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Flashcards in Connective Tissue Disease Deck (86)
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1

What are connective tissue disease characterized by?

the presence of spontaneous over-activity of thewh immune system

2

what type of hypersensitivity is SLE?

type III
immune complexes

3

who is affected more by lupus- males or females?

females

4

what are the 3 main environmental factors which could contribute to the development of SLE?

-virus (eg eptein-barr virus)
-UV light
-silica dust (found in cigarette smoke)

5

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.

6

where do the immune complexes get deposited in SLE?

in the wall of blood vessels

7

what is serositis?

inflammation of a lining ie pericarditis, peritonitis, pleuritis

8

what are the 5 main constitutional symptoms of SLE? (vague/non specific- most common symptoms)

fever
malaise
poor appetite
weight loss
fatigue

9

what are the 7 main mucocutaneous features of SLE?

-photosensitivity
-malar rash
-discoid lupus erythematosus
-subacute cutaneous lupus
-apthous ulcers
-alopecia

10

what is typically spared in an SLE malar rash?

nasolabial folds

11

what is different about discoid lupus?

can be solely cutaneous symptoms

12

what are the 4 main musculoskeletal features of SLE?

-non-deforming polyarthritis/polyarthralgia
-deforming arthropathy (Jaccoud's arthritis)
-erosive arthritis
-myopathy

13

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

14

What is Jaccoud's arthritis?

a reversibly deforming arthropathy (not erosive)

15

what are the 5 main pulmonary features of SLE?

-pleurisy (causing pleural effusion)
-infections
-diffuse lung infiltrate and fibrosis
-pulmonary hypertension
-pulmonary infarct (causing haemoptysis)

16

is a patient with SLE more likely to get a transudate or exudate pleural effusion?

exudate (due to inflammation, transudate more due to leakage)

17

what are the 4 main cardiac features of SLE?

-pericarditis
-cardimyopathy
-pulmonary hypertension
-Libman-Sachs endocarditis

18

what is Libman-Sachs endocarditis?

sterile (nonbacterial) endocarditis, valve vegetation but no microbes on lood cultuees

19

How do you detect glomerulonephritis in a patient with SLE?

urinalysis

20

what are the 5 main neurological features of SLE?

-depression/psychosis
-migraine
-cerebral ischamie (TIA or CVA)
-cranial or peripheral neuropathy
-cerebellar ataxia

21

what are the 4 main haematological features?

-lymphadenopathy
-leukopaenia
-anaemia
-thrombocytopaenia

22

why do patients with SLE have a susceptibility to infection?

-intrinsic factors (impaired immunity)
-extrinsic factors (ie immunosuppressive treatments)

23

what are the main immune tests to do in suspected SLE?

-anti-nuclear antibody
-anti-double stranded DNA antibody
-anti-extractable nuclear antigens (eg anti-Ro, anti-La, anti-Sm and anti-RNP)
-complement levels

24

which is more specific for lupus: anti-ds DNA or ANA

anti-ds DNA
(rarely get false positives)

25

which is antibody is present in more SLE patients- anti-ds DNA or ANA?

ANA

26

what antibody is important in pregnant patients with SLE because of pathogenic effects on foetus?

anti-Ro
(anti-ENA)

27

what can anti-Ro cause in a neonate?

congenital heart block (in utero)
neonatal lupus

28

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

29

why do complement levels decrease in the body during active SLE?

complement is being used up

30

what is the drug treatment of SLE?

-NSAIDs and simple analgesia
-anti-malarials (hyroxychloroquine)
-steroids
-immunosuppressives
-biologics (rituximab)