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ICC2 > SLE > Flashcards

SLE Flashcards

1
Q

what type of disease is SLE ?

A

autoimmune disease

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2
Q

what is the presentation of SLE?

A

fatigue, lethargy, fever, weight loss
skin rashes
mouth ulcers
hair loss
Raynaud’s Phenomenon
aching joint

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3
Q

what are the cutaneous manifestations ?

A

photosensitive ( most common)
raised erythematous malar rash
discoid malar rash
mouth/vaginal/nasal ulcers
alopecia

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4
Q

what are the muscoskeletal manifestations ?

A

polyarthritis
jaccoud’s arthropathy ( similar to RA but correctable)
Myositis

arthritis

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5
Q

what are the cardiovascular manifestations ?

A

pericarditis - usually responds to NSAIDs
myocarditis
MI
vasculitis

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6
Q

what are the renal manifestations ?

A

mild glomerulonephritis

lupus nephritis

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7
Q

what are the hematological manifestations ?

A

anemia
leukopenia
thrombocytopenia

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8
Q

what are the ACR classification criteria ?

A

A RASH POINTS MD
1- facial rash sparing the nasolabial fold (butterfly rash)
2- discoid rash
3- photosensitivity
4- oral or nasopharyngeal ulcerations
5- non-erosive arthritis
6- serositis
7- renal disorders
8- haematological disorders
9- neurological disorders
10- immunological
11- ANA positive

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9
Q

how many of the ACR classification are required for a diagnosis ?

A

4 out of 11

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10
Q

what other investigations are required for a diagnosis of SLE ?

A
  • CBC, ESR, liver function, kidney function, urine analysis and 24 hr protein
  • kidney biopsy and sometimes skin biopsy
  • MRI brain in cases of CNS lupus may be required
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11
Q

what is the management for SLE ?

A 
analgesics 
local treatments such as SPF 
NSAIDS
steroids 
DMARDS
Immunosuppressants - azathioprine and cyclophosphamide
biological treatments ( if not responding to conventional treatment )
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12
Q

what is the management for psychoses and seizures in CNS lupus ?

A

anticonvulsants
antipssychotics

antipsychotics

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13
Q

what is the management for status epilepticus and coma in CNS lupus ?

A

pulse methyprednisolone
IV cyclophosphamide
and/or plasmapheresis

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14
Q

what is antiphospholipid syndrome ?

A

a disease that may be idiopathic or happens along with autoimmune disease where the patient experiences a hypercoaguable state

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15
Q

what is the requirement to make a diagnosis of antiphospholipid syndrome ?

A

requires one clinical criteria ( thrombotic event or pregnancy complication) along with two antibody blood test spaced at least 3 months apart

  • lupus anticoagulant
  • anticardiolipin antibody
  • beta 2 glycoprotein
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16
Q

what are the prophylactic measures for APS ?

A

low does aspirin

aspirin and anti coagulant

17
Q

what would we give a pregnant female with antiphospholipid ?

A

aspirin and low molecular weight heparin

18
Q

generally what is thee first line treatment for patients with APS after a thromboembolic event ?

A

warfain

19
Q

what is the presentation like in pregnant women with SLE?

A

1st trimester - active disease

2nd to 3rd trimester - antiphospholipid syndrome

20
Q

what are the variants of SLE ?

A 
chronic discoid lupus DLE 
subacute cutaneous lupus SCLE 
neonatal Lupus 
Lupus in the elderly 
drug induced lupus
21
Q

what are the features of chronic discoid lupus DLE ?

A

usually really low or ANA negative

22
Q

what are the features of subacute cutaneous lupus ?

A

ANA positive
non-scarring photosensitive rash
anti-ro antibody

Anti-Ro antibody

23
Q

when does neonatal lupus happen ?

A

neonates are born to mothers with Ro antibody
associated with 3 Hs :
hematological problems
heart block k
hepatobiliary disease

24
Q

what are the drugs that could induce lupus ?

A

procainamide
hydralazine
isoniazid
anticonvulsants

25
Q

what are the features of drug induced lupus ?

A

ANA positive mainly histones and ssDNA

mainly histones and ssDNA

26
Q

what are the features of sjorgen’s syndrome ?

A

dry eyes
dry mouth
positive schrimer’s test
serology ro positive
anti-la negative
~~~

27
Q

what are the cutaneous manifestations associated with associated with DLE ?

A

discoid malar rash
circular scaly hyperpigmented lesions
erythematous rim
atrophic centre

28
Q

if a single joint has persistent pain in a patient with SLE what should be considered ?

A

osteonecrosis

29
Q

what does jaccoud’s arthropathy look like ?

A

ulnar deviation of the 2nd to 5th fingers with metacarpophalangeal joint subluxation

30
Q

what are the features associated with lupus inn the elderly ?

A

insidious onset
interstitial lung disease is common
CNS and renal not common

31
Q

what is the the INR target when warfarin is used ?

A

INR 2-3

ICC2 (42 decks)

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