Week 1 Case Study Template
A 35-year-old woman presents to the primary care office with a history of nasal congestion that
has worsened over time and recurrent sinus infections. She considered herself healthy until about
12 months ago when she began experiencing rhinorrhea, sneezing, and nasal stuffiness that
"seems to never go away". She noticed that her rhinorrhea greatly improved when she attended
her family reunion on a two-week Caribbean cruise but returned after being home a few days.
She lives with her husband and 5- year-old child. They have two household pets: a dog that has
lived with them for the last 4 years and a cat who joined the family 1 year ago.
Pathophysiology & Clinical Findings of the Disease
1. Identify the correct hypersensitivity reaction:
The likely diagnoses of this patient would be allergic rhinitis (AR), however there are
methods, diagnostic procedures and tools used to determine a clear diagnosis for this
patient such as: screening the patient’s medical and family history, collection of genetic
factors and environmental factors. The patient may obtain a skin prick test, patch test or
intradermal test through an allergist to determine their sensitivities (American College of
Allergy, Asthma, and Immunology, 2020).
2. Explain the pathophysiology associated with the chosen hypersensitivity reaction:
Allergic rhinitis, also known as hay fever, includes symptoms which affect the nose. It
occurs when the body recognizes something in the environment and overly reacts. This
hypersensitivity is considered an immune response. There are four types of
hypersensitivity reactions: type I (IgE-mediated reactions), type II (tissue-specific
reactions), type III (immune complex–mediated reactions), and type IV (cell-mediated
reactions). Many allergic reactions like allergic rhinitis are considered type I (IgE-
mediated reactions). The first exposure to an allergen causes a presentation of the
antigen-presenting cell to B lymphocytes, which is considered the followers of T-cells
(Th2 cells). These Th2 cells produce cytokines that assist in maturation of the B
lymphocytes into plasma cells that secrete IgE. The IgE is absorbed to the surface of the
mast cell by binding to specific IgE Fc receptors. When there is a significant amount of
IgE bound to the mast cell it then becomes sensitized. When an individual is re-exposed
to the the allergen, the allergen ultimately cross-links the IgE that’s bound to the mast cell
and causes degranulation of the mast cell. The mast cell then induces a reaction which
causes histamine in the body to react inducing local edema, mucous secretion, smooth
muscle contraction and other acute inflammatory responses (McCance, K. L., & Huether,
S. E., 2019). Regarding the case study the 35-year-old woman presented with nasal
congestion and recurrent sinus infections, she noticed a great improvement when she
went on a two-week Caribbean cruise when she was no longer exposed to the allergen,
This study source was downloaded by 100000824189183 from CourseHero.com on 02-26-2022 12:46:29 GMT -06:00
https://www.coursehero.com/file/83075841/NP-NR507-Week-1-Case-Study-Templatedocx/
, Week 1 Case Study Template
the cat who joined the family 1 year ago, the same timeframe of when her symptoms
began.
3. Identify at least three subjective findings from the case:
In the case study presented, the patient stated that she was experiencing the following
symptoms: sneezing, recurrent sinus infections and nasal stuffiness that “seems to never
go away”.
4. Identify at least three objective findings from the case:
If the patient were to visit the primary care office for an examination, objective findings
for the patient who is experiencing allergic rhinitis presents with rhinorrhea, bluish or
pale swelling of the nasal mucosa, ocular issues like swollen conjunctivae and watery
discharge (American Academy of Otolaryngology - Head and Neck Surgery Foundation,
2015).
This study source was downloaded by 100000824189183 from CourseHero.com on 02-26-2022 12:46:29 GMT -06:00
https://www.coursehero.com/file/83075841/NP-NR507-Week-1-Case-Study-Templatedocx/
A 35-year-old woman presents to the primary care office with a history of nasal congestion that
has worsened over time and recurrent sinus infections. She considered herself healthy until about
12 months ago when she began experiencing rhinorrhea, sneezing, and nasal stuffiness that
"seems to never go away". She noticed that her rhinorrhea greatly improved when she attended
her family reunion on a two-week Caribbean cruise but returned after being home a few days.
She lives with her husband and 5- year-old child. They have two household pets: a dog that has
lived with them for the last 4 years and a cat who joined the family 1 year ago.
Pathophysiology & Clinical Findings of the Disease
1. Identify the correct hypersensitivity reaction:
The likely diagnoses of this patient would be allergic rhinitis (AR), however there are
methods, diagnostic procedures and tools used to determine a clear diagnosis for this
patient such as: screening the patient’s medical and family history, collection of genetic
factors and environmental factors. The patient may obtain a skin prick test, patch test or
intradermal test through an allergist to determine their sensitivities (American College of
Allergy, Asthma, and Immunology, 2020).
2. Explain the pathophysiology associated with the chosen hypersensitivity reaction:
Allergic rhinitis, also known as hay fever, includes symptoms which affect the nose. It
occurs when the body recognizes something in the environment and overly reacts. This
hypersensitivity is considered an immune response. There are four types of
hypersensitivity reactions: type I (IgE-mediated reactions), type II (tissue-specific
reactions), type III (immune complex–mediated reactions), and type IV (cell-mediated
reactions). Many allergic reactions like allergic rhinitis are considered type I (IgE-
mediated reactions). The first exposure to an allergen causes a presentation of the
antigen-presenting cell to B lymphocytes, which is considered the followers of T-cells
(Th2 cells). These Th2 cells produce cytokines that assist in maturation of the B
lymphocytes into plasma cells that secrete IgE. The IgE is absorbed to the surface of the
mast cell by binding to specific IgE Fc receptors. When there is a significant amount of
IgE bound to the mast cell it then becomes sensitized. When an individual is re-exposed
to the the allergen, the allergen ultimately cross-links the IgE that’s bound to the mast cell
and causes degranulation of the mast cell. The mast cell then induces a reaction which
causes histamine in the body to react inducing local edema, mucous secretion, smooth
muscle contraction and other acute inflammatory responses (McCance, K. L., & Huether,
S. E., 2019). Regarding the case study the 35-year-old woman presented with nasal
congestion and recurrent sinus infections, she noticed a great improvement when she
went on a two-week Caribbean cruise when she was no longer exposed to the allergen,
This study source was downloaded by 100000824189183 from CourseHero.com on 02-26-2022 12:46:29 GMT -06:00
https://www.coursehero.com/file/83075841/NP-NR507-Week-1-Case-Study-Templatedocx/
, Week 1 Case Study Template
the cat who joined the family 1 year ago, the same timeframe of when her symptoms
began.
3. Identify at least three subjective findings from the case:
In the case study presented, the patient stated that she was experiencing the following
symptoms: sneezing, recurrent sinus infections and nasal stuffiness that “seems to never
go away”.
4. Identify at least three objective findings from the case:
If the patient were to visit the primary care office for an examination, objective findings
for the patient who is experiencing allergic rhinitis presents with rhinorrhea, bluish or
pale swelling of the nasal mucosa, ocular issues like swollen conjunctivae and watery
discharge (American Academy of Otolaryngology - Head and Neck Surgery Foundation,
2015).
This study source was downloaded by 100000824189183 from CourseHero.com on 02-26-2022 12:46:29 GMT -06:00
https://www.coursehero.com/file/83075841/NP-NR507-Week-1-Case-Study-Templatedocx/
