergen in this scenario, his body produces specific antibodies. The produces antibodies are Basophils found in the blood streams (Pourpak et al.,2008). The allergen introduced in the body joined together with the basophils bringing about an antibody-antigen reaction. This resulted to the breakage of the basophils which instigated the occurrence of swelling of the tongue and lips, difficulty in breathing and audible whizzing. During drug allergic reactions, the cells that are involved include the basophils, mast cells and eosinophil. Mast cells are responsible for getting lid of the allergen by releasing mediators such as cytokines and histamine (Finberg & Guharoy, 2012). The mediators are responsible for the symptoms that appear to signify the allergic reaction. The health provider should have assessed whether the boy was allergic to amoxicillin by carrying out the antibiotic test before prescribing the drugs.  An antibiotic prescription to the boy could have yielded different results.  

References 

Finberg, R. W., & Guharoy, R. (2012). Understanding Drug Allergies and Drug Toxicities. In Clinical Use of Anti-infective Agents (pp. 85-96). Springer, New York, NY. 

Pourpak, Z., Fazlollahi, M. R., & Fattahi, F. (2008). Understanding adverse drug 

Sample Answer 5 for NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes

            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 

Sample Answer for NURS 6501 Advanced Pathophysiology Week 1 Discussion Alterations In Cellular Processes

The case involves a 16 years old boy who complains of a sore throat. The physical assessment of the HEENT indicated a reddened posterior pharynx with white exudate on the tonsils that are enlarged to 3+. Furthermore, he is positive for anterior and posterior cervical adenopathy. The boy also tested positive for streptococcus infection and was initiated on amoxicillin 500mg PO q 12 hours *10 days. The boy took the first medication and complained of swelling in the tongue, lips, and difficulties in breathing. Besides, he presented with audible wheezing.

The Role of Genetics in the Disease

The streptococcus infection results from the group A streptococcus bacteria. The bacteria are commonly linked to tonsillitis. Children having repeated cases of streptococcus infections have genetically poor immune responses to the bacteria. People with a family history of tonsillitis are most likely to acquire the infection. According to Cavalcanti e al. (2019), genetic factors and dominance are linked with recurrent tonsillitis. The Waldeyer tonsillar ring provides regional protection against the airborne and alimentary canal antigens. On the other hand, genetic alteration in the local innate and acquired bacterial defence system results in the increased exposure to tonsillitis. Therefore, there is a significant correlation between genetic dominance and additive genetic effects in the predisposition to a strep infection. Furthermore, the genetic factors could predispose the boy to the allergic response evidence when the patient was given amoxicillin. The HLA-DRA variants predict the allergic response to penicillin.

Presenting with the Specific Symptoms

The boy presented with a sore throat and the temperature was raised because of the inflammatory responses linked to the immune defence against the infection. The bacteria produce M proteins that attract immunogenic responses from the host. The invasion of the bacteria to the tonsil also induces an upgrade in the cytokines which triggers the response of various immune cells. The redness and swelling in the tonsils are attributed to the inflammatory responses. The streptococcus bacteria invade the tonsil tissue through the fibronectin-binding proteins and the beta-integrin (Mikola et al., 2018). The increased immune cell responses cause tonsillitis. Furthermore, the intense allergic response characterized by difficulties in breathing is a result of the inflammatory reactions in the upper respiratory system, thus affecting the breathing in and out mechanism.

Physiologic Response to the Stimulus

The body system recognized the amoxicillin drug as a foreign object in the body and so induced an inflammatory response to it. The patient depicted a type 1 hypersensitivity response to the penicillin component in the amoxicillin. The response occurs when the body produces immunoglobulin E (IgE) that induces the hypersensitivity reaction with life-threatening anaphylaxis (Gaedigk, 2020).

Cells That Are Involved in This Process

The CD4 cells in the body influence the production of IgE to fight the specific antigen in the body. Instead of the recruitment of the IgM, IgG, or IgA, the t-helper cells sensitize the production of the IgE and mast cells that eventually cause the allergic response. The IgE binds to the masts cells and basophils which fights identified antigens in the body (Gaedigk, 2020).

Effect of Other Characteristics

The hypersensitivity response is genetically induced. Therefore, people will different genetic compositions would not experience an allergic reaction to amoxicillin drug. Lack of allergic reactions would mean that the patient will respond well to the medication and tonsillitis would resolve with time. There are no significant differences based on gender. As a result, other genders with the same sensitivity to penicillin components will have a similar experience.

Conclusion

The immunological responses indicated by the patient were a result of genetic factors. Alternatively, environmental factors could also trigger allergic reactions. Genetic predisposition was involved in both tonsillitis and the subsequent allergic response to the drugs prescribed.

 

References

Cavalcanti, V. P., Camargo, L. A. D., Moura, F. S., Melo Fernandes, E. J. D., Lamaro-Cardoso, J., Braga, C. A. D. S. B., & André, M. C. P. (2019). Staphylococcus aureus in tonsils of patients with recurrent tonsillitis: prevalence, susceptibility profile, and genotypic characterization. Brazilian Journal of Infectious Diseases, 23(1), 8-14. http://dx.doi.org/10.1016/j.bjid.2018.12.003 

Gaedigk, A. (2020). Faculty opinions recommendation of genome-wide study identifies association between HLA-b∗55:01 and self-reported penicillin allergy. Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature. https://doi.org/10.3410/f.738616609.793578263

Mikola, E., Elenius, V., Saarinen, M., Palomares, O., Waris, M., Turunen, R., Puhakka, T., Ivaska, L., Rückert, B., Aab, A., Vahlberg, T., Vuorinen, T., Allander, T., Camargo, C. A., Akdis, M., Akdis, C. A., & Jartti, T. (2018). Tonsillar cytokine expression between patients with tonsillar hypertrophy and recurrent tonsillitis. Clinical and Translational Allergy, 8(1). https://doi.org/10.1186/s13601-018-0205-z