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ICM Infectious Disease > Lupus > Flashcards

Flashcards in Lupus Deck (51):
1

What is Systemic Lupus Erythematous?

Chronic inflammatory disease of unknown cause.

2

What does SLE affect?

Skin, joints, kidneys, lungs, nervous system, serous membranes

3

What is SLE in origin?

Autoimmune

4

Clinical course of SLE characterized by what?

Periods of remission and chronic/acute relapses

5

What factors play a role in pathogenesis?

Genetics and environmental factors

6

Who has higher incidence?

Blacks and indian tribes

7

Which genetic HLA haplotypes are increased in SLE population?

HLA DR2 and DR3

8

Which Haplotypes on chromosome 2 are associated with increased incidence of rheumatoid and lupus?

STAT4 haplotypes

9

What do STAT4 haplotypes code for?

Cytokines

10

Deficiencies of which complements are associated with SLE and discoid lupus?

Complements C2 and C4

11

What do twin studies show about SLE?

Monozygotic twins both more commonly develop SLE than dizygotic twins

12

What is the estimated number of susceptibility genes needed for development of SLE disease?

4

13

Which drugs can cause an SLE like illness?

Procainamide and hydralazine

14

What are three other environmental factors than can start SLE?

1) Hairy dye
2) Smoking
3) UV light

15

Women of what age are at greatest risk?

Childbearing years

16

Estrogen effect on SLE?

Prolongs survival of autoimmune cells

17

Effects of prolonged autoimmune cells in SLE?

Increases T-helper cell cytokine production
Stimulates B-cell to produce autoantibodies

18

Correlation between CD40 ligand in women?

More X chromosomes express CD40 ligand in women with lupus than women without

19

Is a low level of auto reactivity pathologic?

No, physiologic

20

Activated T cells stimulate B cells to produce what?

Autoantibodies

21

Total T cells are what in lupus?

Decreased

22

T cell function is skewed toward what in lupus?

B-cell help

23

Direction of IL-10 and 12 in SLE?

IL-10 increased
IL-12 decreased

24

Problems with immune regulation in SLE?

Phagocytes defective in clearing immune complexes
T-cell CD8 suppressor cells deficient in function

25

What happens to lymphocytes in patients with SLE?

Apoptosis

26

Increased apoptosis in SLE can lead to what?

Leakage on intracellular antigens which triggers further autoimmune response

27

Where does tissue damage in blood vessels and kidneys come from?

Deposition of antigen-antibody complexes

28

Antibodies to phospholipids is known as what?

Lupus anticoagulent

29

Lupus anticoagulent is associated with what?

Prolonged PTT
Venous/arterial thrombosis
Fetal distress
Thrombocytopenia
Livedo reticularis

30

Most common systemic symptom of SLE?

Fatigue (Too nonspecific)

31

How does arthralgia present in SLE?

Symmetric, mimics RA
Not as erosive as RA
WBC

32

SLE patients have what reaction to sun?

Rashes or activation of systemic disease
Butterfly rash

33

Erythematous maculopapular eruption is what?

SLE pruritic eruption that can occur after sun exposure

34

What is Discoid lupus?

Sharply defined papule and plaques that become atrophic in the center while edges remain edematous and erythematous. Scars

35

Difference between subacute cutaneous lupus and discoid lupus?

Looks like discoid but no scarring

36

Where are oral ulcers commonly found in SLE?

Hard and soft palate

37

How common is alopecia in SLE?

Greater than 50%, can be patchy

38

Cardiac problems due to SLE?

Libman-Sacks (Valve replacement due to bacteria)
Resting tachycardia, abnormal EKG
Coronary artery disease due to immune complex
Conduction deficits

39

What is a big clue for SLE diagnosis?

Leukopenia

40

How will erythrocyte sedimentation rate present in SLE?

Elevated

41

Four pathologic types of Kidney damage in SLE?

1) Mesangial glomerulonephritis
2) Focal proliferative nephritis
3) Diffuse proliferative glomerulonephritis
4) Membranous glomerulonephritis

42

How does Cerebrospinal fluid look in SLE?

Usually normal

43

Abnormal EEG common or uncommon in SLE?

Common 80%

44

What is Raynaud's phenomenon?

3 color change of fingers on exposure to cold. White-> blue -> red

45

Lupus anticoagulant is associated with what?

Frequent miscarriages

46

Bone most frequently damaged by avascular necrosis

Hip

47

Most important lab diagnostic?

ANA

48

Key to SLE treatment?

Patient education

49

Mild SLE treated with?

Antimalarial hydroxychloroquin

50

Major organ disease from SLE treated with?

Corticosteroids and cytotoxic agents

51

Greatest cause of death in SLE patients?

Infection