1. By: Crystal C., Dante P. & Isaiah W.

2. 24 year old male who came into the health clinic with flu like symptoms after 3 days when they first started. He just thought getting sick like this were the after affects of these drugs PATIENT- ROBERT LUPIN

3. Studying to become a lawyer His father passed away from a fatal heart attack 6 months prior. His mother was diagnosed with breast cancer 3 weeks ago. The BAR exam is next month. ROBERT LUPIN

4. Patient was seen by the assigned Physician Assistant. Physical exam was preformed. Patient has epilepsy. Family history reveals heart disease. No allergies. No mental illness recorded Anti seizure medication and Tylenol for the flu. EXAM

5. PA, M.M.S Primary Care specialty Training is 2-3 years of post grad work Emerging field in the Iraq war with about 4 years experience Career is more focused on diagnosing, prescribing, and treating patients in a team with physicians. Everything will be view by the MD ASSIGNED PHYSICIAN ASSISTANT

6. EXAM

7. Lungs sounds are abnormal, patient is wheezing. Heart sounds are normal, 80 B/M Abdominal exam are normal. DX: Influenza. RX: Adequate rest, keep taking current medication for flu like symptoms and anti seizure medication. Return in 1 week for routine urine and blood work. EXAM

8. 3 days after the patients symptoms are relieved, he goes into convulsions during class. Patient regains consciousness and is rushed to the ER. TRAGEDY STRUCK

9. Vital signs in abnormal limits. Patient is too confused to answer questions. Close friend answers for him. Patient’s friend recalls a party where they both had experimented with drugs (LSD, Cocaine and Ecstasy) and alcohol (Beer, Wine and Rum). Attending Physician orders lab tests (Blood and Urine). PATIENT RUSHED TO EM

10. Doctor of Medicine MD Doctor of Osteopathy DO Specialty is internal medicine Defined as a physician who has completed residency and practices medicine in a clinic or hospital, in the specialty learned during residency. ATTENDING HOSPITAL PHYSICIAN

11. Many tests are ordered to explain the onset of the seizure. Physical exam reveals butterfly rash across the face. Patient complains of mouth sores. PATIENT

12. Patient is questioned about when he has been. No evidence of a chemicals in the illegal drugs taken to be the issues. TOXICOLIST IS CALLED IN

13. Worked on the cases in Chernobyl. Plan and carry out laboratory and field studies to identify, monitor and evaluate the impact of toxic materials and radiation on human and animal health, the environment, and the impact of future technology. TOXICOLOGIST

14. Blood work reveals low blood cells count (anemia) Urine tests reveals blood cells in urine and increased protein. DX: Patients appears to have drug-induced lupus erythematous (DILE or DIL) LAB RESULTS

15. Lupus cells in a blood smear.. Lupus red blood cell in urine. LUPUS

16. Pathologists are physicians who diagnose and treat patients through laboratory medicine. They use lab tests to either identify a disease or rule out other diseases that could impact a patient’s well-being. They also investigate unknown deaths. Potentially revealing a hereditary disease to a patient’s family. PATHOLOGIST

17. Corticosteroids work quickly to decrease the swelling, warmth, tenderness, and pain that are associated with inflammation. Aspirin has pain-reducing, anti-inflammatory, and anticoagulant (blood-thinning) properties that can control some of the symptoms of lupus. However, it can cause stomach irritation. CORTICOSTEROIDS AND ASPIRIN

18. reduce inflammation suppress overactive immune system prevent flares and treat them when they occur control symptoms like joint pain and fatigue minimize damage to organs GOAL OF TREATMENT

19. Late 14c Used of several diseases that cause ulcerations of the skin From M.L. lupus, from L. lupus "wolf“. Apparently because it "devours" the affected part. LUPUS ORIGIN

20. Auto immune disease Drug induced ^ One of the most recognized people with lupus LUPUS

21. Drug-induced lupus erythematosus is similar to systemic lupus erythematosus (SLE). It’s an autoimmune disorder, which means the body mistakenly attacks healthy tissue. It’s caused by a hypersensitivity reaction to a medication. DRUG-INDUCED LUPUS ERYTHEMATOSUS

22. Mostly occur in woman but are rare in men. It’s an autoimmune disease that causes inflammation and tissue damage to the body. It’s a chronic disease, which means that you will have lupus for the rest of your life. It’s not contagious. It can cause a mild skin rash, achy joints, or can affect organs inside the body. LUPUS

23. It’s not like or related to cancer. It’s not like or related to HIV or AIDS. It’s unpredictable. Symptoms can appear, disappear, and change. It can range from mild to life-threatening and should always be treated by a doctor. Exposure to the sun may bring on lupus skin lesions or trigger an internal response in susceptible people. LUPUS CONT.

24. Unknown Might be caused by a combination of a combination of genetics, hormones and environmental factors. Some known triggers are: drugs which make a person more sensitive to the sun penicillin or other antibiotic drugs vaccinations containing live viruses CAUSES OF LUPUS

25. ultraviolet light from the sun, tanning beds, or fluorescent lights viral or bacterial infections physical stress, such as injury, illness, or surgery emotional stress, such as divorce, illness, or death in the family CAUSES OF LUPUS CONT.

26. Although clinical depression can occur as a symptom of having lupus, it is a separate illness that should be taken seriously. Symptoms of clinical depression: feelings of helplessness or hopelessness inability to concentrate problems with memory and recalling information indecisiveness thoughts of suicide EMOTIONAL WELL-BEING

27. Learn all you can about lupus. Be patient as you explain to family, friends, and co-workers how lupus affects you. Talk to your doctor if you have questions about lupus, your medications and their side effects, and lifestyle changes that will help you. Take your medications as prescribed, and tell your doctor about any side effects. Try to do something physically active each day. Don’t feel guilty about needing rest and a stress-free environment. LIVING WITH LUPUS

28. Don’t be afraid to ask for help. Focus on what you can do, not what you cannot do. If lupus symptoms prevent you from your usual activities, find new ways to relax, exercise, spend time with loved ones, and enjoy life. If you think you are experiencing symptoms of clinical depression, talk to your doctor. Connect with others who understand what you’re going through. LIVING WITH LUPUS CONT.

29. Auto immune reaction to anti seizure medication Prescribe new anti-seizure medication DIAGNOSIS

30. A year after he stopped taking his originally prescribed medication for seizures, and his lupus symptoms went away. He passed the BAR exam with flying colors He quickly get a job working for a law firm in downtown Seattle ROBERT LUPIN

31. http://en.wikipedia.org/wiki/Lupus_erythematosus http://lupusface.wordpress.com/what-is-lupus-the-disease-of-a-thousand-faces/ http://sshouse18.hubpages.com/hub/Lupus-the-disease-of-1000-faces http://nancynurse.hubpages.com/hub/What-are-the-symptoms-and-treatment-for- Lupus http://nancynurse.hubpages.com/hub/What-are-the-symptoms-and-treatment-for- Lupus http://pamela99.hubpages.com/hub/Lupus-Symptoms-Diagnosis http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnunderstanding. aspx?articleid=2232&zoneid=523 http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnunderstanding. aspx?articleid=2232&zoneid=523 http://www.lupus.org/webmodules/webarticlesnet/templates/new_aboutindividualized 02.aspx?articleid=109&zoneid=18 http://www.lupus.org/webmodules/webarticlesnet/templates/new_aboutindividualized 02.aspx?articleid=109&zoneid=18 http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnmen.aspx?artic leid=4025&zoneid=529 http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnmen.aspx?artic leid=4025&zoneid=529 http://www.chw.org/display/PPF/DocID/21653/router.asp http://www.mayoclinic.com/health/lupus/DS00115/DSECTION=symptoms WORKS CITED

32. http://www.lupus.org/webmodules/webarticlesnet/templates/new_abouta ffects.aspx?articleid=377&zoneid=17 http://www.lupus.org/webmodules/webarticlesnet/templates/new_abouta ffects.aspx?articleid=377&zoneid=17 http://www.lupus.org/webmodules/webarticlesnet/templates/default.aspx ?a=377&template=print-article.htm http://www.lupus.org/webmodules/webarticlesnet/templates/default.aspx ?a=377&template=print-article.htm http://www.belgraviacentre.com/blog/new-lupus-treatment-may-help- with-hair-loss-208/ http://www.belgraviacentre.com/blog/new-lupus-treatment-may-help- with-hair-loss-208/ WORKS CITED CONT.