systemic lupus erythematosus

systemic lupus erythematosus

Part A

Ms. X, a 32-year-old Hispanic woman, has had a history of intermittent pleuritic chest pain and joint pain for the past several years. Recently, she went to her physician because she noticed that an erythematous, butterfly-shaped rash had appeared on her face. Further lab tests indicated protein in her urine. Her blood test indicated the presence of numerous antinuclear antibodies, especially anti-DNA, and mature neutrophils containing nuclear material. A diagnosis of systemic lupus erythematosus (SLE) was made. (Refer to Chapter 7, Immunity)

1. Discuss possible reasons why SLE was not diagnosed earlier.
2. Discuss how the presence of antibodies can cause such widespread damage in organ systems.
3. Discuss treatments for SLE and a prognosis for the patient in this case.

Part B

Mr. F, age 46 years, has had a persistent unproductive cough for several months that did not respond to cough medications. Recently, he has developed a productive cough accompanied by fatigue, anorexia, and night sweats.

Examination indicated abnormal chest sounds and weight loss. A chest radiograph showed a small cavity and infiltrate, the tuberculin test was positive, and the sputum sample contained a small amount of blood and numerous acid-fast bacilli, confirming the diagnosis of active tuberculosis. (Refer to Chapter 13, Respiratory Disorders)

1. Discuss the pathologic changes occurring during the development of active tuberculosis.
2. Discuss the transmission of TB and the conditions predisposing to the development of TB.
3. Discuss the treatment of tuberculosis and the precautions involved for health care personnel coming into contact with the patient.
4. Suggest how family members or co-workers can protect themselves.