Associated alterations of tonsillitis

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Adaptive Response

Soha Alammoury

Walden University

NURS-6501N-1, Advanced Pathophysiology

March 15, 2015

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Adaptive Response

Scenario 1: Tonsillitis

The disorder depicted in the first scenario is tonsillitis. Tonsillitis can be caused by either

a viral or bacterial infection, although viral infections are more common. Bacteria cause 15-30%

of cases of pharyngotonsillitis. Anaerobic bacteria play an important role in tonsillar disease.

Most cases of bacterial tonsillitis are caused by group A beta-hemolytic Streptococcus pyogenes

(GABHS) (Shah & Meyers, 2014).

The adaptive responses associated with tonsillitis include fever, sore throat, foul breath,

dysphagia, odynophagia, swollen, red tonsils, headache, as well as loss of appetite. Tonsillitis

caused by Streptococcus species typically occurs in children aged 5-15 years (Shah & Meyers,

2014). The child in the scenario presents with a fever, tympanic membranes reddened on the

periphery, throat is erythematous with 4+ tonsils and diffuse exudates, and anterior cervical

nodes are tender to touch.

Scenario 2: Allergic Contact Dermatitis

The disorder depicted in the second scenario is allergic contact dermatitis. Allergic

contact dermatitis is “a common form of cell-mediated or delayed hypersensitivity that responds

in an interaction of skin barrier function, reaction to irritants, and neuronal responses, such as

pruritus” (Huether & McCance, 2012). With the pathophysiology of allergic contact dermatitis,

“as the allergens contacts the skin, the allergen is bound to a carrier protein, forming a sensitizing

antigen. The Langerhans cells (dendritic cells) process the antigen and carry it to T cells that then

become sensitized to the antigen, inducing the release of inflammatory cytokines and the

symptoms of dermatitis” (Huether & McCance, 2012). The disease is induced by chemicals and

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metal ions which penetrate the skin and form complexes with host proteins (Freudenberg, Esser,

Jakob, Galanos, & Martin, 2009).

The adaptive responses associated with allergic contact dermatitis include fever, itching,

erythema as well as pain. There are many common allergens including: adhesives, fabrics,

clothing, fragrances, nail polish, poison ivy, latex and metal. The individual in the scenario

works with abrasive solvents and chemicals which are most likely the reason for his problem of

redness and irritation in his hands. Allergy testing as well as physical assessment can help in

diagnosing.

Scenario 3: Depression

The disorder depicted in the third scenario is depression. There are many different factors

that cause depression. These factors include trauma, genetics, life circumstances (such as marital

status, finances), and drug and alcohol abuse. “Clinical and preclinical trials suggest a

disturbance in central nervous system serotonin (5-HT) activity as an important factor. The role

of CNS 5-HT activity in the pathophysiology of major depressive disorder is suggested by the

therapeutic efficacy of selective serotonin reuptake inhibitors (SSRIs). In addition, studies have

shown that an acute, transient relapse of depressive symptoms can be produced in research

subjects in remission using tryptophan depletion, which causes a temporary reduction in CNS 5-

HT levels” (Halverson & Bienenfeld, 2015).

The adaptive responses associated with depression include changes in sleep, changes in

appetite, lack of concentration, loss of energy, lack of interest, low self-esteem, hopelessness,

changes in movement and physical aches and pains ("National Alliance on Mental Illness -

Depression," 2015). In the scenario, Martha’s clinical presentation include a “racing heart,” loss

of appetite, and trouble sleeping.

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References

Freudenberg, M., Esser, P., Jakob, P., Galanos, C., & Martin, S. (2009). Innate and adaptive

immune responses in contact dermatitis: analogy with infections. US National Library of

Medicine National Institutes of Health, 144(2), 173-85.. Retrieved from

http://www.ncbi.nlm.nih.gov/pubmed/19357624

Halverson, J., & Bienenfeld, D. (2015). Depression. Retrieved from

http://emedicine.medscape.com/article/286759-overview#aw2aab6b2b3

Huether, S., & McCance, K. (2012).Understanding pathophysiology (5th ed.). St. Louis, MO:

Mosby.

National Alliance on Mental Illness - Depression. (2015). Retrieved from

http://www.nami.org/Learn-More/Mental-Health-Conditions/Depression

Shah, U., & Meyers, A. (2014). Tonsillitis and Peritonsillar Abscess. Retrieved from

http://emedicine.medscape.com/article/871977-overview#aw2aab6b2b2aa

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