Flashcards in Connective Tissue Disease Deck (86)
What are connective tissue disease characterized by?
the presence of spontaneous over-activity of thewh immune system
what type of hypersensitivity is SLE?
who is affected more by lupus- males or females?
what are the 3 main environmental factors which could contribute to the development of SLE?
-virus (eg eptein-barr virus)
-silica dust (found in cigarette smoke)
why might defective apoptosis lead to the production of auto-antibodies?
cell death happens less efficiently so remnants are not cleared away quickly. This allows extended exposure to nuclear and intracellular antigens which might trigger the production of auto-antibodies.
where do the immune complexes get deposited in SLE?
in the wall of blood vessels
what is serositis?
inflammation of a lining ie pericarditis, peritonitis, pleuritis
what are the 5 main constitutional symptoms of SLE? (vague/non specific- most common symptoms)
what are the 7 main mucocutaneous features of SLE?
-discoid lupus erythematosus
-subacute cutaneous lupus
what is typically spared in an SLE malar rash?
what is different about discoid lupus?
can be solely cutaneous symptoms
what are the 4 main musculoskeletal features of SLE?
-deforming arthropathy (Jaccoud's arthritis)
how is non-deforming polyarthritis of SLE differentiated from rheumatoid arthritis even though they have the same distribution?
SLE polyarthritis has no sign of erosion on radiological investigation
What is Jaccoud's arthritis?
a reversibly deforming arthropathy (not erosive)
what are the 5 main pulmonary features of SLE?
-pleurisy (causing pleural effusion)
-diffuse lung infiltrate and fibrosis
-pulmonary infarct (causing haemoptysis)
is a patient with SLE more likely to get a transudate or exudate pleural effusion?
exudate (due to inflammation, transudate more due to leakage)
what are the 4 main cardiac features of SLE?
what is Libman-Sachs endocarditis?
sterile (nonbacterial) endocarditis, valve vegetation but no microbes on lood cultuees
How do you detect glomerulonephritis in a patient with SLE?
what are the 5 main neurological features of SLE?
-cerebral ischamie (TIA or CVA)
-cranial or peripheral neuropathy
what are the 4 main haematological features?
why do patients with SLE have a susceptibility to infection?
-intrinsic factors (impaired immunity)
-extrinsic factors (ie immunosuppressive treatments)
what are the main immune tests to do in suspected SLE?
-anti-double stranded DNA antibody
-anti-extractable nuclear antigens (eg anti-Ro, anti-La, anti-Sm and anti-RNP)
which is more specific for lupus: anti-ds DNA or ANA
(rarely get false positives)
which is antibody is present in more SLE patients- anti-ds DNA or ANA?
what antibody is important in pregnant patients with SLE because of pathogenic effects on foetus?
what can anti-Ro cause in a neonate?
congenital heart block (in utero)
what happens to anti-ds DNA titre and complement titre when SLE starts to become active again?
anti-ds DNA titre increase
complement titre decreases
why do complement levels decrease in the body during active SLE?
complement is being used up