Response #2: Go back into your own initial post.

• Identify what diagnostic testing or additional information you might need to establish a diagnosis.
• Identify what you believe is the correct diagnosis for the patient in the case study with the rationale for your response.
• Identify why the differential diagnoses left by your peers are or are not the correct diagnosis and support this with evidence from research and from the case posted by your peers.

                            My  Initial Post

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

All of her vital signs are normal. This indicates that she isn’t suffering from a life-threatening infection. If she had an infection, she would have a high fever, hypotension, vomiting, diarrhea, nausea, or overall exhaustion (Sepsis, 2020).

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

Form 1 immediate hypersensitivity.

IgE is the mediator of category 1 hypersensitivity reactions. They are a reaction to antigens in the air that are often referred to as allergies. IgE binds to mast cells through the crystalline segment Fc receptor, causing degranulation of mast cells and histamine production (McCance & Huether, 2019).

3. 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 three weeks later?

Anna was symptom-free as her body became sensitized to cat dander from the moment she was first subjected to it. Her B-lymphocytes were producing antibodies that bound on the outside of the mast cells. To become sensitized, an individual must be exposed to the agent regularly. With adequate antigen exposure, one antigen can bind to two molecules of IgE-Fc binding proteins on the membrane of a mast cell, allowing intracellular signal transduction pathways to be triggered and mast cell chemotaxis to occur. Signs of an inflammatory reaction can develop once mast cells begin to degranulate.

4. What class of antibodies bind to the mast cells? 

Antibodies which attach to mast cells are divided into two categories; cytotropic (i.e., cell-attracting) antibody, or restore (skin) Skin-binding antibodies (sensitizing antibodies)

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

Mast cells hazard the board and produce inflammatory cytokines as cat dander allergens bind to IgE antibodies on their surface. Redness is caused by mediators that induce vasodilation. The biological effect of histamine is thought to be the cause of type 1 reaction. Areas with a significant number of mast cells, typically at the main point of entry, are the most frequently affected tissues. The intestinal mucosa, eyes, and respiratory system contain most mast cells, which are the most responsive to histamine. The redness of Anna’s nasal mucosa, also known as rhinitis, is because signs are most frequently expressed at the port of entry. Blood vessels dilation, mucus hypersecretion, fluid retention, and inflammation of the mucous membranes of the breathing tract’s mucosal layer are the causes of these effects (McCance & Huether, 2019)

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

Fluid exudation and elevated mucus secretion were caused by high capillary permeability and dilation of blood vessels caused by inflammatory cytokines produced by mast cells. This runoff is most likely the source of Anna’s tickling cough. Also, signs are most likely at the point of entry; for this situation, the nose routes, which may result in mucus hypersecretion from the mucosa in the nasal tract, can flow down the lower part and induce cough.

References

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: the biologic basis for disease in adults and children (Eighth). Elsevier.

What is Sepsis (December 16, 2020). Centers for Disease Control and Prevention. https/cdc.gov/sepsis/what-is-sepsis.html