Lupus

Part A
Lupus is a disease that occurs when your body's immune system attacks your
own tissues and organs (autoimmune disease). Inflammation caused by
lupus can affect many different body systems — including your joints, skin,
kidneys, blood cells, brain, heart and lungs.
Factors that may increase your risk of lupus include:
• Sex - Lupus is more common in women than men.

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• Age - Although lupus affects people of all ages, it’s most often
diagnosed between the ages of 15 and 45.

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• Race - Lupus is more common in African Americans, Hispanics and
Asian Americans
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Causes
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As an autoimmune disease, lupus occurs when your immune system attacks

healthy tissue in your body. It's likely that lupus results from a combination
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of your genetics and your environment.

It appears that people with an inherited predisposition for lupus may develop
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the disease when they come into contact with something in the environment
that can trigger lupus. The cause of lupus in most cases, however, is
unknown. Some potential triggers include:
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• Sunlight. Exposure to the sun may bring on lupus skin lesions or

trigger an internal response in susceptible people.
• Infections. Having an infection can initiate lupus or cause a
relapse in some people.
• Medications. Lupus can be triggered by certain types of blood
pressure medications, anti-seizure medications and antibiotics.
People who have drug-induced lupus usually get better when they
stop taking the medication. Rarely, symptoms may persist even
after the drug is stopped

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Part B
Classification

Severity How it affects the body

Mild Joint and skin problems, tiredness

Moderate Inflammation of other parts of the skin and body, including your
lungs, heart and kidneys

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Severe Inflammation causing severe damage to the heart, lungs, brain

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or kidneys can be life threatening
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No two cases of lupus are exactly alike. Signs and symptoms may come on
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suddenly or develop slowly, may be mild or severe, and may be temporary or

permanent. Most people with lupus have mild disease characterized by
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episodes — called flares — when signs and symptoms get worse for a while,
then improve or even disappear completely for a time.
The signs and symptoms of lupus that you experience will depend on which
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body systems are affected by the disease. The most common signs and
symptoms include:
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• Fatigue
• Fever
• Joint pain, stiffness and swelling
• Butterfly-shaped rash on the face that covers the cheeks and
bridge of the nose or rashes elsewhere on the body
• Skin lesions that appear or worsen with sun exposure
• Fingers and toes that turn white or blue when exposed to cold or
during stressful periods

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 • Shortness of breath
• Chest pain
• Dry eyes
• Headaches, confusion and memory loss

Text C
How lupus is diagnosed

Lupus, also called systemic lupus erythematosus (SLE) , can be difficult to

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diagnose because its signs and symptoms often mimic those of other
ailments. The most distinctive sign of lupus — a facial rash that resembles
the wings of a butterfly — occurs in many but not all cases of lupus.

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• Symptoms include inflammation of different parts of the body
including the lungs, heart, liver, joints and kidneys.
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• Usually will do some blood tests, high levels of a type of antibody,
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combined with typical symptoms, means lupus is likely.

• X-rays and scans of the heart, kidney and other organs if the doctor
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thinks they might be affected.

• Once lupus is diagnosed, you'll be advised to have regular checks and

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tests, such as regular blood tests to check for anaemia and urine tests
to check for kidney problems.
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Treatment for lupus

Lupus is generally treated using:

• Anti-inflammatory medicines like ibuprofen

• Hydroxychloroquine for fatigue and skin and joint problems

• Steroid tablets, injections and creams for kidney inflammation and

rashes
Two medicines, rituximab and belimumab, are sometimes used to treat
severe lupus. These work on the immune system to reduce the number of
antibodies in the blood.

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Although medicines are important in controlling lupus, you can help manage
your symptoms and reduce the risk of it getting worse.

Do Don’t

Use high-factor (50+) sunscreen – you can •Do not smoke – Quit smoking
get it on prescription if you have lupus is the most important thing to
do if you have lupus
•Learn to pace yourself to avoid getting too
tired •Do not sit in direct sunlight or
spend a lot of time in rooms
•Try to stay active even on a bad day with fluorescent lights

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•Try relaxation techniques to manage
stress – stress can make symptoms worse

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•Wear a hat in the sun

•Tell your employer about your condition –

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you might be able to adjust your working
pattern
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•Ask for help from family, friends and

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health professionals
•Eat a healthy, balanced diet, including
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vitamin D and calcium

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Text D
Complications
Inflammation caused by lupus can affect many areas of your body, including
your:

• Kidneys. Lupus can cause serious kidney damage, and kidney

failure is one of the leading causes of death among people with
lupus.

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 • Brain and central nervous system. If your brain is affected
by lupus, you may experience headaches, dizziness, behavior
changes, vision problems, and even strokes or seizures.
• Blood and blood vessels. Lupus may lead to blood problems,
more likely a reduced number of healthy red blood cells (anemia)
and an increased risk of bleeding or blood clotting. It can also
cause inflammation of the blood vessels.
• Lungs. Having lupus increases your chances of developing an
inflammation of the chest cavity lining, which can make breathing
painful. Bleeding into lungs and pneumonia also are possible.

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• Heart. Lupus can cause inflammation of your heart muscle, your
arteries or heart membrane. The risk of cardiovascular disease and

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heart attacks increases greatly as well.
Having lupus also increases your risk of:
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• Infection. People with lupus are more vulnerable to infection
because both the disease and its treatments can weaken the
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immune system.
Cancer. Having lupus appears to increase your risk of cancer;
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•
however, the risk is small.
Bone tissue death. This occurs when the blood supply to a bone
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•
declines, often leading to tiny breaks in the bone and eventually to
the bone's collapse.
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• Pregnancy complications. Women with lupus have an

increased risk of miscarriage and preterm birth.

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Time: 15 minutes

• Look at the four texts, A-D, in the separate Text Booklet.

• For each question,1-20,look through the texts, A-D, to find in this
Question Paper

• Answer all the questions within the 15 Minute time limit

• Your answers should be correctly spelt.

Lupus :Questions
Questions 1-7

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For each question, 1-7, decide which text (A,B,C or D) the

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Information comes from. You may use any letter more than

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once. In which text can you can find information about..

1. Bone tissue death occurs

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2. Vulnerable group of people are from
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3. Classification based on the severity

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4. Disease control measures

5. The potential triggers include
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6. Radiographic studies to detect

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7. Flares disappear over a time

Questions 8- 14

Answer the questions,8-14,with a word or short phrase from one

of the texts. Each answer may include words, numbers or both.
8. What is the classical sign of lupus - - - - - - - - - - - - - - - - - - - -?
9. Which type of lupus usually get better when people stop taking the
medication - - - - - - - - - - - - - - - - - - ?

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 10. Which is the most common blood disorder seen in patients with
lupus - ------------------------ -?
11. Which are the two medications can help to treat severe lupus

- - - - - - - - - - - - - - - - - -?
12. What are the characteristics in mild cases of patients with lupus - - - -
- - - - - - - - - - - - - - - - - - --?
13. What is the drug of choice to relieve fatigue and joint problems
associated with lupus - - - - - - - - - - - - - - - - - ?

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14.What is SLE - - - - - - - - - - - - - - - - - - - - - - - -?

Questions 15-20

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Complete each of the sentences, 15-20, with a word or short
phrase from one of the texts. Each answer may include words,
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numbers or both.
15. Wearing - - - - - - - - - - - - - can help to reduce the risk of lupus getting
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worse while the sunlight exposure?

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16.Lupus is more common in - - - - - - - - - - than - - - - - - - - -?

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17. ----------------------is the most important thing to do if you have lupus?

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18. Women with lupus have an increased risk of - - - - - - - - - - - and

- - - - - - - -?
19.---------------------is an autoimmune disease, which occurs when the
immune system attacks healthy tissue in your body?
20. Lupus most often affects the people between the ages of - - - - -
and - - - - -?

End of Part A
Proceed to Part B & C