NURS 6501 Advanced Pathophysiology Week 1 Discussion

An infection by a disease causing microorganisms often lead to alteration in the cellular responses. The alteration in the cellular responses result in the development of signs and symptoms that guide the development of diagnoses and treatment plans. The cellular responses also reflect the active role that innate and acquired immunity plays in preventing individuals from a disease. The management of diseases relies on the use of interventions such as prescription of pharmacological agents. Patient factors must be considered in the prescription of drugs to minimize the risk of adverse events. Therefore, this paper examines a case study to evaluate the role of genetics, presentation of signs and symptoms and influence of age on the selected patient assignment.

The Role of Genetics in the Disease

Recurrent sore throat is a common health problem in children. Streptococcus group A bacteria causes this health problem and is often associated with genetics (Zupin et al., 2016). Accordingly, the existence of genetic variations in the HLA region have been linked to the recurrence in sore throat. The variations in the HLA region of the genes have been shown to cause gene mediated interaction with the bacteria causing sore throat (Tian et al., 2017). The genetic variation in the HLA region has also been shown to alter the normal innate as well as acquire defense systems towards the bacterial infection (Pearce et al., 2020). The influence of genetics in sore throat can also be seen in the recurrence of the disease in twins. The recurrence of sore-throat related infections such as tonsillitis in identical twins is almost similar while the rate of recurrence varies in dizygotic twins. Due to this, scholars argue that about 60% of sore throat recurrence in children is associated with environmental exposures while the rest occurs due to environmental exposure. Similar findings can be seen in the study by Bager et al., (2018) where the researchers found the recurrence of severe tonsillitis to be highly linked to genetic factors. The authors found that the influence of genetics on the development of severe tonsillitis did not depend on patient’s age and sex. Therefore, genetics play a role in the recurrence of the sore throat infections.

Why Patient is presenting with the Specific Symptoms

The signs and symptoms that the patient presented with to the hospital is attributed to the changes in the cellular response processes. The invasion of the body with Streptococcus group A bacteria stimulates immune response that is characterized by the secretion of pus as well as reddening and inflammation of the tonsils. The production of pus arises from the release of inflammatory cells in response to the infection to fight the bacteria. As a result, the clinical symptoms of sore throat develop due to the accumulation of the fibronectin-binding proteins in the pharynx. The symptoms that the patient reported following ingestion of amoxicillin were attributed to allergic reactions to antibiotics. The symptoms show that the ingestion of amoxicillin led to the stimulation of the immune system to release IgE. The release of IgE increased the secretion of inflammatory cells such as interleukins and cytokines. The result of these processes is that massive inflammation occurred leading to vomiting, nausea, fast heart rate, difficulty in breathing, wheezing, swelling of the face and lips and shock. These symptoms are the signs or allergic response to an allergen such as drug or environmental pollutant.

Physiologic Response to Stimuli

A number of signs and symptoms in the case study demonstrate the patient’s response to stimuli. The signs and symptoms include the reddening of the posterior pharynx alongside the enlargement of the tonsils 3+. The assessment also revealed posterior and anterior cervical adenopathy, which imply immune response to the infection. A rapid strep test also confirmed the positive diagnosis of streptococcus group A bacteria (Volavšek, 2016). These symptoms were experienced due to the patient’s acquired and innate response to the infection.

Cells and Cellular Mediators

The cellar mediators that were involved in the response to the infection include prostaglandins E2m chemokines, leukotriene B4, eicosanoids, antimicrobial peptides, and cytokines that enhanced the inflammatory processes. The cells that were involved in the response include macrophages, neutrophils, epithelial, mast, and dendritic cells. The mediated actions of these cells and the cellular response mechanisms led to the development of the signs and symptoms of the disease as well as recovery from it (Kırmusaoğlu, 2018). The response to infection by the cells also led to the symptoms seen in the allergic reaction to amoxicillin.

Effect of Age on Response

The response to Streptococcus group A bacterial infections vary with age. Unlike children, adults are least likely to be affected by the infection. The symptoms of the infection are also less severe in adults than in children. The differences in the response is attributed to the influence of immune system development in adults than in children (Chanmugam et al., 2016). Therefore, healthcare providers should make treatment decisions with a consideration of the age of the patients to minimize the risk of adverse drug events.

References

Bager, P., Corn, G., Wohlfahrt, J., Boyd, H. A., Feenstra, B., & Melbye, M. (2018). Familial aggregation of tonsillectomy in early childhood and adolescence. Clinical Epidemiology, 10, 97–105. https://doi.org/10.2147/CLEP.S148575

Chanmugam, A. S., Bissonette, A., Rothman (MD), R., Desai, S. V., & Putman, S. B. (2016). Infectious Diseases Emergencies. Oxford University Press.

Kırmusaoğlu, S. (2018). Bacterial Pathogenesis and Antibacterial Control. BoD – Books on Demand.

Pearce, S., Bowen, A. C., Engel, M. E., Lande, M. de la, & Barth, D. D. (2020). The incidence of sore throat and group A streptococcal pharyngitis in children at high risk of developing acute rheumatic fever: A systematic review and meta-analysis. PLOS ONE, 15(11), e0242107. https://doi.org/10.1371/journal.pone.0242107

Tian, C., Hromatka, B. S., Kiefer, A. K., Eriksson, N., Noble, S. M., Tung, J. Y., & Hinds, D. A. (2017). Genome-wide association and HLA region fine-mapping studies identify susceptibility loci for multiple common infections. Nature Communications, 8(1), 599. https://doi.org/10.1038/s41467-017-00257-5

Volavšek, M. (2016). Head and Neck Pathology. Springer International Publishing.

Zupin, L., Angelelli, F., Grasso, D., & Crovella, S. (2016). Lactoferrin gene polymorphisms in Italian patients with recurrent tonsillitis. International Journal of Pediatric Otorhinolaryngology, 88. https://doi.org/10.1016/j.ijporl.2016.07.002

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.

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.

Read a selection of your colleagues’ responses.

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

NURS 6501 Advanced Pathophysiology Week 1 Discussion