Choose one multisystem dysfunction. Describe pathophysiological changes, abnormal findings, and symptoms of the chosen dysfunction. How does it affect the patient's activities of daily living?
Multisystem dysfunction.
Sample Answer
Multisystem Dysfunction: Systemic Lupus Erythematosus (SLE)
Pathophysiological Changes
The core pathophysiological change in SLE is a dysregulation of the immune system, specifically involving both innate and adaptive immunity. This leads to the production of autoantibodies that target the body's own cells and tissues.
Autoantibody Production:
The hallmark of SLE is the production of autoantibodies, particularly antinuclear antibodies (ANAs), which target components within the cell nucleus (e.g., anti-dsDNA, anti-Sm, anti-Ro/SSA, anti-La/SSB).
Other autoantibodies can target blood cells (e.g., anti-platelet, anti-red blood cell antibodies), phospholipids (antiphospholipid antibodies), and other self-antigens.
Immune Complex Formation and Deposition:
These autoantibodies bind to their corresponding self-antigens, forming immune complexes.
These immune complexes circulate in the bloodstream and deposit in various tissues, especially in small blood vessels, kidney glomeruli, and synovial membranes.
Inflammation and Tissue Damage:
The deposited immune complexes activate the complement system, a cascade of proteins that promotes inflammation.
This activation attracts inflammatory cells (e.g., neutrophils, macrophages) to the site of deposition, leading to the release of pro-inflammatory cytokines, chemokines, and proteases.