Part 1: Choose a condition from the following case studies: (Week 2 Case Study Details). You may work in small groups of up to 3 students if desired.

Part 2: Select two different students/topics and discuss the condition encompassing clinical experiences and critique the post. Case Studies and Discussion: HIV, Chronic Sinusitis and Benign Endometrial Hyperplasia Essay Paper

Case Studies and Discussion: HIV, Chronic Sinusitis, and Benign Endometrial Hyperplasia

Case study 1: A 30 year-old with a history of IV drug use, HIV, and diagnosed with pneumonia

1. This patient probably has a chronic state of inflammation. The rationale for this is that they are a regular intravenous drug user who regularly injects themselves. This in itself is injurious to the tissues and will elicit a chronic inflammatory response. Having HIV is also another reason as to why this patient would be having a chronic state of inflammation. The reason is that HIV causes immunosuppression such that the body’s immune system cannot function well. For this reason, any disease process that starts may go unchallenged and cause rampant inflammation (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
2. Cellular replication is important in HIV because the virus causing the condition is a reverse transcriptase virus or retrovirus. This means that it causes the replication of cells through reverse transcription. Translation and transcription are two processes at the genetic and molecular level that cells use to manufacture proteins. The HIV virus hijacks the transcription phase and uses the cell’s resources to produce copies of itself (Jameson et al., 2018).
3. Viral load is the amount of freely moving HIV retroviruses in the body as measured by the CD4 count. The relationship with the CD4 T cells is that it is these immune cells that are preferred for attack by the virus such that they inhabit inside these cells. Measuring the number of these cells in an infected person helps estimate the viral load of HIV (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
4. The pneumonia occurred because of the immunosuppression. Persons with HIV who are not actively taking antiretroviral medications to reduce the viral load usually are prone to getting the particular type of pneumonia known as Pneumocystis carinii pneumonia (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
   

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Case study 2: A 25 year-old male with chronic sinusitis and allergic rhinitis

1. Innate immunity is immunity that one is born with and it is provided by the immune cells of the body such as the T lymphocytes. Epithelial barriers also provide the first line of defense and thus qualify as innate immunity. Acquired immunity on the other hand is immunity that has been stimulated as a result of an intervention such as vaccination (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
2. Active immunity occurs when one produces antibodies themselves after stimulation of their immune cells by pathogens. Passive immunity on the other hand is immunity from a differ source that is just introduced into the host’s body. In other words, the antibodies are not made by the host. The best example is immunization or vaccination (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
3. The genetic predisposition of allergens is that a person is usually born with a genetic polymorphism that makes them sensitive to a specific allergen. When exposed to the allergen, the person then develops symptoms mediated by the immune system such as the release of histamine (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
4. The antigen-antibody response involves the stimulation of immune cells by external stimuli (antigens). These are recognized by the immune system and the cells immediately start producing antibodies against the antigens. The first response is usually not so pronounced in most cases. However, subsequent exposure may cause such an immediate and magnified response that it may be life-threatening as in anaphylactic reaction (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
5. The pathology of sinusitis is the infection by a pathogen that is usually a virus. The differential diagnosis could be a bacterial infection (Cook & Décary, 2019). The inflammation causes swelling and the production of secretions from the nasal glands. This is what causes blockage and the rhinorrhea (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).  Case Studies and Discussion: HIV, Chronic Sinusitis and Benign Endometrial Hyperplasia Essay Paper

Case study 3: A 40 year-old female with benign endometrial hyperplasia on biopsy

1. Benign endometrial hyperplasia means that there is a rapid growth of cells in the interior lining of the uterus but that is not cancerous (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
2. The cells involved are called benign endometrial cells or BECs. Atrophy is the reduction in size of a gland or a muscle due to lack of use or exercise. Hyperplasia on the other hand is the rapid multiplication of cells in a part of the body (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
3. Hyperplasia and dysplasia are both rapid proliferations of cells in the body. However, in hyperplasia the cells look normal under a microscope. In dysplasia, they look abnormal under a microscope but are not malignant (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).
4. Hyperplasia cannot lead to neoplasia for a simple reason. Neoplasia is the proliferation of cells as a result of genetic changes. Hyperplasia on the other side is proliferation based on either pathophysiology or physiology (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018).

References

Cook, C.E., & Décary, S. (2019). Higher order thinking about differential diagnosis. Brazilian Journal of Physical Therapy, 24(1), 1-7. https://doi.org/10.1016/j.bjpt.2019.01.010 

Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8^th ed. McGraw-Hill Education.

Huether, S.E. & McCance, K.L. (2017). Understanding pathophysiology, 6^th ed. Elsevier, Inc.

Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., & Loscalzo, J. (Eds) (2018). Harrison’s principles of internal medicine, 20^th ed. McGraw-Hill Education.

MSN570 Week 2 Case Studies

A 30-year-old presents with a history of IV drug use, HIV +, and is today diagnosed with  pneumonia.

1. Does the patient have an acute or chronic state of inflammation? Explain the rationale.
2. What is the significance of cellular replication in a patient with HIV?
3. What is viral load and what is the relationship with CD4 T cells?
4. How did the pneumonia occur?

A 25-year-old male presents with chronic sinusitis and allergic rhinitis.

1. Define innate vs. acquired immunity.
2. Define active vs. passive immunity.
3. Discuss the genetic predisposition of allergens.
4. Describe the antigen-antibody response.
5. What is the pathology of sinusitis?

A 40-year-old has an endometrial biopsy report:  benign endometrial hyperplasia.

1. Explain the diagnosis.
2. Which cells are implicated in this diagnosis?  Compare and contrast atrophy vs. hyperplasia.
3. How does dysplasia differ from hyperplasia?
4. Does hyperplasia lead to neoplasia? Defend your answer.

Case Studies and Discussion: HIV, Chronic Sinusitis and Benign Endometrial Hyperplasia Essay Paper