Janet, a 20 year-old college student, is experiencing a five-week history of itchy eyes and nasal congestion with watery nasal discharge. She also complains of a “tickling” cough, especially at night, and she has had episodes of repetitive sneezing. Janet gets frequent “colds” every spring and fall.
Vital Signs: Temp, 98.8; BP 110/68; Pulse 72; Respirations 18
Skin: Flaking erythematous rash on the flexor surfaces of both arms
Head, Eyes, Ears, Nose, and Throat: Tender over maxillary sinuses; sclera red and slightly swollen with frequent tearing; outer nares with red, irritated skin; internal nares with red, boggy, moist mucosa and one medium-sized polyp on each side; pharynx slightly erythematous, with clear postnasal drainage
Lungs: Clear to auscultation and percussion
- Provide three differential diagnoses based on Janet’s subjective and objective data and discuss your reasoning for each.
- What additional history questions would be useful in your evaluation of Janet?
- Discuss the pathophysiological process of your primary diagnosis.
- Differentiate the types of hypersensitivity mechanisms.
- As per your analysis, what type of hypersensitivity reaction is Janet experiencing?