1) 2) 3) Does Corbin likely have a defect in his innate or adaptive immune cells?...
Fantastic news! We've Found the answer you've been seeking!
Question:
Transcribed Image Text:
1) 2) 3) Does Corbin likely have a defect in his innate or adaptive immune cells? Which particular cell(s) and immune function is likely defective? Defend your answer with evidence from the patient background and laboratory test results. Describe the steps a phagocyte goes through during its fight against a localized microbial infection. List any receptors, enzymes, or any other important factors that are involved and describe their role in the process. Could any of these steps be impaired in Corbin? Which one(s)? Could you test for this/these defects, and what specific laboratory test(s) would you use? Leukocyte Adhesion Deficiency (LAD) and Chronic Granulomatous Disease (CGD) both cause frequent persistent infections like those Corbin has had. Which one would you support in the diagnosis of Corbin and why? Patient History: Corbin Johnson, a 7-year-old boy, has experienced several severe infections requiring physician treatment. Corbin was a normal full-term birth. At 8 months of age, he had to be treated for a perianal abscess. A physician lanced the abscess, sent a sample to the laboratory for microbiological culture, and treated Corbin with antibiotics. Gram stain of the abscess fluid showed numerous gram positive cocci in clusters and the culture reported Staphylococcus aureus. The abscess healed with antibiotic treatment. When he was 2 years old, Corbin developed a slight fever, a non-productive cough, and was having difficulty breathing. He was admitted to the hospital because of suspected pneumonia and low blood oxygen saturation. He went under the care of a pediatric infectious disease hospitalist. The infectious disease doctor noted that lymph nodes around his chest were enlarged. Chest X-rays showed granulomas in the middle of his right lung. One of these densities was sampled by guided fine needle aspiration. Microscopic examination of the aspirate showed numerous acid-fast bacilli, both outside and within macrophages. A culture of the aspirate grew Nocardia. Corbin was started on intravenous trimethoprim- sulfamethoxazole and put on supplemental oxygen. He slowly improved over the course of two months. Currently, Corbin is hospitalized for colic and uncontrollable vomiting leading to precipitous weight loss. Gastrointestinal workup revealed gastrointestinal granulomas causing a partial bowel obstruction. He is receiving parenteral nutritional support, aggressive intravenous antibiotics, and low dose corticosteroids. Results of blood tests ordered on Corbin are below. Age: 7 yrs Patient: Corbin Johnson Complete Blood Cell Count: Indice WBC (x 10⁹/L) RBC (x 1012/L) Hemoglobin (g/dL) Hematocrit (%) MCH (pg) MCHC (g/dL) MCV (fL) Platelets (x 10⁹/L) Neutrophils (%) Neutrophilic bands (%) Lymphocytes (%) Monocytes (%) Eosinophils (%) Basophils (%) Test Result 17.6 4.8 13.4 39.6 940 157 205 27.9 33.8 82.5 272 60 13 20 5 2 0 2.1 1.2 0.9 Sex: Male Peripheral Blood Lymphocyte Subset analysis by flow cytometry: Lymphocyte subset Patient Result Absolute T Lymphocyte Count Absolute CD4 T Count Absolute CD8 T Count Reference 5.0 14.5 4.0-5.2 11.5-15.5 35-45 450-1050 36-204 39-240 130 - 400 32-54 0-11 25-33 32 - 36 77-95 Reference 1.2-2.6 x 109/L 0.7-1.5 x 10⁹/L 0.4-1.1 x 10⁹/L 28 48 Total Serum Antibodies: Isotype Patient Result Reference (mg/dL) IgG IgA IgM HIV-1/2 antigen/antibody combination immunoassay: Negative (Reference = negative) 5-7 0-3 0-12 1) 2) 3) Does Corbin likely have a defect in his innate or adaptive immune cells? Which particular cell(s) and immune function is likely defective? Defend your answer with evidence from the patient background and laboratory test results. Describe the steps a phagocyte goes through during its fight against a localized microbial infection. List any receptors, enzymes, or any other important factors that are involved and describe their role in the process. Could any of these steps be impaired in Corbin? Which one(s)? Could you test for this/these defects, and what specific laboratory test(s) would you use? Leukocyte Adhesion Deficiency (LAD) and Chronic Granulomatous Disease (CGD) both cause frequent persistent infections like those Corbin has had. Which one would you support in the diagnosis of Corbin and why? Patient History: Corbin Johnson, a 7-year-old boy, has experienced several severe infections requiring physician treatment. Corbin was a normal full-term birth. At 8 months of age, he had to be treated for a perianal abscess. A physician lanced the abscess, sent a sample to the laboratory for microbiological culture, and treated Corbin with antibiotics. Gram stain of the abscess fluid showed numerous gram positive cocci in clusters and the culture reported Staphylococcus aureus. The abscess healed with antibiotic treatment. When he was 2 years old, Corbin developed a slight fever, a non-productive cough, and was having difficulty breathing. He was admitted to the hospital because of suspected pneumonia and low blood oxygen saturation. He went under the care of a pediatric infectious disease hospitalist. The infectious disease doctor noted that lymph nodes around his chest were enlarged. Chest X-rays showed granulomas in the middle of his right lung. One of these densities was sampled by guided fine needle aspiration. Microscopic examination of the aspirate showed numerous acid-fast bacilli, both outside and within macrophages. A culture of the aspirate grew Nocardia. Corbin was started on intravenous trimethoprim- sulfamethoxazole and put on supplemental oxygen. He slowly improved over the course of two months. Currently, Corbin is hospitalized for colic and uncontrollable vomiting leading to precipitous weight loss. Gastrointestinal workup revealed gastrointestinal granulomas causing a partial bowel obstruction. He is receiving parenteral nutritional support, aggressive intravenous antibiotics, and low dose corticosteroids. Results of blood tests ordered on Corbin are below. Age: 7 yrs Patient: Corbin Johnson Complete Blood Cell Count: Indice WBC (x 10⁹/L) RBC (x 1012/L) Hemoglobin (g/dL) Hematocrit (%) MCH (pg) MCHC (g/dL) MCV (fL) Platelets (x 10⁹/L) Neutrophils (%) Neutrophilic bands (%) Lymphocytes (%) Monocytes (%) Eosinophils (%) Basophils (%) Test Result 17.6 4.8 13.4 39.6 940 157 205 27.9 33.8 82.5 272 60 13 20 5 2 0 2.1 1.2 0.9 Sex: Male Peripheral Blood Lymphocyte Subset analysis by flow cytometry: Lymphocyte subset Patient Result Absolute T Lymphocyte Count Absolute CD4 T Count Absolute CD8 T Count Reference 5.0 14.5 4.0-5.2 11.5-15.5 35-45 450-1050 36-204 39-240 130 - 400 32-54 0-11 25-33 32 - 36 77-95 Reference 1.2-2.6 x 109/L 0.7-1.5 x 10⁹/L 0.4-1.1 x 10⁹/L 28 48 Total Serum Antibodies: Isotype Patient Result Reference (mg/dL) IgG IgA IgM HIV-1/2 antigen/antibody combination immunoassay: Negative (Reference = negative) 5-7 0-3 0-12
Expert Answer:
Answer rating: 100% (QA)
1 Based on the patient history and laboratory test results it is likely that Corbin has a defect in his adaptive immune cells specifically in his T lymphocytes The evidence supporting this conclusion ... View the full answer
Related Book For
Leadership Theory Application and Skill Development
ISBN: 978-1285127361
5th edition
Authors: Robert N. Lussier, Christopher F. Achua
Posted Date:
Students also viewed these biology questions
-
Is there any history of chronic illness or disease in your family?
-
Describe a time when you experienced role ambiguity or role conflict. What stress management techniques did you use to cope with the stress this situation created?
-
Describe the steps involved with the selection or hiring process for a new employee.
-
Top managers of Ryan Products, Inc., have asked you to compare the companys profit performance and financial position with the average for the industry. The companys accountant has given you the...
-
The partnership agreement of Kray, Lam, and Mann provides for the division of net income as follows: 1. Lam, who manages the partnership, is to receive a salary of $11,000 per year. 2. Each partner...
-
9) A car with a gross weight of 3600 pounds, is parked on a street with a slope of 6. Show all work, include units in your answer. a) Find the force required to keep the car from rolling down the...
-
Due to an economic recession, Anton Corporation faces severe cash flow problems. Management forecasts that payments to some suppliers will have to be delayed for several months. Jay Newton,...
-
Ever since the day she took her first economics class in high school, Lydia wondered about the financial practices of her parents. They worked very hard to earn enough money to live a comfortable...
-
Exercise Gross Domestic Product (GDP) 1) In your opinion, what is (are) the major shortcoming (s) of GDP as a measure of economic perforumece? 2) Macroeconomic data of one country in 2021 is shown...
-
Alexander Smith and his wife Allison are married and file a joint tax return for 2019. The Smiths live at 1234 Buena Vista Drive, Orlando, FL 32830. Alexander is a commuter airline pilot but took 6...
-
Suppose the government applies a specific tax to a good where the demand elasticity, &, is -1.8, and the supply elasticity, n, is 1.8. If a specific tax, t, of $2.75 was placed on the good, to the...
-
What kinds of provisions do couples typically include in a prenuptial agreement?
-
Under PKPA, when can a state modify the decree of another state?
-
What direction are courts moving in with respect to reviewing premarital contracts? What considerations underlie this shift?
-
Under PKPA, at what point does the continuing jurisdiction of the decree state terminate?
-
How are the two concepts interrelated?
-
Explain the most likely causes of high inflation and reduced GDP in the UK during the last 12 months. Question 2: Critically discuss whether stock options for managers are an effective mechanism for...
-
Stephen Schor, an accountant in New York City, advised his client, Andre Romanelli, Inc., to open an account at J. P. Morgan Chase Bank, N.A., to obtain a favorable interest rate on a line of credit....
-
Name five situational factions that can influence the nature of the exchange relationship between leaders and followers?
-
Describe why a senior leaders physical presence is critical during a crisis.
-
1. using the Whirlpool Corporation Web Site (www.whirlpoolcorp.com), identify the employee network groups at Whirlpool and the mission of each. 2. Do you think Whirlpools encouragement of employee...
-
At most movie theaters, one employee is usually responsible for issuing tickets and collecting cash while another person collects those tickets when patrons enter the theater. What is the reason for...
-
How is the activity rate determined?
-
How is a single plantwide factory overhead rate calculated?
Study smarter with the SolutionInn App