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Submitted by: III – B1 Submitted to: Dr. Sandra Navarra

Homework on Case: Persistent fever, anemia and abdominal pain in a patient with systemic lupus erythematosus. Submitted by: III – B1 Submitted to: Dr. Sandra Navarra. 1. Pathomechanism/s for cytopenia in active SLE.

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Submitted by: III – B1 Submitted to: Dr. Sandra Navarra

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  1. Homework on Case:Persistent fever, anemia and abdominal pain in a patient with systemic lupus erythematosus Submitted by: III – B1 Submitted to: Dr. Sandra Navarra

  2. 1. Pathomechanism/s for cytopenia in active SLE. Blood cytopenia in SLE patients maybe resulted from the destructions of bone marrow hematopoietic cells by the autoantibodies. Fu R, Uehara T, Gong L, Shao ZH. Study on the pathogenesis of blood cytopenia in patients with systemic lupus erythematosus. 2008 Jan;29(1):48-51. http://www.ncbi.nlm.nih.gov/pubmed/18512316.

  3. 2. Define Febrile Neutropenia occurs when a patient has a fever and a significant reduction in their white blood cells (neutropenia) that are needed to fight infections Many patients when undergoing cancer treatment will have a reduction in their white blood cells that may be temporary or may persist for some time. The fever may be caused by an infectious agent, and when it is rapid treatment is required. A patient with febrile neutropenia needs assessment for the possible source and type of infection and treatment until the cause is found or it subsides. Reference:http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/SupportiveCare/FebrileNeutropenia/default.htm

  4. 3. Enumerate Risk Factors for Candidiasis • Surgery • Indwelling urinary catheters • Indwelling intravascular catheters • Low birth weight neonates • total parenteral nutrition • transplant recipients • malignancy • neutropenia • burn patients Reference: 17th Ed. Harrison’s Principle of Internal Medicine p. 1254 • Antibacterial agents • Hyperalimenation fluids • Parenteral glucocorticoids • Respirators • Cytotoxic chemotherapy • Persons using IV illicit drugs • HIV-infected patients w/ low CD4+ T cell counts • Diabetes

  5. 4. Outline the antimicrobial treatment of systemic candidiasis. Harrison’s principle of Internal Medicine p. 1256

  6. 5. Define sepsis and septic shock. SEPSIS – the presence of infection in a patient with SIRS SEPTIC SHOCK – severe sepsis with hypotension or evidence of hypoperfusion that cannot be corrected despite adequate fluid resuscitation Harrison’s Principle of Internal Medicine 17th edition p. 1695

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