Question

Introductory scenario A 30-year-old Hispanic woman visits her primary care physician with complaints of fever, joint pain, and a rash on her hands and face. The patient reports that the rash worsens after spending time in the sun. The patient also reports a decrease in energy and appetite. The physician suspects the patient has an autoimmune disease but needs to gather more data to diagnose a specific disease such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), or multiple sclerosis. Continue to questions Chapter15 Atomunity Notes 1. The physician orders a complete blood count (CBC), urinalysis (UA), and antinuclear antibody (ANA) analysis as part of the diagnostic process. Which test results would confirm that an autoimmune disease is present? A. Low white blood cell count B. Protein in the urine C. Positive ANA analysis results D. Low platelet count Additional laboratory results Reference Range Reference Range 3.3 x 103/uL 4.8-10.8 x 10/uL WBC Neutrophils 81% 60%-70 % 1.9 x 10/L 4.7-6.1x 109/L RBC Lymphocytes 19% 20%-30 % Hgb 7.2 g/dL 14-18 g/dL Monocytes 5%-10 % Hct 21% 42%-52 % Eosinophils 0%-5% 57 x 10/L 150-450 x 10/L Plt Basophils 0%-2% 1.4-6.5 x 10/uL Absolute neutrophils 2.7 1.2-3.4x10/uL Absolute lymphocytes 0.6 0.1-0.6 x 10/ul Absolute monocytes 0 0-0.5 x 10/uL Absolute eosinophils 0-0.2 x 10/uL Absolute basophils 0 CHEpt 15Automiunity Notes UA and ANA results Continue to next question Reference Range Reference Range Antinuclear Antibody Analysis Urinalysis Anti-DSDNA Pos Neg Color Yellow Light-dark yellow Neg Anti-SSDNA Pos Clarity Cloudy Clear Neg Anti-DNP Pos Specific gravity 1.034 1.015-1.025 Neg Pos 4.5-8.0 Anti-Sm 8.1 pH Anti-RNP Neg Pos Neg Pos Protein Neg Anti-Scl-70 Neg Neg Glucose Neg Neg Anti-Jo-1 Neg Neg Ketones Neg Neg Blood Neg Bilirubin Neg Neg Urobilinogen Neg Neg Neg Nitrite Pos Neg Pos Leukocyte esterase Coter U uni 2. Based on the specific antibodies found in this patient, which autoimmune disease is most likely? A. Scleroderma B. RA C. MS D. SLE 3. Do the other laboratory findings align with diagnosis for SLE? A. Yes B. No

Answer 1

Question 1.

C. Positive ANA analysis results.

Question 2.

D. SLE .

• Systemic Lupus Erythematosus -An inflammatory disease caused when the immune system attacks its own tissues.

Question 3.

A. YES.

• Erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)

• Complement levels

• Liver function tests

• Creatine kinase assay

• Spot protein/spot creatinine ratio.

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