CASE: Wilbur, a 55-year-old male client, presents to the NP complaining of a flat, purple-colored rash
on his back and chest. Wilbur states the rash is not painful or itchy. He states it has been there for
months, and he has also developed a white coating on his tongue and has “been sick a lot” lately.
Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
a. Discuss the underlying pathophysiological mechanisms of your assigned disease process.
Which clinical manifestations observed in Wilbur’s case may be explained by the
pathophysiological mechanisms?
b. Analyze Wilbur’s clinical manifestations as they relate to your assigned disease process. Do these
findings support your assigned disease process? Why or why not?
ALLERGIES
Allergies are mediated by a class of antibodies called immunoglobulin E or IgE. This antibody is
activated by a subtype of T-lymphocytes known as type 2 helper T-cells. IgE molecules then bind to their
receptors on the surface of mast cells and basophils. This then triggers a signaling cascade that induces the
release of histamine, prostaglandins, and leukotrienes (Elzagallaai & Rieder, 2024). These chemicals
cause dilation and increased permeability of blood vessels, mucus secretions, muscle spasms, or
stimulation of sensory nerves and are responsible for allergic symptoms, which can range from mild to
severe. In the case scenario given, the patient’s signs and symptoms do not support the allergies
pathophysiological mechanisms. Allergic reactions typically cause clinical manifestations such as runny
nose, hives, itching, inflammation, and respiratory symptoms, none of which the said patient is
experiencing.
c. Identify and justify the diagnostic tests (including labs, imaging, or other diagnostic tests)
that may be most appropriate for investigating your assigned disease process as the diagnosis for
Wilbur. Discuss anticipated test results.
on his back and chest. Wilbur states the rash is not painful or itchy. He states it has been there for
months, and he has also developed a white coating on his tongue and has “been sick a lot” lately.
Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
a. Discuss the underlying pathophysiological mechanisms of your assigned disease process.
Which clinical manifestations observed in Wilbur’s case may be explained by the
pathophysiological mechanisms?
b. Analyze Wilbur’s clinical manifestations as they relate to your assigned disease process. Do these
findings support your assigned disease process? Why or why not?
ALLERGIES
Allergies are mediated by a class of antibodies called immunoglobulin E or IgE. This antibody is
activated by a subtype of T-lymphocytes known as type 2 helper T-cells. IgE molecules then bind to their
receptors on the surface of mast cells and basophils. This then triggers a signaling cascade that induces the
release of histamine, prostaglandins, and leukotrienes (Elzagallaai & Rieder, 2024). These chemicals
cause dilation and increased permeability of blood vessels, mucus secretions, muscle spasms, or
stimulation of sensory nerves and are responsible for allergic symptoms, which can range from mild to
severe. In the case scenario given, the patient’s signs and symptoms do not support the allergies
pathophysiological mechanisms. Allergic reactions typically cause clinical manifestations such as runny
nose, hives, itching, inflammation, and respiratory symptoms, none of which the said patient is
experiencing.
c. Identify and justify the diagnostic tests (including labs, imaging, or other diagnostic tests)
that may be most appropriate for investigating your assigned disease process as the diagnosis for
Wilbur. Discuss anticipated test results.
