Diagnosing and Treating Allergic and Intolerant Conditions: A Case Study Approach

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Diagnosing and Treating Allergic and Intolerant Conditions: A Case Study Approach

College/UniversityHealth1 days

This project uses a case study approach to teach students how to differentiate, diagnose, and treat complex conditions like salicylate intolerance, exercise-induced food allergy, Celiac Disease, and eosinophilic esophagogastroenteritis (EoE). Students will learn the key differences between food intolerances and food allergies, identify common food intolerances and allergens, and develop treatment plans based on patient symptoms and diagnostic tests. The project culminates in a reflection on the diagnostic approaches and challenges encountered during the case studies.

Food IntoleranceFood AllergySalicylate IntoleranceCeliac DiseaseEosinophilic EsophagogastroenteritisCase StudyDiagnosis

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Inquiry Framework

Question Framework

Driving Question

The overarching question that guides the entire project.How can we use progressive case studies to differentiate, diagnose, and treat complex conditions like salicylate intolerance, exercise-induced food allergy, Celiac Disease, and eosinophilic esophagogastroenteritis (Eo), while highlighting the key differences between food intolerances and food allergies?

Essential Questions

Supporting questions that break down major concepts.

What are the key differences between food intolerance and food allergy, and how do these differences manifest in conditions like salicylate intolerance and exercise-induced food allergy?
How can progressive case studies effectively illustrate the diagnosis and treatment of complex conditions such as Celiac Disease and eosinophilic esophagogastroenteritis (Eo)?

Standards & Learning Goals

Learning Goals

By the end of this project, students will be able to:

Explain the difference between a food intolerance and a food allergy.
Identify the common food intolerances giving two examples for each.
Identify the common food allergens

Entry Events

Events that will be used to introduce the project to students

Pop-Up Clinic Simulation

Create a simulated 'pop-up clinic' scenario where students act as healthcare professionals encountering patients with symptoms suggestive of the target conditions. They must take patient histories, order (virtual) tests, interpret results, and propose treatment plans, receiving feedback from instructors acting as supervising physicians.

Mystery Diagnosis Challenge

Students receive a set of cryptic medical symptoms related to salicylate intolerance, exercise-induced food allergy, celiac disease, and eosinophilic esophagogastroenteritis (EoE). Working in teams, they must analyze the clues, research potential diagnoses, and present their findings, culminating in a 'grand rounds' style presentation where they defend their diagnostic reasoning.

'The Disappearing Dish' Culinary Investigation

Present students with a seemingly normal recipe that subtly contains ingredients problematic for individuals with salicylate intolerance, exercise-induced food allergy, celiac disease, and eosinophilic esophagogastroenteritis (EoE). Their task is to identify the problematic ingredients, explain why they cause issues, and propose alternative recipes that are safe and delicious.

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Portfolio Activities

These activities progressively build towards your learning goals, with each submission contributing to the student's final portfolio.

Activity 1

Decoding Food Reactions: Intolerance vs. Allergy

Students begin by defining and differentiating between food intolerance and food allergy. They'll explore the underlying mechanisms, symptoms, and diagnostic approaches for each.

Steps

Here is some basic scaffolding to help students complete the activity.

1. Research and define 'food intolerance' and 'food allergy'. Include the physiological processes involved in each type of reaction.

2. Create a Venn diagram comparing and contrasting food intolerance and food allergy. Highlight key differences in symptoms, onset, and immune system involvement.

3. Find real-life examples from case studies or news articles that illustrate the differences between intolerance and allergy.

Final Product

What students will submit as the final product of the activityA detailed Venn diagram and a short essay explaining the key differences between food intolerance and food allergy, supported by real-life examples.

Alignment

How this activity aligns with the learning objectives & standardsAddresses the learning goal: Explain the difference between a food intolerance and a food allergy.

Activity 2

Intolerance Investigator: Unmasking Common Culprits

Students will dive deeper into common food intolerances, identifying specific triggers and their effects on the body.

Steps

Here is some basic scaffolding to help students complete the activity.

1. Research common food intolerances such as lactose intolerance, histamine intolerance, and FODMAP intolerance.

2. For each intolerance, identify at least two specific food examples that commonly trigger symptoms.

3. Create a table summarizing each intolerance, its triggers, common symptoms, and potential management strategies.

Final Product

What students will submit as the final product of the activityA comprehensive table detailing common food intolerances, their food triggers, symptoms, and management strategies.

Alignment

How this activity aligns with the learning objectives & standardsAddresses the learning goal: Identify the common food intolerances giving two examples for each.

Activity 3

Allergen Alert: Spotting the Usual Suspects

This activity focuses on identifying common food allergens and understanding the severity of allergic reactions.

Steps

Here is some basic scaffolding to help students complete the activity.

1. Research the 'Big 9' food allergens: milk, eggs, peanuts, tree nuts, soy, wheat, fish, shellfish, and sesame.

2. For each allergen, describe the types of reactions it can cause, ranging from mild to severe (anaphylaxis).

3. Design an infographic that visually represents the common food allergens and their potential health consequences.

Final Product

What students will submit as the final product of the activityAn informative infographic detailing the 'Big 9' food allergens and their potential health consequences.

Alignment

How this activity aligns with the learning objectives & standardsAddresses the learning goal: Identify the common food allergens.

Activity 4

Case Study 1: Salicylate Sensitivity Sleuth

Students analyze a progressive case study of a patient with salicylate intolerance, tracking symptoms, diagnostic tests, and treatment approaches.

Steps

Here is some basic scaffolding to help students complete the activity.

1. Read the first part of the case study, focusing on the patient's initial symptoms and medical history.

2. Hypothesize potential diagnoses based on the information provided, considering salicylate intolerance as one possibility.

3. As new information is revealed, update your diagnostic reasoning and propose appropriate dietary modifications.

Final Product

What students will submit as the final product of the activityA detailed analysis of the salicylate intolerance case study, including initial hypotheses, evolving diagnoses, and recommended dietary modifications.

Alignment

How this activity aligns with the learning objectives & standardsIntegrates learning goals by applying knowledge of intolerances to a specific condition.

Activity 5

Case Study 2: Exercise-Induced Allergy Expert

Students investigate a case of exercise-induced food allergy, paying close attention to the relationship between food intake, exercise, and allergic reactions.

Steps

Here is some basic scaffolding to help students complete the activity.

1. Examine the case study, noting the temporal relationship between exercise, food consumption, and the onset of allergic symptoms.

2. Research potential triggers and cofactors that can exacerbate exercise-induced food allergies.

3. Develop a management plan for the patient, including dietary advice, exercise recommendations, and emergency treatment protocols.

Final Product

What students will submit as the final product of the activityA comprehensive management plan for a patient with exercise-induced food allergy, including dietary and exercise recommendations.

Alignment

How this activity aligns with the learning objectives & standardsIntegrates learning goals by applying knowledge of allergies to a specific condition.

Activity 6

Case Study 3: Celiac Disease Detective

Students will follow a case study to understand the diagnosis and management of Celiac Disease, an autoimmune disorder triggered by gluten.

Steps

Here is some basic scaffolding to help students complete the activity.

1. Analyze the patient's symptoms, medical history, and family history to identify potential risk factors for Celiac Disease.

2. Interpret the results of diagnostic tests, such as antibody tests and intestinal biopsies, to confirm or rule out Celiac Disease.

3. Design a gluten-free meal plan for the patient, ensuring adequate nutrient intake and addressing potential deficiencies.

Final Product

What students will submit as the final product of the activityA complete gluten-free meal plan for a patient with Celiac Disease, addressing nutrient needs and potential deficiencies.

Alignment

How this activity aligns with the learning objectives & standardsReinforces understanding of food-related autoimmune conditions.

Activity 7

Case Study 4: EoE Investigator

Students explore a case of eosinophilic esophagogastroenteritis (EoE), focusing on its diagnosis, potential triggers, and treatment strategies.

Steps

Here is some basic scaffolding to help students complete the activity.

1. Review the patient's symptoms, endoscopic findings, and biopsy results to diagnose EoE.

2. Investigate potential food allergens or environmental factors that may be contributing to the patient's condition.

3. Propose a treatment plan that may include dietary elimination, medication, or a combination of both.

Final Product

What students will submit as the final product of the activityA detailed treatment plan for a patient with EoE, considering dietary modifications and medical interventions.

Alignment

How this activity aligns with the learning objectives & standardsDeepens knowledge of complex gastrointestinal disorders related to food sensitivities.

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Rubric & Reflection

Portfolio Rubric

Grading criteria for assessing the overall project portfolio

Comprehensive Food Reaction Analysis Rubric

Category 1

Understanding Food Intolerance vs. Allergy

Demonstrates comprehension of the physiological differences, symptoms, and diagnostic approaches for food intolerances and allergies.

Criterion 1

Accuracy of Definitions

Provides clear and accurate definitions of food intolerance and food allergy, including the underlying mechanisms.

Exemplary

4 Points

Provides comprehensive and precise definitions of both food intolerance and food allergy, clearly articulating the distinct physiological processes involved. Demonstrates a nuanced understanding of the immune system's role (or lack thereof).

Proficient

3 Points

Accurately defines food intolerance and food allergy, highlighting the key differences in their mechanisms and symptoms.

Developing

2 Points

Provides basic definitions of food intolerance and food allergy, but may lack detail or clarity regarding the underlying mechanisms.

Beginning

1 Points

Struggles to define food intolerance and food allergy accurately, with significant gaps in understanding.

Criterion 2

Venn Diagram Clarity and Accuracy

Effectively uses a Venn diagram to compare and contrast food intolerance and food allergy, highlighting key similarities and differences.

Exemplary

4 Points

Creates a visually compelling and highly accurate Venn diagram that comprehensively compares and contrasts food intolerance and food allergy, including nuanced distinctions in symptoms, onset, and immune system involvement. The diagram is exceptionally clear and well-organized.

Proficient

3 Points

Constructs a clear and accurate Venn diagram that effectively compares and contrasts food intolerance and food allergy, highlighting key similarities and differences.

Developing

2 Points

Creates a Venn diagram with some attempt to compare and contrast food intolerance and food allergy, but may contain inaccuracies or lack clarity.

Beginning

1 Points

Produces a poorly constructed or inaccurate Venn diagram that fails to effectively compare and contrast food intolerance and food allergy.

Criterion 3

Real-Life Examples

Provides relevant and accurate real-life examples to illustrate the differences between food intolerance and food allergy.

Exemplary

4 Points

Provides insightful and compelling real-life examples (case studies or news articles) that vividly illustrate the distinct characteristics of food intolerance and food allergy. Examples are analyzed with a high degree of sophistication.

Proficient

3 Points

Offers relevant and accurate real-life examples that effectively illustrate the differences between food intolerance and food allergy.

Developing

2 Points

Provides real-life examples that are somewhat relevant, but may lack accuracy or fail to fully illustrate the differences between food intolerance and food allergy.

Beginning

1 Points

Provides irrelevant or inaccurate real-life examples, demonstrating a poor understanding of the differences between food intolerance and food allergy.

Category 2

Identifying Common Food Intolerances

Demonstrates the ability to identify common food intolerances, their triggers, symptoms, and management strategies.

Criterion 1

Research Breadth

Identifies and researches a variety of common food intolerances (e.g., lactose intolerance, histamine intolerance, FODMAP intolerance).

Exemplary

4 Points

Demonstrates extensive research by identifying and thoroughly investigating a wide range of common food intolerances, exceeding expectations in the breadth and depth of coverage.

Proficient

3 Points

Identifies and researches a variety of common food intolerances, such as lactose intolerance, histamine intolerance, and FODMAP intolerance.

Developing

2 Points

Identifies and researches a limited number of common food intolerances, with potential gaps in coverage.

Beginning

1 Points

Struggles to identify and research common food intolerances, demonstrating a lack of awareness of the topic.

Criterion 2

Accuracy of Food Triggers

Accurately identifies specific food examples that commonly trigger symptoms for each intolerance.

Exemplary

4 Points

Accurately identifies and provides an exhaustive list of specific food examples that commonly trigger symptoms for each intolerance, showcasing a deep understanding of dietary considerations.

Proficient

3 Points

For each intolerance, accurately identifies at least two specific food examples that commonly trigger symptoms.

Developing

2 Points

Identifies some food triggers for each intolerance, but may contain inaccuracies or omissions.

Beginning

1 Points

Struggles to identify accurate food triggers for common intolerances, demonstrating a lack of knowledge.

Criterion 3

Table Comprehensiveness

Creates a comprehensive table summarizing each intolerance, its triggers, common symptoms, and potential management strategies.

Exemplary

4 Points

Constructs an exceptionally detailed and well-organized table that comprehensively summarizes each intolerance, its triggers, common symptoms, potential management strategies, and additional relevant information. The table demonstrates a sophisticated understanding of the topic.

Proficient

3 Points

Creates a comprehensive table detailing common food intolerances, their food triggers, symptoms, and management strategies.

Developing

2 Points

Creates a table with some information on common food intolerances, but may lack detail or contain inaccuracies.

Beginning

1 Points

Produces an incomplete or inaccurate table that fails to effectively summarize common food intolerances.

Category 3

Identifying Common Food Allergens

Demonstrates the ability to identify common food allergens and understand the severity of allergic reactions.

Criterion 1

Identification of Allergens

Identifies the 'Big 9' food allergens: milk, eggs, peanuts, tree nuts, soy, wheat, fish, shellfish, and sesame.

Exemplary

4 Points

Accurately and comprehensively identifies all of the 'Big 9' food allergens, demonstrating complete knowledge of common allergenic foods.

Proficient

3 Points

Accurately identifies the 'Big 9' food allergens: milk, eggs, peanuts, tree nuts, soy, wheat, fish, shellfish, and sesame.

Developing

2 Points

Identifies most of the 'Big 9' food allergens, but may omit one or two.

Beginning

1 Points

Struggles to identify the 'Big 9' food allergens, demonstrating a lack of awareness of common allergenic foods.

Criterion 2

Description of Reactions

Describes the types of reactions each allergen can cause, ranging from mild to severe (anaphylaxis).

Exemplary

4 Points

Provides a detailed and nuanced description of the types of reactions each allergen can cause, ranging from mild to severe anaphylaxis. Accurately describes the physiological mechanisms underlying different allergic reactions.

Proficient

3 Points

For each allergen, describes the types of reactions it can cause, ranging from mild to severe (anaphylaxis).

Developing

2 Points

Describes some of the reactions that each allergen can cause, but may lack detail or accuracy regarding the severity of reactions.

Beginning

1 Points

Struggles to describe the types of reactions that food allergens can cause, demonstrating a limited understanding of allergic reactions.

Criterion 3

Infographic Design

Designs an informative infographic that visually represents the common food allergens and their potential health consequences.

Exemplary

4 Points

Creates a visually stunning and highly informative infographic that effectively communicates complex information about common food allergens and their potential health consequences. The infographic is well-organized, easy to understand, and creatively designed.

Proficient

3 Points

Designs an informative infographic detailing the 'Big 9' food allergens and their potential health consequences.

Developing

2 Points

Creates an infographic with some information on common food allergens, but may lack clarity, accuracy, or visual appeal.

Beginning

1 Points

Produces a poorly designed or inaccurate infographic that fails to effectively communicate information about common food allergens.

Category 4

Case Study Analysis: Salicylate Sensitivity

Demonstrates the ability to analyze a case study of salicylate intolerance, tracking symptoms, diagnostic tests, and treatment approaches.

Criterion 1

Initial Hypotheses

Formulates reasonable initial hypotheses based on the patient's initial symptoms and medical history, considering salicylate intolerance as one possibility.

Exemplary

4 Points

Formulates insightful and well-reasoned initial hypotheses based on a thorough analysis of the patient's initial symptoms and medical history, demonstrating a comprehensive understanding of potential diagnoses, including salicylate intolerance.

Proficient

3 Points

Hypothesizes potential diagnoses based on the information provided, considering salicylate intolerance as one possibility.

Developing

2 Points

Formulates limited or poorly reasoned initial hypotheses, with a superficial consideration of salicylate intolerance.

Beginning

1 Points

Struggles to formulate any reasonable initial hypotheses based on the patient's symptoms and medical history.

Criterion 2

Evolving Diagnosis

Updates diagnostic reasoning as new information is revealed in the case study.

Exemplary

4 Points

Demonstrates exceptional critical thinking by skillfully updating diagnostic reasoning as new information is revealed, providing a nuanced and comprehensive understanding of the evolving case.

Proficient

3 Points

As new information is revealed, updates diagnostic reasoning appropriately.

Developing

2 Points

Updates diagnostic reasoning inconsistently or with limited justification as new information is revealed.

Beginning

1 Points

Fails to update diagnostic reasoning appropriately as new information is revealed.

Criterion 3

Dietary Modifications

Proposes appropriate dietary modifications for the patient, based on the evolving diagnosis.

Exemplary

4 Points

Proposes highly specific and effective dietary modifications tailored to the patient's evolving needs, demonstrating an in-depth knowledge of salicylate intolerance and nutritional management.

Proficient

3 Points

Proposes appropriate dietary modifications based on the evolving diagnosis.

Developing

2 Points

Proposes dietary modifications that are somewhat relevant, but may be incomplete or lack specific justification.

Beginning

1 Points

Fails to propose appropriate dietary modifications for the patient.

Category 5

Case Study Analysis: Exercise-Induced Allergy

Demonstrates the ability to analyze a case study of exercise-induced food allergy.

Criterion 1

Temporal Relationship

Notes the temporal relationship between exercise, food consumption, and the onset of allergic symptoms

Exemplary

4 Points

Provides excellent description on the relationship between exercise, food consumption, and the onset of allergic symptoms

Proficient

3 Points

Notes the temporal relationship between exercise, food consumption, and the onset of allergic symptoms

Developing

2 Points

Partially notes the temporal relationship between exercise, food consumption, and the onset of allergic symptoms

Beginning

1 Points

Fails to note the temporal relationship between exercise, food consumption, and the onset of allergic symptoms

Criterion 2

Research potential triggers

Researches potential triggers and cofactors that can exacerbate exercise-induced food allergies

Exemplary

4 Points

Provides comprehensive research on potential triggers and cofactors that can exacerbate exercise-induced food allergies

Proficient

3 Points

Researches potential triggers and cofactors that can exacerbate exercise-induced food allergies

Developing

2 Points

Provides basic research on potential triggers and cofactors that can exacerbate exercise-induced food allergies

Beginning

1 Points

Fails to research potential triggers and cofactors that can exacerbate exercise-induced food allergies

Criterion 3

Develop a management plan

Develops a management plan for the patient, including dietary advice, exercise recommendations, and emergency treatment protocols

Exemplary

4 Points

Provides excellent managemnet plan for the patient, including dietary advice, exercise recommendations, and emergency treatment protocols

Proficient

3 Points

Develops a management plan for the patient, including dietary advice, exercise recommendations, and emergency treatment protocols

Developing

2 Points

Provides some elements for the management plan for the patient, including dietary advice, exercise recommendations, and emergency treatment protocols

Beginning

1 Points

Fails to develop a management plan for the patient, including dietary advice, exercise recommendations, and emergency treatment protocols

Category 6

Case Study Analysis: Celiac Disease

Demonstrates the ability to analyze a case study of Celiac Disease.

Criterion 1

Risk factors identification

Analyzes the patient's symptoms, medical history, and family history to identify potential risk factors for Celiac Disease.

Exemplary

4 Points

Provides excellent analysis on the patient's symptoms, medical history, and family history to identify potential risk factors for Celiac Disease.

Proficient

3 Points

Analyzes the patient's symptoms, medical history, and family history to identify potential risk factors for Celiac Disease.

Developing

2 Points

Partially provides the analysis on the patient's symptoms, medical history, and family history to identify potential risk factors for Celiac Disease.

Beginning

1 Points

Fails to provide the analysis on the patient's symptoms, medical history, and family history to identify potential risk factors for Celiac Disease.

Criterion 2

Diagnostic tests interpretation

Interprets the results of diagnostic tests, such as antibody tests and intestinal biopsies, to confirm or rule out Celiac Disease.

Exemplary

4 Points

Provides excellent interpretation on the results of diagnostic tests, such as antibody tests and intestinal biopsies, to confirm or rule out Celiac Disease.

Proficient

3 Points

Interprets the results of diagnostic tests, such as antibody tests and intestinal biopsies, to confirm or rule out Celiac Disease.

Developing

2 Points

Partially interprets the results of diagnostic tests, such as antibody tests and intestinal biopsies, to confirm or rule out Celiac Disease.

Beginning

1 Points

Fails to interpret the results of diagnostic tests, such as antibody tests and intestinal biopsies, to confirm or rule out Celiac Disease.

Criterion 3

Design a gluten-free meal plan

Designs a gluten-free meal plan for the patient, ensuring adequate nutrient intake and addressing potential deficiencies.

Exemplary

4 Points

Provides excellent meal plan for the patient, ensuring adequate nutrient intake and addressing potential deficiencies.

Proficient

3 Points

Designs a gluten-free meal plan for the patient, ensuring adequate nutrient intake and addressing potential deficiencies.

Developing

2 Points

Provides some elements of a meal plan for the patient, but may lack adequate nutrient intake and addressing potential deficiencies.

Beginning

1 Points

Fails to provide a meal plan for the patient, ensuring adequate nutrient intake and addressing potential deficiencies.

Category 7

Case Study Analysis: EoE

Demonstrates the ability to analyze a case study of eosinophilic esophagogastroenteritis (EoE).

Criterion 1

Review Patient Symptoms

Reviews the patient's symptoms, endoscopic findings, and biopsy results to diagnose EoE

Exemplary

4 Points

Provides excellent review the patient's symptoms, endoscopic findings, and biopsy results to diagnose EoE

Proficient

3 Points

Reviews the patient's symptoms, endoscopic findings, and biopsy results to diagnose EoE

Developing

2 Points

Partially reviews the patient's symptoms, endoscopic findings, and biopsy results to diagnose EoE

Beginning

1 Points

Fails to review the patient's symptoms, endoscopic findings, and biopsy results to diagnose EoE

Criterion 2

Investigate potential food allergens

Investigates potential food allergens or environmental factors that may be contributing to the patient's condition

Exemplary

4 Points

Provides excellent investigation on potential food allergens or environmental factors that may be contributing to the patient's condition

Proficient

3 Points

Investigates potential food allergens or environmental factors that may be contributing to the patient's condition

Developing

2 Points

Partially investigates potential food allergens or environmental factors that may be contributing to the patient's condition

Beginning

1 Points

Fails to investigate potential food allergens or environmental factors that may be contributing to the patient's condition

Criterion 3

Propose a treatment plan

Proposes a treatment plan that may include dietary elimination, medication, or a combination of both

Exemplary

4 Points

Provides excellent treatment plan that may include dietary elimination, medication, or a combination of both

Proficient

3 Points

Proposes a treatment plan that may include dietary elimination, medication, or a combination of both

Developing

2 Points

Provides some elements of the treatment plan that may include dietary elimination, medication, or a combination of both

Beginning

1 Points

Fails to provide a treatment plan that may include dietary elimination, medication, or a combination of both

Reflection Prompts

End-of-project reflection questions to get students to think about their learning

Question 1

Reflecting on the progressive case studies, what were the key differences in diagnostic approaches for salicylate intolerance, exercise-induced food allergy, Celiac Disease, and eosinophilic esophagogastroenteritis (EoE)?

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Question 2

How did your understanding of the differences between food intolerance and food allergy evolve throughout the case study analyses? Provide specific examples from the cases to illustrate your points.

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Question 3

Which case study did you find the most challenging, and why? What strategies did you use to overcome the challenges in diagnosing and treating the condition presented?

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Question 4

How confident do you feel in your ability to differentiate between food intolerances and food allergies based on patient symptoms and diagnostic tests?

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Question 5

In what ways can progressive case studies, like the ones used in this module, enhance your ability to apply theoretical knowledge to real-world clinical scenarios?

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