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AJB

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Cop 4.5 jennifer lee summary document 2004 301021

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How would you explain the concept of an autoimmune disease to Jennifer?

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How would you explain the concept of an autoimmune disease to Jennifer?

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What impact may this condition have on her life?

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What impact may this condition have on her life?

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Describe and explain Jennifer's diagnosis (and differential)

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Describe and explain Jennifer's diagnosis (and differential)

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AJB

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Jennifer Lee’s cop question ajb 1957 301021

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Can any of the above conditions/ symptoms (in 6. & 7.) have a pharmacologically iatrogenic cause?

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Can any of the above conditions/ symptoms (in 6. & 7.) have a pharmacologically iatrogenic cause?

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What are DMARDs and what are the general principles around using them?

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What are DMARDs and what are the general principles around using them?

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https://drive.google.com/file/d/12IRkKDBgwXxkGSUOrH1DkMGab1e2OnTV/view

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Get access to files anywhere through secure cloud storage and file backup for your photos, videos, files and more with Google Drive.

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Name some causes of i) discoid rash ii) photosensitive rash iii) myalgia

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Name some causes of i) discoid rash ii) photosensitive rash iii) myalgia

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1. Discoid Rash
Factors leading to DLE include:

Genetic predisposition

Exposure to sunlight (often several weeks before the presentation)

Toxins such as cigarette smoke

Hormones.

The manifestations of DLE are due to loss of regulation of the immune system in the skin.

2. Photosensitive Rash
Photosensitivity is caused by an abnormal reaction to some component of the electromagnetic spectrum of sunlight and a chromophore (reactive compound) within the skin.

Primary photodermatoses
The causes of primary or idiopathic photodermatoses have not yet been discovered. Exposure to the sun produces a clearly defined disease entity. These include:

Juvenile spring eruption

Polymorphic light eruption

Exogenous photodermatoses

Exogenous photodermatoses are those in which phototoxic or photoallergic reaction is caused by an external photosensitiser. These include:

Drug-induced photosensitivity: common photosensitising drugs are thiazides, tetracyclines, non-steroidal anti-inflammatory drugs (NSAIDs)

Photocontact dermatitis: due to phototoxic chemicals such as psoralens in plants, vegetables, fruit; fragrances in cosmetics; sunscreen chemicals; dyes and disinfectants

Photoexacerbated dermatoses

Photoexacerbated dermatoses include:

Lupus erythematosus

Pemphigus vulgaris

Pemphigus foliaceus

Atopic dermatitis

Psoriasis

3. Myalgia

Myalgia can typically be localized to one area of the body, or groups of muscles. The most common causes of muscle pain are stress, overuse, injuries, and tension. Muscle pain – specifically systemic muscle pain – can be caused by an illness, infection, or a side effect of certain medications.

Common causes of myalgia includes:

Chronic fatigue syndrome

Fibromyalgia

Lyme disease

Lupus

Myofascial pain syndrome

Rheumatoid arthritis

Many other diseases and conditions cause pain to muscles such as hyperthyroidism, influenza, and dystonia.

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https://drive.google.com/file/d/1WI-3BVsGX5UQnZMD0TQdVHUfft4sTSyY/view

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Get access to files anywhere through secure cloud storage and file backup for your photos, videos, files and more with Google Drive.

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Thanks for doing all this work again. It looks like you are on the right track. Summary and Diagnosis looking good. Some resources to help in the other areas:

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Thanks for doing all this work again. It looks like you are on the right track. Summary and Diagnosis looking good. Some resources to help in the other areas:

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Some further resources for case 4.5 Jennifer Lee.

Further reading on SLE:

https://patient.info/doctor/systemic-lupus-erythematosus-pro

Dermatology:

https://dermnetnz.org/topics/discoid-lupus-erythematosus

https://dermnetnz.org/topics/photosensitivity

Have a look at some patient information resources:

https://www.nhs.uk/conditions/lupus/

https://www.kidney.org.uk/lupus-and-lupus-kidney-disease

DMARDS:

https://cks.nice.org.uk/topics/dmards/

https://bnf.nice.org.uk/treatment-summary/rheumatoid-arthritis.html