Rheum

Question 1

SLE skin

Answer 1

subacute cutaneous
discoid lupus
alopecia
mouth ulcers
malar flush
photosensitivity
raynauds

Question 2

SLE renal

Answer 2

lupus nephritis

Question 3

lupus nephritis classes

Answer 3

class I: normal kidney
class II: mesangial glomerulonephritis
class III: focal (and segmental) proliferative glomerulonephritis
class IV: diffuse proliferative glomerulonephritis
class V: diffuse membranous glomerulonephritis
class VI: sclerosing glomerulonephritis

Question 4

most common class lupus nephritis

Answer 4

grade IV: diffuse proliferative glomerulonephritis

Question 5

grade IV: diffuse proliferative glomerulonephritis histology

Answer 5

endothelial and mesangial proliferation, ‘wire-loop’ appearance
thickened capillary wall
electron microscopy shows subendothelial immune complex deposits
granular appearance on immunofluorescence

Question 6

lupus nephritis management

Answer 6

treat hypertension
class III/IV lupus nephritis: steroids with either mycophenolate or cyclophosphamide
subsequent therapy: mycophenolate is generally preferred to azathioprine to decrease the risk of developing end-stage renal disease

Question 7

SLE mild OR skin and arthralgia treatment

Answer 7

NSAIDs
steroids
hydroxychloroquine

Question 8

SLE moderate OR arthritis, lung and cardio

Answer 8

azathioprine
methotrexate
mycofenate mofetil

Question 9

SLE severe OR CNS/renal involvement

Answer 9

IV steroids
cyclophosphamide
rituximab