Alterations in cellular processes
The disease suggested by the case study is streptococcal pharyngitis, which is primarily an infection of the back of the throat. Clinical research shows that genetics often play a role in the disease’s pathogenesis. The disease is a multifactorial disorder. McCance and Huether (2019) define a multifactorial disorder as a disease resulting when small variations in genes interact with the environmental factors to produce severe defects. This is the nature of streptococcal pharyngitis. According to Ibrahim, Eisen, Jospin, Coil, Khazen, and Tokajian (2016) when variations in emm28 strains occur, and it follows that a person is exposed to environmental pollutants including occupational and hazardous irritants, streptococcal pharyngitis is more likely to develop. McCance and Huether (2019) document that multifactorial disorders cluster in families.
The boy described in the case study is presenting with a series of specific symptoms. These include a sore throat that has lasted for three days, a pulse of 78 and regular with respirations of 18, and a temperature of 99.6F. Besides this, the physical examination shows that the client has reddened posterior pharynx characterized by white exudate on tonsils, which are enlarged to 3+. The patient has positive posterior and anterior cervical adenopathy. Also, the case study reveals that the rapid strep test was positive. The key reason for these symptoms is primarily because of infectious mononucleosis. According to McCance and Huether (2019), the action of infectious mononucleosis involves a proliferation of T and B cell clones along with the removal of damaged and dead leukocytes. This process, in turn, leads to the swelling of cervical lymphoid tissues. Once a person is infected, splenomegaly occurs, leading to acute sore throat due to inflammation at the viral entry site.
The case study reveals a physiologic response to the stimulus. After taking an amoxicillin capsule, the patient complained immediately of swelled lips and tongue. He also complained that he was having difficulties breaking with audible wheezing. The most probable cause of this physiologic response was because of the lack of B cells. As Soo (2018) seems to show, deficient B cells implies that a person does not have the lasting function typical following the suppression of a specific infectious invader. Another potential cause of the reactions, as supposed by Vaillant and Zito (2020) is drug allergy mediated by IgE antibodies, which are often produced by the immune system in response to environmental proteins. Vaillant and Zito (2020) claim that drugs such as penicillin, which amoxicillin is part of, causes allergic reactions through any hypersensitivity mechanisms. For instance, the drug cause IgE-mediated anaphylaxis leading to a cross-reaction with other semisynthetic drugs.
If the case study incorporated other characteristic, my response above would change depending on the attribute mentioned. For example, if the case study identified a different gender (a girl instead of a boy), my response would remain the same. McCance and Huether (2019) show that the impact of deficient B cells is the same for expectant mothers and people of all ages. However, if the case study mentioned something to do with genetics, my response would inevitably change. I would pose that the boy’s genetic composition comprises HLA genes. According to Bergmann, Villard, and Caubet (2014), the HLA genes are risk factors in the pathogenesis of severe allergic reactions to specified drugs. According to the authors, these genes lead to hypersensitivity even before a drug starts a reaction in the body after ingestion.
References
Bergmann, M. M., Villard, J., & Caubet, J. C. (2014). Genetic predispositions in drug allergy: the role of HLA. Revue medicale suisse, 10(426), 864-868.
Ibrahim, J., Eisen, J. A., Jospin, G., Coil, D. A., Khazen, G., & Tokajian, S. (2016). Genome analysis of Streptococcus pyogenes associated with pharyngitis and skin infections. PloS one, 11(12), e0168177.
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, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds
Vaillant, A. A. J., & Zito, P. M. (2020). Immediate Hypersensitivity Reactions. New York, NY: StatPearls Publishing.