Presentation Outline
Abstract: Systemic lupus erythematosus (SLE), the most common type of lupus, is a condition that can affect many organs of the body in an uncontrolled manner (Brescia, 2014). It is an autoimmune disease in which the mechanism by which the phagocytotic system of clearing immune complexes is defective. As a result, the host’s antibodies attack all cells (Mok & Lau, 2003). Common symptoms include but are not limited to rashes, joint pain, fatigue, hair loss, and mouth ulcers. SLE is more prevalent in the African American ethnicity compared to others and it is common in urban settings (Schur & Hahn, 2016). It is important to note that because it can affect different organs in the body, it’s medical presentation is sometimes hard to diagnose. While there is no cure for systemic erythematosus lupus, recent research has revealed some novel therapies that try to manage
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The doctor first misdiagnosed her condition as an aggravated gallbladder. However, after diet modifications, symptoms continued to return and worsen resulting in her referral to a rheumatologist (https://www.netce.com/casestudies.php?courseid=1121).
Patient B: A 23-year-old woman was referred to the rheumatology clinic after complaining of swelling in the joints of her hands and a rash that affected certain areas of her face. Her condition did not improve after six months of receiving steroidal anti-inflammatories. It was later determined that an antibiotic that she was using to treat a severe form of acne induced her condition (Chapel et al., 2014).
• Disease Pathoetiology o Cause of systemic lupus erythematosus is not known but recent studies have associated the complex autoimmune disorder with the dysregulation of B cells. Autoantibodies in the body target and affect the tolerance, longevity and selection of B
Arch Dermatol. 2007;143(1):124–125. Puchenkova, S. G. (1996). "
HPI: MR is a 70 y.o. male patient who presents to ER with constant, dull and RUQ abdominal pain onset yesterday that irradiate to the back of right shoulder. Client also c/o nauseas, vomiting and black stool x2 this morning. He reports that currently resides in an ALF; they called the ambulance after his second episodes of black stool. Pt reports he drank Pepto-Bismol yesterday evening without relief. Pt states that he never experienced similar symptoms in the past. Denies any CP, emesis, hematochezia or any other associated symptoms at this time. Client was found with past history gallbladder problems years ago.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. "Hidradenitis Suppurativa: MedlinePlus." Nlm.nih.gov/. U.S. National Library of Medicine, n.d. Web. .
In nearly 85% of patients with untreated SLE test positive of dsDNA. This finding shows that it is probable SLE even though it is not always present in every case, but because it is not seen positive with other connective tissue problems, it is associated with Lupus.
She had a two week history of feeling generally unwell, complaining of tiredness and lethargy. She had no other significant symptoms. Her past history includes well controlled asthma and anxiety. She was a smoker of 20 cigarettes per day. She was taking amitriptyline, Symbicort (budesonide and formoterol inhaler). She had no significant family history of medical illness and had no clinical findings on examination. Blood tests showed corrected calcium of 4.22mmol/L (NR 2.20 -2.60) with suppressed paired PTH of 1.45pmol/L (NR1.60- 6.9). Her renal function was initially impaired, but normalized with rehydration. Her liver function tests, full blood count, vitamin D, myeloma screen and serum ACE levels were all within normal limits. Ultra sound scan (USS) of kidneys, USS of parathyroid and computerized tomography (CT) of thorax, abdomen and pelvis were all reported as normal with no cause found for her
The incidence of SLE is 7.6 cases per 100,000 with a prevalence of approximately 68 cases per 100,000 (Bernknopf, Rowley, & Bailey, 2011). It affects women more than men with a 9:1 ratio, and typically affects women of childbearing age (Patel, Fenves, & Colbert, 2012). The mean age of symptom onset was 29 years in the Euro Lupus Project that studied 1000 patients with SLE (“Systemic Lupus Erythematosus”, 2012). Children and older adults are also diagnosed with SLE but at a much lower rate, 8%-15% and 3%-18%, respectively (Arnaud, Mathian, Boddaert, & Amoura, 2010). Patients with ethnic backgrounds have a higher incidence rate with African Americans developing SLE 3-4 times more than Caucasians, unlike drug-induced lupus erythematosus (DILE) which has an equal male to female prevalence yet a higher disease severity in Caucasians (Bernknopf, Rowley, & Bailey, 2011).
At 2:44pm Arlethea from Cardinal innovations contacted Mobile Crisis Management (MCM) in regards to requesting services for Mr. Shane Edmonds. Arlethea reported Mr. Edmonds is requesting assistance with his opiate abuse. Dispatcher contacted Qualified Professional (QP) to respond to 4615 Siler City Snow Camp Rd. Siler City, NC 27344. QP spoke with Bill Cook from Carinal Innovations to schedule estimated time of arrival of 4:00pm, which QP arrived at 4:10pm due to traffic. QP contacted Cardinal innovations upon arrival and MCM dispatcher.
•The forty five year old patient is diagnosed with the progressive cirrhosis inflaming the liver along with the parenchymal cells. The plain symptoms is manifested primarily because of the augmentation of edema internally in the lower abdomen.
Every case of lupus presents slightly differently. Symptoms can develop slowly over time or come on suddenly. Cases range from mild to severe, and most sufferers have “flares,” which are periods during which symptoms become worse.
When someone has lupus they have a different outlook on life. For patients with this disease, even the easiest task can be painful to the body or joints. Lupus is not contagious. “Lupus is a disease of the immune system. The immune system protects the body from inflection”(http://lupus.webmd.com). With lupus, the immune system attacks the tissue in many parts of the body. Lupus affects women more than men(www.womenshealth.gov). There are many different types of lupus, and each symptom affect different parts of the body. With treatment you can obtain and fulfill a healthy lifestyle.
Makover, M. & Zieve, D. (2011, February 14). Systemic Lupus Erythematosus. National Center for Biotechnology Information. Retrieved July 14, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001471/
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning urination, and decreased urine output for three days. Upon admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings.
Lupus is a chronic disease that damages any part of the body. For example: skin, joints, and organs, are all problem areas for this disease. The cause of Lupus is unknown and could be very difficult to diagnose. It may take years to officially diagnose a patient of having the Lupus disease. Doctors examine your blood, skin, and kidneys to finalize the diagnosis. Symptoms last up to six weeks or longer.[1] These symptoms being pain or swelling in the the joints, fever, hair loss, feeling tired, redness in the face, etc. Lesser symptoms would be things such as dizziness, confusion, and seizures. Lupus is treated by a doctor's prescription, and a list of doctors who specialize in things such as kidney disease, blood disease, skin disease, etc.
Psoriasis is an autoimmune disease that affects 125 million people world wide according to the World Psoriasis Day consortium. The origin of psoriasis is unknown, but many doctors and researches believe that genetics, along with environmental factors, trigger a hyperactive reaction of the immune system that leads to the relatively harmless, yet uncomfortable skin disease. The response of the immune system induces skin cells to multiply and mature rapidly, causing the skin cells to accumulate on top of each other and as a result, the skin becomes red, scaly, itchy, and forms thick patches on the skin. Despite that this disease is the most frequent auto-immune disease in the world, there is no cure for it. Not only is there no cure for psoriasis, but this disease can lead to other problems depending on the severeness of the disorder for example: psoriatic arthritis. However, this chronic disease has several treatment options that if used correctly and in a timely manner, will reduce and lessen the symptoms.( Although there is no cure for psoriasis, understanding how it begins, recognizing the symptoms, and learning about treatment options can enhance the quality of life for a person diagnosed with psoriasis.)
This was his second episode since 10 days ago where he develop the same pain at his right flank. He suddenly experienced severe pain 8 hours before admission when the pain shifts to his right lower quadrant of his abdomen. The onset is at 6.30 am before worsening at 10 p.m to 2 p.m. He described the pain as continuous sharp pain and gradually increased in severity. There is no radiation of the pain. The pain was exaggerated on movement and touch. There were no relieving factor and he scale the severity as 7/10. He experienced fever for 1 day prior to admission. It was a mild grade continuous fever. He does not experienced chills and rigor. The patient does not experience any nausea or vomiting, no dysphagia, no pain during micturition and no alteration in bowel habit. He experienced loss of appetite but not notice any weight loss.