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1. Provide three differential diagnoses based on Janet’s
subjective and objective data and discuss your reasoning for
each.
Hay fever, food allergies and viral infection that presents as a
cold with allergic symptoms would be the top three indications
based off of the signs and symptoms being presented by Janet
(Mayo Clinic, 2019b). Hay fever causes seasonal allergies along
with a clear runny nose, post-nasal drip and irritated nares.
Food allergies can cause eczema and allergic symptoms
affecting the ear note and throat (Mayo Clinic, 2017). A viral
infection such as the common cold can also exacerbate a runny
nose, sneezing, post-nasal drainage and inflamed lymph nodes
(Mayo Clinic, 2019a).
2. What additional history questions would be useful in your
evaluation of Janet?
You can ask valid questions such like when did the symptoms
begin? Have you been around anyone else who is sick? What
makes the symptoms worse? Have you had a recent in change in
environment or food? What makes the symptoms seem worse or
better? Have you tried taking any medication and if so, what has
worked/not worked? Does anyone in your family suffer from
any allergies? Have you had seasonal/food allergies ever
checked?
3. Discuss the pathophysiological process of your primary
diagnosis.
Janet is suffering from Hay fever during the changes in seasons
during Spring and Fall which is when pollen counts are
elevated. According to Mayo Clinic (2019) Hay fever, also
called allergic rhinitis, causes cold-like signs and symptoms,
such as a runny nose, itchy eyes, congestion, sneezing and sinus
pressure. But unlike a cold, hay fever isn't caused by a virus.
Hay fever is caused by an allergic response to outdoor or indoor
allergens, such as pollen, dust mites, or tiny flecks of skin and
saliva shed by cats, dogs, and other animals with fur or feathers
(pet dander).
4. Differentiate the types of hypersensitivity mechanisms.
Type I hypersensitivity is also known as immediate or
anaphylactic hypersensitivity. The reaction may involve skin
(urticaria and eczema), eyes (conjunctivitis), nasopharynx
(rhinorrhoea, rhinitis), bronchopulmonary tissues (asthma) and
gastrointestinal tract (gastroenteritis). The reaction may cause a
range of symptoms from minor inconvenience to death. The
reaction usually takes 15 - 30 minutes from the time of exposure
to the antigen, although sometimes it may have a delayed onset
of 10-12 hours (Ghaffar, 2016).
Type II hypersensitivities are also known as cytotoxic
hypersensitivities and may affect a variety of organs and
tissues. The antigens are normally endogenous, although
exogenous chemicals (haptens) which can attach to cell
membranes and lead to type II hypersensitivity. Drug-induced
hemolyticanemia, granulocytopenia and thrombocytopenia are
examples. The reaction time is minutes to hours. Type II
hypersensitivity are primarily mediated by antibodies of the
IgM or IgG classes and complement. Phagocytes and K cells
may also play a role (Ghaffar, 2016).
Type III hypersensitivity is also known as immune complex
hypersensitivity. The reaction may be general such as serum
sickness or may involve individual organs including skin like
systemic lupus erythematosus, an Arthur reaction, kidneys,
lupus-nephritis, lungs-aspergillosis, blood vessels-polyarteritis,
joints-rheumatoid arthritis, or other organs. This reaction may
be the pathogenic mechanism of diseases caused by many
microorganisms.
Type IV hypersensitivity is involved in the pathogenesis of
many autoimmune and infectious diseases (tuberculosis,
leprosy, blastomycosis, histoplasmosis, toxoplasmosis,
leishmaniasis, etc.) and granulomas due to infections and
foreign antigens. Another form of delayed hypersensitivity is
contact dermatitis such as with poison ivy, and heavy metals
(Ghaffar, 2016).
5. As per your analysis, what type of hypersensitivity reaction
is Janet experiencing?
Allergic disorders (type I hypersensitivity) associated with
asthma, hay fever, and drug reactions, as well as parasitic
infections (particularly with metazoan parasites) are often cited
as causes. Allergic reactions can present as the patient having
and increased number in eosinophilia is an absolute increase
(more than 450/μL) in the total numbers of circulating
eosinophils (McCance&Huether, 2014).
References
Ghaffar, A. (2016, April 2).
Hypersensitivity reactions.
Retrieved from
http://www.microbiologybook.org/ghaffar/hyper00.htm
Mayo Clinic. (2019, April 20).
Common cold Symptoms and causes.
Retrieved from https://www.mayoclinic.org/diseases-
conditions/common-cold/symptoms-causes/syc-20351605
Mayo Clinic. (2017, May 2).
Food allergy Symptoms and causes.
Retrieved from
https://www.mayoclinic.org/diseases-conditions/food-
allergy/symptoms-causes/syc-20355095
Mayo Clinic. (2019, March 19).
Hay fever symptoms and causes.
Retrieved from
https://www.mayoclinic.org/diseases-conditions/hay-
fever/symptoms-causes/syc-20373039
McCance, K., Huether, S. (2014).
Pathophysiology: The Biologic Basis for Disease in Adults and
Children
, (7th Ed). Mosby, St. Louis, Missouri. [Vital Book
File]. HASDOIHFOCINDLKCNBION

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1. Provide three differential diagnoses based on Janet’s subjective .docx

  • 1. 1. Provide three differential diagnoses based on Janet’s subjective and objective data and discuss your reasoning for each. Hay fever, food allergies and viral infection that presents as a cold with allergic symptoms would be the top three indications based off of the signs and symptoms being presented by Janet (Mayo Clinic, 2019b). Hay fever causes seasonal allergies along with a clear runny nose, post-nasal drip and irritated nares. Food allergies can cause eczema and allergic symptoms affecting the ear note and throat (Mayo Clinic, 2017). A viral infection such as the common cold can also exacerbate a runny nose, sneezing, post-nasal drainage and inflamed lymph nodes (Mayo Clinic, 2019a). 2. What additional history questions would be useful in your evaluation of Janet? You can ask valid questions such like when did the symptoms begin? Have you been around anyone else who is sick? What makes the symptoms worse? Have you had a recent in change in environment or food? What makes the symptoms seem worse or better? Have you tried taking any medication and if so, what has worked/not worked? Does anyone in your family suffer from any allergies? Have you had seasonal/food allergies ever checked? 3. Discuss the pathophysiological process of your primary diagnosis. Janet is suffering from Hay fever during the changes in seasons during Spring and Fall which is when pollen counts are elevated. According to Mayo Clinic (2019) Hay fever, also called allergic rhinitis, causes cold-like signs and symptoms, such as a runny nose, itchy eyes, congestion, sneezing and sinus
  • 2. pressure. But unlike a cold, hay fever isn't caused by a virus. Hay fever is caused by an allergic response to outdoor or indoor allergens, such as pollen, dust mites, or tiny flecks of skin and saliva shed by cats, dogs, and other animals with fur or feathers (pet dander). 4. Differentiate the types of hypersensitivity mechanisms. Type I hypersensitivity is also known as immediate or anaphylactic hypersensitivity. The reaction may involve skin (urticaria and eczema), eyes (conjunctivitis), nasopharynx (rhinorrhoea, rhinitis), bronchopulmonary tissues (asthma) and gastrointestinal tract (gastroenteritis). The reaction may cause a range of symptoms from minor inconvenience to death. The reaction usually takes 15 - 30 minutes from the time of exposure to the antigen, although sometimes it may have a delayed onset of 10-12 hours (Ghaffar, 2016). Type II hypersensitivities are also known as cytotoxic hypersensitivities and may affect a variety of organs and tissues. The antigens are normally endogenous, although exogenous chemicals (haptens) which can attach to cell membranes and lead to type II hypersensitivity. Drug-induced hemolyticanemia, granulocytopenia and thrombocytopenia are examples. The reaction time is minutes to hours. Type II hypersensitivity are primarily mediated by antibodies of the IgM or IgG classes and complement. Phagocytes and K cells may also play a role (Ghaffar, 2016). Type III hypersensitivity is also known as immune complex hypersensitivity. The reaction may be general such as serum sickness or may involve individual organs including skin like systemic lupus erythematosus, an Arthur reaction, kidneys, lupus-nephritis, lungs-aspergillosis, blood vessels-polyarteritis, joints-rheumatoid arthritis, or other organs. This reaction may be the pathogenic mechanism of diseases caused by many
  • 3. microorganisms. Type IV hypersensitivity is involved in the pathogenesis of many autoimmune and infectious diseases (tuberculosis, leprosy, blastomycosis, histoplasmosis, toxoplasmosis, leishmaniasis, etc.) and granulomas due to infections and foreign antigens. Another form of delayed hypersensitivity is contact dermatitis such as with poison ivy, and heavy metals (Ghaffar, 2016). 5. As per your analysis, what type of hypersensitivity reaction is Janet experiencing? Allergic disorders (type I hypersensitivity) associated with asthma, hay fever, and drug reactions, as well as parasitic infections (particularly with metazoan parasites) are often cited as causes. Allergic reactions can present as the patient having and increased number in eosinophilia is an absolute increase (more than 450/μL) in the total numbers of circulating eosinophils (McCance&Huether, 2014). References Ghaffar, A. (2016, April 2). Hypersensitivity reactions. Retrieved from http://www.microbiologybook.org/ghaffar/hyper00.htm Mayo Clinic. (2019, April 20). Common cold Symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases- conditions/common-cold/symptoms-causes/syc-20351605 Mayo Clinic. (2017, May 2). Food allergy Symptoms and causes.
  • 4. Retrieved from https://www.mayoclinic.org/diseases-conditions/food- allergy/symptoms-causes/syc-20355095 Mayo Clinic. (2019, March 19). Hay fever symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/hay- fever/symptoms-causes/syc-20373039 McCance, K., Huether, S. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children , (7th Ed). Mosby, St. Louis, Missouri. [Vital Book File]. HASDOIHFOCINDLKCNBION