Case Study

Case 1

After spending an hour and a half in the countryside a 30-year-old man noticed that his eyelids became red and swollen, lacrimation and nasal secretions appeared, the voice became hoarse. He had a feeling of tightness in his chest. When he returned home the intensity of these symptoms decreased, but they were still present.

Questions:

Define the type of pathologic process developed in the patient. Substantiate your opinion.

What methods can be used to determine the cause of this pathologic process?

What are the main components of the mechanism of the given process?

What treatment approaches and preventive procedures can be used in this case?

Case 2

A patient with an open lower extremity trauma was repeatedly injected tetanus antitoxin in combination with antihystamines. On the ninth day after the last antiserum injection he presented with high body temperature (up to 38⁰C), severe weakness, swelling and tenderness of the shoulder and knee joints; intensely pruritic disseminated urticarial eruptions, and the enlarged tender popliteal and inguinal lymph nodes.

Questions:

What form(s) of pathology may be suspected in this patient?

What additional data do you need to make a final conclusion about the form of pathology which the patient suffers from?

Taking into account the given data, outline the possible cause and mechanisms of development of this pathology.

What approaches can be used to prevent the development of this pathologic process?

Case 3

A patient with an extensive full-thickness burn of the thigh was intravenously infused blood plasma. Soon after this, he presented with hyperemia of the face and neck, psychomotor agitation, restlessness, fear of death, an intense throbbing headache, buzzing in the ears, and nausea. A physician suspected the development of allergic reaction and gave the patient an injection of an antihistamine drug. However, the patient's state continued to worsen. He developed a choking sensation, acute systemic hypotension (blood pressure 65/45 mm Hg), confusion, pallor, cold sweat, and lost his consciousness. Later, seizures and spontaneous urination occurred.

Questions:

What pathologic process (or reaction) and what type of it developed in the patient after the infusion of blood plasma? Substantiate your answer.

Name and characterize the main steps of pathogenesis of this pathologic process.

Why did the parenteral injection of the antihistamine drug not improve the patient's condition? What procedures should be performed to prevent this pathologic process (reaction)?