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SCENARIO 1:
PATHOPHYSIOLOGY:
According to Shah et al. (2015), tonsillitis most commonly occurs either by viruses or bacterial infections. Few viruses that are involved in the etiopathogenesis of tonsillitis are Epstein Barr virus (EBV), herpes simples, measles, adenovirus and cytomegalovirus. It is noteworthy that tonsillitis, in children is most commonly caused by EBV. Similarly, the bacteria that most commonly cause tonsillitis are called as beta haemolytic streptococcus. This group specifically binds to the adhesin receptors located on the surface of the tonsillar tissue. Other rare causes of bacterial tonsillitis are corynebacterium diphtheriae, mycoplasma pneumonia and Chlamydia. It is also noteworthy that in cases of recurrent tonsillitis, there is a mixture of both, aerobic and anaerobic bacteria.
ALTERATIONS:
Typical presentation includes:
Fever
Sore throat
Dysphagia
Odynophagia
Swollen and painful cervical lymph nodes
Sleep apnea
Rarely halitosis
ADAPTIVE RESPONSE:
Patient will most likely stop taking liquids and food orally due to the intense pain associated. There will be difficulty in swallowing.
SCENARIO 2:
PATHOPHYSIOLOGY:
The described scenario corresponds to contact or irritant dermatitis. According to Hogan et al. (2014), contact dermatitis is a result of skin inflammation mediated by the release of proinflammatory cytokines from keratinocytes. There are three main morphological changes that occur in contact dermatitis. They are skin barrier disturbance, cellular changes in the epidermis and release of cytokine. According to DermNetNZ.org (2016), contact dermatitis is very prevalent among individuals who work at cleaning, metal works or catering industry. This patient most likely has hand dermatitis because he has history of exposure to chemicals and rigorous hand washing after wards.
The first step in the pathogenesis of contact dermatitis is merely the removal of essential fats and oils from the skin which fundamentally makes the skin dehydrated.
ALTERATIONS:
Few alterations noted in contact dermatitis are:
Insidious onset with severe pruritis and burning.
Severe dryness causes fissuring of the skin.
Skin becomes flaky due to hyperkeratosis.
Pain may also be associated
ADAPTIVE RESPONSE:
Patient is at risk of developing negative association and might quit working. Also, patient might mal-associate hand washing as harmful, which is beyond truth.
SCENARIO 3:
PATHOPHYSIOLOGY:
In scenario 3, the patient described, most likely has developed depression due to the stress involved. According to Halverson et al. (2016), the pathophysiology of any depressive disorder is very vaguely elucidated. It has been postulated that it is a combination of a complex interaction between availability of the neurotransmitter with regulation of receptor and sensitivity of the presenting symptoms. Various studies have shown that there is a disturbance in CNS activity of serotonin.
According to Hasler (2010), women are more prone to develop depression owing to their inability to cope with an individuals’ existence in their lives. Similarly in this patient, she is not very much able to cope with the attention her ill mother seeks and she has difficulty keeping up with her own schedule.
ALTERATIONS:
Depressive patient may feel:
Somatic symptoms
Dysphoria
Psychosis
Hopelessness
Worthlessness
Suicidal thoughts
Sense of being alone and helpless
ADAPTIVE RESPONSE:
Patient with depression and specially this patient is at risk of neglecting her old mother. She could even lose herself in the deep sense of serving her mother and eventually living a distasteful life.
MIND MAP OF TONSILLITIS:
References
DermNetNZ.org. (2016). Hand dermatitis. Retrieved 7 March 2016, from http://www.dermnetnz.org/dermatitis/hand-dermatitis.html
Halverson, J. (2016). Depression: Practice Essentials, Background, Pathophysiology. Emedicine.medscape.com. Retrieved 7 March 2016, from http://emedicine.medscape.com/article/286759-overview#a3
Hasler, G. (2010). Pathophysiology Of Depression: Do We Have Any Solid Evidence Of Interest To Clinicians? World Psychiatry,9(3), 155–161.
Hogan, D. et al. (2014). Irritant Contact Dermatitis: Background, Pathophysiology, Etiology. Emedicine.medscape.com. Retrieved 7 March 2016, from http://emedicine.medscape.com/article/1049353-overview#a3
Shah, U. et al. (2015). Tonsillitis and Peritonsillar Abscess Clinical Presentation: History, Physical Examination, Complications. Emedicine.medscape.com. Retrieved 7 March 2016, from http://emedicine.medscape.com/article/871977-clinical
