Immune

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Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. 

A 38 year female old med student goes to her physician with complaints of arthralgia and a new rash on her face bilaterally. The rash get worse when in the sun. When she is fatigued, she complains of a sharp pain in her chest when taking a deep breath. She has experienced this before, but this present episode has been the worst she has ever felt. An exam was completed and tests ordered. The following results are:

Physical:

Temperarture, respiratory rate, and BP normal, Heart rate regular and normal

Facial rash macular over the bridge of her nose and cheeks. Discoid scaling also noted on her extensor surfaces of her arms.

Joint pain and stiffness and pain in hands on active and passive motion

Pleural friction rub auscultated with deep respiration

Other systems examined normal.

Labs:

Serum electrolytes – normal

Hemoglibin and Hematocrit – low

Platelet count – slightly low

White blood cells – normal

BUN and Creatinine – elevated

Urine – Positive for Protein

CXR – Small pleural effusion noted

Antinuclear antibody (ANA) – positive

Anti-DNA antibodies – positive

Diagnosis: Systemic Lupus Erythematosus (SLE)

Questions:

1. What is the common descriptive term for this patient’s facial rash and why?

1. What does sunlight do to people with this disease that they are taught t avoid it?

1. Which lab results indicate renal dysfunction. Is this dysfunction related to SLE? Why or why not?

1. State the other signs and symptoms of SLE that are manifested in this patients physical exam and labs? Give the rationale for each.

1. What is the pathophysiology behind SLE causing widespread tissue damage?

1. What is discoid lupus and is it different from SLE?

1. What type of teaching and management plan will be need to be devised by the APN for this patient?