Assignment Details

MN551-2: Apply knowledge of tissue and organ
structure and function to physiologic alterations in systems and analyze
the cause and effect relationship in response to disease.

Select one of the case studies below. In your
discussion be sure to include evidence of your knowledge of tissue and
organ structure and function to physiologic alterations in systems and
analyze the cause and effect relationship in response to disease.

Requirements

1. Make sure all of the topics in the case study have been addressed. 
2. Cite at least three sources—journal articles, textbooks, or evidenced-based websites—to support the content. 
3. All sources must have been written within five years. 
4. Do not use .com, Wikipedia, or up-to-date, etc., for your sources. 

Case Study 1

Mechanisms of Infectious Disease 

Thirty-two–year-old Jason is a general laborer, who fell ill shortly
after working on a job digging up old water pipes for the town he lived
in. The task involved working around shallow pools of stagnant water.
Ten days after the contract ended, Jason developed a fever and aching
muscles. He also had nausea, vomiting, and diarrhea. Jason’s friend took
him to his physician who listened carefully to Jason’s history. She
told him she suspected West Nile fever and ordered serological testing.
Jason went home to recover and was feeling better by the end of the
week.

1. Jason’s physician ordered serological tests. How would antibody titers assist the doctor in confirming his diagnosis?
2. When Jason was feeling at his worst, he had extreme malaise,
   vomiting, and diarrhea. What stage of the illness was he experiencing at
   that time? What are the physiological mechanisms that give rise to the
   signs and symptoms of infectious illness?
3. West Nile virus has a single-stranded RNA genome. How does this
   virus replicate? In general terms, what are the various effects viruses
   can have on host cells?

Case Study 2

Innate and Adaptive Immunity

Melissa is a 15-year-old high school student. Over the last week, she
had been feeling tired and found it difficult to stay awake in class.
By the time the weekend had arrived, she developed a sore throat that
made it difficult to eat and even drink. Melissa was too tired to get
out of bed, and she said her head ached. On Monday morning, her mother
took her to her doctor. Upon completing the physical exam, he told
Melissa the lymph nodes were enlarged in her neck and she had a fever.
He ordered blood tests and told Melissa he thought she had
mononucleosis, a viral infection requiring much bed rest. 

1. Innate and adaptive immune defenses work collectively in
   destroying invasive microorganisms. What is the interaction between
   macrophages and T lymphocytes during the presentation of antigen?
2. Melissa’s illness is caused by a virus. Where are type I
   interferons produced, and why are they important in combating viral
   infections?
3. Humoral immunity involves the activation of B lymphocytes and
   production of antibodies. What are the general mechanisms of action that
   make antibodies a key component of an immune response?

Case Study 3

Disorders of the Immune Response

Ahmed has worked as a phlebotomist in the local hospital for the last
7 years. Last year, he began to complain of watery, nasal congestion
and wheezing whenever he went to work. He suspected he was allergic to
something at the hospital because his symptoms abated when he was at
home over the weekends. One day he arrived at work for the morning shift
and put on his gloves. Within minutes, he went into severe respiratory
distress requiring treatment in the emergency ward. It was determined at
that time his allergic response was due to latex exposure.

1. Ahmed experienced a type I, IgE-mediated hypersensitivity
   response. How can this be determined by his signs and symptoms? How
   might another type of latex hypersensitivity reaction present?
2. How do T2H cells, mast cells, and eosinophils function to produce
   the signs and symptoms typical of a type I hypersensitivity disorder?
3. How is it that someone who does not come into direct contact with
   latex can still have a hypersensitivity response to the material? What
   do food allergies have to do with latex allergies?

Case Study 4

Inflammation, Tissue Repair, and Wound Healing

Carlton, a six-year-old boy, was playing on a sandy beach with his
mother. He began to run along the shoreline when he stepped on the sharp
edge of a shell, giving himself a deep cut on his foot. His mother
washed his foot in the lake and put on his running shoe to take him
home. One day later, Carlton’s foot looked worse. The gash was red and
painful. The foot was warm to touch and appeared swollen. Carlton’s mom
put some gauze over the wound and prepared to take him to the local
community health clinic. 

1. What is the physiologic mechanism causing the wound to become red,
   hot, swollen, and painful? How is this different than the inflammatory
   response that might occur in an internal organ?
2. What are the immunologic events that are happening at the local level during Carlton’s acute inflammatory response?
3. Nutrition plays an important factor in wound healing. What stages
   of wound healing would be affected by a deficiency in vitamins A and C?

Case Study 5

Acquired Immunodeficiency Syndrome 

Patience is 29 years old and has been HIV positive for nine years.
She has remained asymptomatic and is not taking antiretroviral
medication. Recently she was at the drop-in clinic to talk to a public
health nurse about having a baby through artificial insemination. She
said she had met a man who wanted to marry her and have children with
her, but she was concerned about the baby contracting HIV. Her latest
blood tests indicated her CD4+ count was 380/µL. The PCR test indicated
her viral load was 850. The nurse referred her to the physician to
discuss antiretroviral therapy during her pregnancy. 

1. What are the factors that increase the chance of HIV transmission from mother to infant, and how the transmission occurs? 
2. Patience was told that after she became pregnant, she would begin
   HAART therapy. Describe what this therapy is and what particular
   antiretroviral medication would be particularly useful to her during her
   pregnancy. What concern is there about administering certain
   antiretrovirals early in the pregnancy?
3. Individuals with HIV are prone to contracting opportunistic
   infections. What are opportunistic infections and the risk factors that
   leave an individual with HIV particularly prone to contracting this type
   of illness?

Case Study 6

Blood Cells and the Hematopoietic System

Charlie is a 53-year-old man with non-Hodgkin lymphoma. His treatment
has been only modestly successful in delaying the progression of the
disease, and he has recently relapsed. His medical team decided to
administer aggressive chemotherapy. Knowing that the intensive treatment
would have a destructive effect on Charlie’s bone marrow, they removed
stem cells from his blood before the chemotherapy began. Afterward, the
stem cells were returned by IV to reestablish his bone marrow function.

1. What are the therapeutic advantages of an autologous stem cell transplant on Charlie’s bone marrow and immune system?
2. Before harvesting stem cells, a cytokine growth factor is administered to the patient. What is the benefit of this procedure?
3. Non-Hodgkin lymphoma is a disease involving B and T lymphocytes.
   What aspects of the immune response are these cells responsible for?
4. When considering erythrocytes, how is the body able to meet
   hematopoietic demand in conditions such as hemolytic anemia or blood
   loss?

Case Study 7

Disorders of Hemostasis 

Leona is 52 years old and smokes. She is also overweight and has
atherosclerosis. When she was given a two-week vacation from work, she
packed up her bags and flew from Minnesota to Sydney, Australia, for the
trip she always wanted to take. Unfortunately, just three days after
she arrived, she was hospitalized when her left calf became inflamed,
causing her considerable pain. The physician attending to her told her
she developed a deep vein thrombosis. 

1. Explain, using your knowledge of hypercoagulability, why the trip
   to Australia contributed to Leona’s DVT? Why was Leona already at risk
   for thrombus development?
2. How does Leona’s atherosclerosis affect platelet function?
   Conversely, what is the effect of increased platelet activity on the
   development of atherosclerosis?
3. How do atherosclerosis and immobility promote changes in blood coagulation?
4. When Leona was in hospital, she received heparin therapy. Explain
   why this course of action was taken to treat her DVT. Why was she not
   given heparin tablets to take back to the hotel with her?

Case Study 8

Disorders of Red Blood Cells

Henry is 77 years old and lives with his daughter and son-in-law. He
has chronic renal failure, but likes to get out whenever he can to work
in his daughter’s backyard garden. Over the last few months, he began to
go outside less often. He said he was feeling unusually tired and he
was running out of breath doing the simplest of tasks. He also said his
head ached and he often felt dizzy. His daughter took him to his doctor
who performed a complete physical examination and diagnosed Henry with
anemia. 

1. From what you know of Henry’s history, what type of anemia do you
   suspect he has? How would Henry’s red blood cells appear on a peripheral
   blood smear?
2. What is the physiological basis that would explain why Henry’s anemia would cause him to have the symptoms he is experiencing?
3. Predict the cellular adaptations erythrocytes undergo when chronic
   hypoxia is present. How would this be evident on an oxygen–hemoglobin
   dissociation curve?

Case Study 9

Disorders of White Blood Cells and Lymphoid Tissues

Max is a 60-year-old living in Iowa. For the 27 years, he has been
working in the agricultural industry, particularly in the management of
corn production. Recently he began to feel weak during work and tired
easily. During the night he woke up sweating, and he often felt
unusually warm during the day. Max was also surprised that, in spite of
eating regularly, his weight was declining and his work pants were now
too large for him. Upon physical examination, his physician noted his
inguinal lymph nodes were swollen although Max said they were not sore.
Subsequent laboratory tests confirmed follicular, non-Hodgkin lymphoma.
Chemotherapy in conjunction with rituximab was immediately initiated. 

1. What are the key cellular differences between non-Hodgkin lymphoma and Hodgkin lymphoma?
2. The early manifestations of non-Hodgkin lymphoma and Hodgkin
   lymphoma in lymphatic tissue appear differently. In terms of lymphatic
   presentation, how would these two diseases appear clinically?
3. What are the pharmacologic properties of rituximab, and what is its mechanism of action on malignant cells?
4. Outline the structure of lymph node parenchyma including the areas
   where B and T lymphocytes reside. Where did Max’s lymphoma arise?

Assignment Requirements:

Before finalizing your work, you should:

• Ensure you have written at least four double-spaced pages.
• be sure to read the Assignment description carefully (as displayed above);
• consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
• utilize spelling and grammar check to minimize errors.
• follow the conventions of Standard American English (correct grammar, punctuation, etc.);
• be well ordered, logical, and unified, as well as original and insightful;
• display superior content, organization, style, and mechanics; and
• use APA 6th Edition format.

To see your assignment instructions and grading rubric, go to Course Resources / Grading Rubrics.

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