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IM > SLE > Flashcards

SLE Flashcards

1
Q

Best screening test for SLE

A

ANA - 98% prevalence

multiple nuclear

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2
Q

Correlates with disease activity, nephritis and vasculitis

A

Anti-dsDNA - 70% prevalence

double stranded

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3
Q

Specific for SLE

No definite clinical correlations

A

Anti-SM - 25% prevalence

protein complexed to 6 species of nuclear U1 RNA

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4
Q

Associated w/ Sicca syndrome, predisposes to subacute cutaneous lupus and neonatal lupus w/ congenital heart block

Associated w/ decreased risk for nephritis

A

Anti-Ro (SS-A) - 30% prevalence

protein complexed to hY RNA (60 kDA and 52kDA)

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5
Q

Usually associated w/ anti-Ro

Associated w/ decreased risk for nephritis

A

Anti-La (SS-B) -10% prevalence

47 kDA protein complexed to hY RNA

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6
Q

More frequent in DRUG INDUCED lupus

A

Antihistone - 70% prevalence

histones associated w/ DNA (in nucleosome, chromatin)

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7
Q

Predisposes to clotting, fetal loss, thrombocytopenia

ELISA - cardiolipin and B2G1
sensitive prothrombin time (DRVVT) - for lupus anticoagulant

A

Antiphospholipid - 50% prevalence

phospholipids, B2 glycoprotein cofactor, prothrombin

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8
Q

Measured as direct Coombs test

A

Antierythrocyte - 60% prevalence

erythrocyte membrane

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9
Q

Associated w/ THROMBOCYTOPENIA

NOT a useful clinical test

A

antiplatelet

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10
Q

Positive test in CSF correlates w/ active CNS lupus

A

Antineuronal - 60% prevalence

neuronal and lymphocyte surface antigens

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11
Q

Positive test in serum correlates w/ DEPRESSION or PSYCHOSIS d.t. CNS lupus

A

Antiribosomal P - 20% prevalence

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12
Q

22 y/o woman presents w/ fatigue, malaise and fever of 10 days duration, swelling hands and ankles

chest pain during inspiration
raised erythema on the cheeks, hand and ankle joints swelling and tenderness

A

systemic lupus erythematosus (SLE)

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13
Q

Mainstay treatment for life threatening SLE

A

systemic glucocorticoid

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14
Q

CLASS I: Minimal Mesangial LN

A

LM: normal glomeruli
IF: mesangial immune deposits

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15
Q

CLASS II: Mesangial Proliferative LN

A

LM: purely mesangial hypercellularity or mesangial matrix expansion
IF/EM: few isolated subepithelial/subendothelial deposits

start HIGH DOSE STEROIDS

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16
Q

CLASS III: Focal LN

A

GN involving <50% of glomeruli

start CYCLOPHOSPHAMIDE

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17
Q

CLASS IV: Diffuse LN

A

GN involving >50% of glomeruli

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18
Q

CLASS V: Membranous LN

A

global/segmental subepithelial immune deposits

19
Q

CLASS VI: Advanced Sclerotic LN

A

> 90% of glomeruli globally sclerosed w/o residual activity

20
Q

Treatment for non life threatening disease

A

analgesic and antimalarials

21
Q

Treatment for arthritis/arthralgia

A

NSAIDs

22
Q

Treatment for dermatitis, arthritis and fatigue

A

antimalarials - hydroxychloroquine, chloroquine, quinacrine

23
Q

Treatment for lupus dermatitis

A

antimalarials, topical sunscreen, topical steroid and/or tacrolimus

24
Q

Mainstay treatment for life threatening disease

A

systemic glucocorticoids

25
Q

Treatment for lupus nephritis

A

high dose IV glucocorticoid pulse

26
Q

Treatment for severe thrombocytopenia

A

high dose IV glucocorticoid pulse

27
Q

Treatment for disease relapse

A

cyclophosphamide, azathioprine, mycophenolate mofetil

28
Q

More common w/ MYCOPHENOLATE MOFETIL

A

diarrhea

29
Q

More common w/ CYCLOPHOSPHAMIDE

A

nausea

30
Q

Management of SLE in PREGNANCY

A

hydroxychloroquine

prednisone/prednisolone (LOWEST DOSE)

31
Q

Most serious of manifestation of SLE

A

lupus nephritis

32
Q

Leading causes of mortality on the 1st decade

A

infection and nephritis

33
Q

MC acute rash of SLE

A

butterfly rash

  • photosensitive
  • raised, erythema
  • scaly
  • on nose, cheeks, ears, chin, V region of neck and chest, upper back and extensor surface of arms
34
Q

Most have INTERMITTENT POLYARTHRITIS

Most commonly found in

A

hands, wrists, knees

35
Q

MC chronic dermatitis in lupus

A

discoid lupus erythematosus (DLE)

  • circular lesions
  • slightly raised
  • scaly hyperpigmented erythematous rims and depigmented
  • atrophic centers
36
Q

MC manifestation of diffuse CNS lupus

A

cognitive dysfunction

37
Q

MC pulmonary manifestation

A

pleuritis w/ or w/o pleural effusion

38
Q

MC cardiac manifestation

A

pericarditis

39
Q

Most serious cardiac manifestation

A

myocarditis, Liebman-sacks endocarditis

40
Q

Endocardial involvement –> valvular insufficiencies

A

MITRAL or AORTIC valves

41
Q

MC hematologic manifestations

A

ANEMIA (normochromic, normocytic)

42
Q

MC musculoskeletal manifestation

A

arthralgia/myalgia

43
Q

MC cutaneous manifestation

A

photosensitivity

44
Q

Worst prognosis

A

Crescentic Lupus Nephritis

IM (66 decks)

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