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DISCUSSION POST # 1 Betsy

A 25 Year Old Male Presents with Chronic Sinusitis and Allergic Rhinitis.

Patients who go to the hospital presenting with allergic rhinitis (AR) experience nasal obstruction, itching, nasal discharge and sneezing (Helman et al., 2020). On the other hand, patients that present chronic sinusitis experience irritation of the sinus or nasal passages, which can occur exceeding 12 weeks at a time. Such patients present with cardinal signs of sinusitis that are pus-filled nasal discharge, facial or dental pain, and nasal obstruction (Kwon & O’Rourke, 2022).

Innate and Acquired Immunity

The immune system is instrumental beyond the structural and chemical barriers to pathogens. According to Marshall et al. (2018), the immune system comprise of two essential lines of resistance, which is the innate immunity and adaptive or acquired immunity. In innate immunity, it is the first immunological mechanism that aids in the fight against an intruding pathogen and it is a rapid immune system that arises in minutes of or hours of aggression (Marshall et al., 2018). On the other hand, the acquired immunity is antigen-dependent and antigen-specific, with the capacity to have memory, thereby enabling the host to mount a speedy and well-organized immune reaction upon ensuing contact to the antigen (Marshall et al., 2018).

Active and Passive Immunity

Active immunity arises after the production of antibodies against a particular antigen or pathogens after contact with the antigen, while passive immunity arises after the introduction of “ready-made” antibodies from one individual to the other (Marshall et al., 2018).

Genetic Predisposition of Allergens

These refer to the augmented chance or the probability of the development of a particular disease based on the presence of one or more genetic variants in a family or the history suggestive of an increased risk of the disease in the family (Larsson & Gill, 2021). For the case of the aforementioned patient it would have been because of genetic variants.

Antigen-Antibody Response

Antigen-antibody response encompasses a specific chemical collaboration between the antibodies formed by the B-cells of the white blood cells and antigens during the immune reaction (O’Connor, 2015).

Pathology of Sinusitis

This arises because of the chronic inflammation which can cause nasal passage thereby hindering drainage, leading to lower oxygen tension (Kwon & O’Rourke, 2022). 

DISCUSSION POST # 2 Nozomi

 In this case study, the 30-year old patient has a history of IV drug use, is HIV+, and is diagnosed with pneumonia. According to Capriotti and Frizzell (2017), HIV mainly infects CD4 cells, which are called helper T cells. CD4 cells play an important role in the human immune system by influencing all other cells of the immune system, including other T cells, B lymphocytes, macrophages, and NK cells (Capriotti & Frizzell, 2017). Additionally, CD4 cells are key players in cell-mediated immunity and are also involved in antibody-mediated adaptive immunity (Capriotti & Frizzell, 2017). In other words, when HIV attacks CD4 cells, it can potentially destroy both cell-mediated and antibody-mediated immune responses, which are two of the strongest human defense mechanisms (Capriotti & Frizzell, 2017).

                Once HIV infects CD4 cells, it fuses with CD4 cell surface receptors, and it inserts its RNA into the cell and uses an enzyme called reverse transcriptase to make viral DNA from RNA, which is then inserted into CD4 cell genome (Capriotti & Frizzell, 2017). When this happens, the HIV DNA makes the host cell CD4 synthesize and replicate more HIV particles (Capriotti & Frizzell, 2017). It is also terrifying that once HIV uses a CD4 cell to make more HIV, it then destroys the CD4 cell and moves on to the next CD4 cell (Capriotti & Frizzell, 2017). It is important to note that while the CD4 is inactive, HIV remains to be dormant until CD4 begins to replicate (Capriotti & Frizzell, 2017). In this way, HIV uses CD4 as a factory for HIV to multiply, and destroys the body’s immune system in the process.

                An important concept regarding HIV is the topic of viral load, which is a measure of how much virus is found in the blood stream (Capriotti & Frizzell, 2017). A viral load of over 100,000 copies/ml indicates a high risk for the development of AIDS for the patient (Capriotti & Frizzell, 2017). As the viral load increases, the number of CD4 cells decreases because of viral replication (Capriotti & Frizzell, 2017). When the number of CD4 cells is at or below 200, a patient is likely to experience opportunistic infections, such as candida, 
Pneumocysitis carinii pneumonia, toxoplasmosis, Cryptococcus, and TB (Capriotti & Frizzell, 2017).

                In the acute stage of the HIV infection, patients often experience flu-like symptoms and mucocutaneous lesions, which are called the acute retroviral syndrome (Dlugasch & Story, 2021). During this stage, HIV replicates rapidly and CD4 counts fluctuate (Dlugasch & Story, 2021). After this early infection stage, patients may be asymptomatic for months to years while the virus continues to replicate slowly (Dlugasch & Story, 2021). Once the patient enters the late stage of the infection, CD4 count drops drastically, opportunistic infections, such as pneumonia, will begin to occur (Dlugasch & Story, 2021). Thus, the patient in this case study, who is diagnosed with pneumonia, is likely to be in the late stage of the infection, rather than the acute stage. Additionally, his or her pneumonia is probably caused by 
Pneumocysitis carinii attacking the weakened immune system with decreased CD4 count and increased viral load.

 

 

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