Clinical challenge case:
….. Her daughter has called to ask for help in babysitting her
three children, who are home with the chicken pox. She elected to make sure
they contracted chicken pox instead of getting them vaccinated. Betty is glad
to help her daughter, who is working full time and usually relies on after-school
care for her three children. Betty has been coming down with a cold, but feels
fine and goes to take care of the three children, ages 10, 8 and 5. Betty takes
care of the children, who are in various stages of chicken pox, for a total of 7
days and then returns home with what seems to be the same cold she had
when she arrived. Over the next two weeks, Betty develops a line of painful,
oozing lesions along her right thorax. Seeking medical attention, she is
diagnosed with shingles and given pain medication and an antiviral agent.
Look at the problem, as if you are entering a patient room…what is happening
in the body? (what happens with the disease…from entry into the body,
through the presentation of shingles…and then how does it apply to this
woman..what is going on with her that led to the presentation…)
Problem/Questions must answer in relationship to Betty:
Explain the process of the clinical manifestations of chicken pox:

– How does a respiratory infection become itchy spots ?
– Why is there a delay from the time of exposure until the clinical presentation?
– What happens with repeated exposure to chicken pox – the next year in
school, for instance ?
– What happened to Betty – consider her age and her “coming down with a
cold.”
– What causes shingles, what is the process that is going on?
– Could this have been avoided?
– Did the fact that the children had chickenpox have any direct effect on the
presentation of her shingles?
Required txt:
Hall, J (2010) Guyton and Hall’s textbook of medical Physiology. (12th ed)
Philadelphia: Saunders
Porth’s Pathophysiology (2014) (9th ed) Philadelphia, Lippincott Williams &
Wilkins