what information provided by jamie would lead the physician to suspect a systemic disease
Transcribed Text
Differential Diagnosis and Handling of an Immune Response Part I – The Investigative Procedure Jamie is a 26-year-one-time graduate student at the University of Arkansas—Monticello. She is working on her PhD in biology. As a biologist, she enjoys spending time outdoors when she tin. The campus is on the edge of the woods and it is a nice identify for Jamie to walk and relax to relieve the stress of graduate school. Jamie has non been able to enjoy her walks lately due to the fatigue she has been experiencing. Others have noticed that she does not accept the stamina she had in the past to complete her enquiry. Her major professor convinces her that it would exist a good idea to brand an date to run into her family physician to determine the source of her fatigue. He suggests that peradventure she has a viral infection, and she just needs to go some residual. She is able to go an appointment with her family practitioner. When she arrives at the dispensary, the nurse takes her blood force per unit area and temperature. Her blood pressure is 128/74 and her temperature is a slightly elevated 101.20F. She is asked to provide her family unit medical history and to depict whatsoever symptoms she has noticed. Jamie tells her doctor that her maternal grandmother had rheumatism and was not able to go effectually. Her father had prostate cancer. She cannot think of whatever other family illnesses. She tells her md that in add-on to feeling run down, her knees and elbows accept been aching, and she has been having trouble pipetting considering of pain in her hands. She has been experiencing frequent common cold sores that she has been treating with over-the-counter medication. She attributes her recent weight loss to poor eating habits as a student. On full general examination, the doctor finds a rash on her upper back where she is typically exposed to the sun and swollen lymph nodes on her neck. The dr. decides that further tests are required to rule out some obvious possibilities. He suspects an autoimmune affliction such equally lupus (systemic lupus erythematous, SLE) or rheumatoid arthritis (RA), a tick born disease like Lyme disease, anemia, or chronic Epstein Barr virus syndrome. Jamie is sent to the lab where blood is fatigued. She is asked to render the following week to review the lab test results. Questions 1. What information provided by Jamie would atomic number 82 the physician to suspect a systemic disease? Include any ecology or lifestyle clues. two. Ascertain autoimmune disease and autoantibody. 3. What ecology triggers are associated with autoimmune diseases? 4. What are some of the autoimmune diseases? 5. What are the typical signs and symptoms of autoimmune diseases using lupus as an instance? half dozen. Using WebMD (world wide web.webmd.com) or MedlinePlus (www.nlm.nih.gov/medlineplus), find the criteria for the di- agnosis of systemic lupus erythematous, rheumatoid arthritis, Lyme disease, and chronic Epstein Barr syndrome. 7. Why does the doctor suspect that Jamie may be anemic? Page 1 Part 2 –Understanding Results Lab Test CBC WBC count RBC count Hemoglobin Hematocrit Platelet count Differential Neutrophils Lymphocytes Monocytes Eosinophils Basophils ESR – (Sedimentation Rate) Chem Panel Sodium Potassium Chloride Carbon Dioxide Glucose Total Poly peptide Albumin BUN Creatinine Iron Microbiology Claret Civilization Immunology C-Reactive Protein Rheumatoid Factor VDRL ANA Rickettsial Immunofluorescence Mono-spot Lyme Antibodies Straight Combs Questions Jamie's Results 3.8 ten 109/50 3.2 x 1012/L 10.6 g/dl 32.8% 140 x 109/L 44% twoscore% ix% 6% 1% 61 mm/hr 141 mEq/L 4.two mEq/L 108 mEq/L 26 mmol/Fifty 101 mg/dL 6.9 g/dL 4.8 g/L 18 mg/dL 0.9 mg/dL 189 μg/dL Negative 5.viii mg/L Negative Positive Positive 1:640 Negative Negative Negative Negative Reference Range for Women 4.eight–10.8 10 109/L 4.0–5.0 x 1012/L 12.0–sixteen.0 g/dl 36–46% 150–450 x 109/Fifty 40–60% 20–40% ii–x% 0–5% 0–1% 0–twenty mm/hour 136–148 mEq/Fifty 3.half dozen–5.0 mEq/L 95–110 mEq/L 23–29 mmol/L seventy–99 mg/dL six.5–viii.three g/dL 3.v–5.0 g/50 6–xx mg/dL 0.6–one.1 mg/dL 30–150 μg/dL Negative three–five mg/L Negative Negative Negative Negative Negative Negative Negative NATIONAL Centre FOR CASE STUDY TEACHING IN SCIENCE 1. Which test results are abnormal? 2. What exercise these exam results betoken? Include a give-and-take on what conditions have been eliminated. What status could exist causing the abnormal results? 3. Based on your cess of Jamie's condition, what kind of doctor (specialist) should she see? Page 2 Role III – Therapeutic Treatments Jamie meets with the rheumatologist and she explains to her the diagnosis of systemic lupus erythematosus. She reviews with Jamie the brusk-term and long-term treatment options. She explains that even though lupus can exist controlled in many cases, in that location are often complications associated with the drugs used to treat symptoms. She outlines a treatment plan, and they concur to take a moderately aggressive approach. Jamie leaves the doctor's office understanding that this will exist a lifelong fight and very probable her symptoms will become worse. She plans to make the almost of her life and care for the flares of this potentially aggressive disease. Questions 1. Draw the four different groups of medications that are used to treat lupus. 2. How do these medications piece of work in controlling lupus? Give some specific examples. three. With lupus, what approach to treatment would you accept? iv. What are possible long-term complications with the utilize of these medications? NATIONAL CENTER FOR Instance STUDY Didactics IN SCIENCE Folio three Part IV – Late Stage Complications After Jamie's visit with the rheumatologist, she was treated with high levels of prednisone later on NSAIDs (non-steroidal anti-inflammatory drug) and anti-malarials were non effective. Subsequently graduation, Jamie married another doctoral pupil. Presently after she was married, Jamie became pregnant, but sadly, the pregnancy ended in miscarriage. Jamie was told by her md that sometimes patients with lupus produce antibodies that brand pregnancy high run a risk. Jamie and her husband decided to adopt to avert the pain of another miscarriage. Ten years have passed since her initial diagnosis and Jamie has continued to suffer frequent lupus flares. As a outcome of long-term drug usage, she has developed steroid-induced diabetes, hypertension, and osteoporosis. Over the past ii weeks, Jamie has not been feeling well. Her symptoms are unlike from her usual lupus flares. She is experiencing fatigue, chest pain, and shortness of breath with small action. Jamie decides she needs to start exercising and begins running on the treadmill and collapses. She regains consciousness and is rushed to the emergency room. She describes to the physician that she is having chest hurting, and the physician evaluates her for a cardiac event. An ECG (electrocardiogram) is performed and shows abnormal results. The laboratory testing includes myoglobin, cardiac troponin I, and CK-MB. The results are every bit follows: Cardiac Indicators Jamie's Results fifteen.eight ng/ml 8.5 μg/L 153.7 ng/ml Reference Values 0–1.5 ng/mL < 5 μg/L 0–85 ng/ml NATIONAL Center FOR CASE Study TEACHING IN Science Troponin I CK-MB Myoglobin Questions 5. What is Jamie'south long-term prognosis? one. What ii. What 3. What four. What is myoglobin? are the three types of troponin plant in cardiac musculus? are the three isoenzymes of creatine kinase? Which one is constitute predominately in middle muscle? does an elevated myoglobin, cardiac troponin I, and CK-MB (creatine kinase isoenzyme) in the blood indicate to the dr.? Page 4
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Function I – The Investigative Process
Questions
1. What information provided by Jamie would atomic number 82 the physician to suspect a systemic affliction? Include any ecology or lifestyle clues.
Ans:
The dr. suspects a systemic disease due to the fatigue experienced by Jamie along with frequent cold sores. Too her life way indicates the same, like poor eating habits; spend most of the time outdoor and rashes due to exposure to dominicus.
2. Ascertain autoimmune affliction and autoantibody.
Ans:
Autoimmune disease is defined as a disease causing the production of antibodies against ain cells which lead to the destruction of tissues
Autoantibody is defined as an antibody which is produced in response to the component of its own tissues...
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