Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IM IMMUNO/RHEUMA > SLE > Flashcards

SLE Flashcards

1
Q
  • an autoimmune disease in which organs and cells undergo damage initially
    mediated by tissue-binding autoantibodies and immune complexes
  • Ninety percent of patients are women of child-bearing years
  • highest prevalence is in African-American and Afro-Caribbean women, and lowest prevalence is in white men
A

SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  • Inducing activation of innate immunity
A

Autoimmunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

is a genetic “signature” in peripheral blood cells 4 of 50-80% of SLE patients

A

Upregulation of genes induced by IFNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

-present antigen and secrete IL6 and IL10, further promoting autoreactive cell survival
- favored by estrogen

A

B cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

reduced capacity to clear immune complexes, apoptotic cells, and their DNA/RNA/ Ro/La and phospholipid containing surface blebs

A

Lupus phagocytic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

destruction mediated by complement activation and release of
cytokines/chemokines

A

Deposition of autoantibodies and/or immune complexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PREDISPOSING FACTORS

GENES

A
  • High Hazard Ratios (268);
    + Deficiencies of C1q, C2,C4 (rare)
    + TREX1 mutations affecting DNA
    degradation (rare)
  • Affecting Ag presentation or persistence,
    e.g., phagocytosis of immune complexes
    + HLA-DRB1 (*1501,°0301), ORS, DQOA2
    + CR2, FCGR2A/8
  • Enhance Innate Immunity, including production of IFNs
    + TNFEFAIPS, IRFS/TNPOS, IRF7/PHRF1, ITGAM, ICAMs
  • Alter Adaptive Immunity B and/or T Cell Signaling
    + BANK1, STAT4, MSHS, IZKF3, TCF7
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PREDISPOSING FACTORS
GENES FOR LUPUS NEPHRITIS

A
  • HLA-DRS,
  • STAT4,
  • APOL1 (African Americans),
  • FCGRBA,
  • ITGAM,
  • IRFS,
  • IRF7,
  • TNFSF4 (Ox40L),
  • DNAse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

PREDISPOSING FACTORS
ENVIRONMENT/ MICROENVIRONMENT

A
  • Ultraviolet Light,
  • Smoking.
  • Crystalline Silica,
  • EBV infection
  • Femaleness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PREDISPOSING FACTORS
EPIGENETICS

A
  • Hypomethylation of DONA: In CD4+T, B and monocytes
  • Some affect IFN production
  • Histone modifications: Some increase expression of predisposing genes and/or IFN production
  • MicroRNaA affecting gene expression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

is permissive for SLE

A

Female sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Women exposed to ___ have an increased risk of developing SLE

A

estrogen-containing oral contraceptives or hormone replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

binds to receptors on T and B lymphocytes, increasing activation and survival of those cells, especially autoreactive subsets, thus favoring prolonged immune responses

A

Estradiol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Genes on the X chromosome that influence SLE, such as ___, may play a role in gender predisposition

A

TREX-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Most SLE patients have autoantibodies for ___ before the first symptoms of disease, suggesting that regulation controls the degree of
autoimmunity for years before quantities and qualities of autoantibodies, pathogenic B and T cells, and activated tissue-fixed cells such as macrophages cause clinical disease

A

3 years or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Exposure to ___causes flares of SLE in ~70% of patients

A

ultraviolet light

17
Q

may be one infectious
agent that can trigger SLE in susceptible
individuals

A

Epstein Bar Virus (EBV)

18
Q

increases risk
for SLE

A
  • Current tobacco smoking
  • Prolonged occupational exposure to crystalline silica
19
Q

reduces the risk of SLE

A

Drinking alcohol (2 glasses of wine a week or 1/2 of an alcoholic drink daily)

20
Q

Any combination of____ in the clinical and one in
the immunologic category, well documented at any time during an individual’s history, makes it likely that the patient has SLE

A

four or more criteria,
with at least one

21
Q

___ of patients have either continuing active disease (on current treatment) or one or more flares of active disease annually

A

85%

22
Q

are present most of the time

A

fatigue, myalgias/arthalgia

23
Q

varying from mild to _ disabling, characterized by soft tissue swelling and tenderness in joints and/or tendons, most commonly in hands, wrists, and knees

A

intermittent polyarthritis

24
Q

rheumatoid-like arthritis with erosions and fulfill criteria for both RA and SLE

A

Rhupus

25
Q

the most common reason that px increase their dose of glucocorticoids

A

Joint pain

26
Q
  • If pain persists in a single joint, such as knee, shoulder, or hip, a diagnosis of ___ should be considered
  • prevalence is increased in SLE, especially in patients treated with systemic glucocorticoids
A

ischemic necrosis of bone (INB)

27
Q

with clinical muscle weakness, elevated creatine kinase levels, positive magnetic resonance imaging (MRI) scan, and muscle necrosis and inflammation on biopsy can occur

A

Myositis

28
Q
  • common therapies
  • rare therapies used for SLE
A
  • Glucocorticoid therapies
  • antimalarial
29
Q
  • most common chronic dermatitis in lupus
  • roughly circular with slightly raised, scaly
    hyperpigmented erythematous rims and
    depigmented, atrophic centers in which all dermal appendages are permanently destroyed
A

Discoid Lupus Erythematous (DLE)

30
Q
  • most common
    rash
  • acute SLE rash
  • photosensitive, slightly raised erythema, occasionally scaly, on the face (particularly the cheeks and nose), ears ,chin, V region of the neck and chest, upper back, and extensor surfaces of the arms
  • Worsening of this rash often accompanies flare of systemic disease
A

Butterfly-rash

31
Q

consists of scaly red
patches similar to psoriasis, or circular flat redrimmed lesion

A

Subacute cutaneous lupus erythematosus (SCLE)

32
Q

Other SLE rashes include:

A
  • recurring urticaria
  • lichen planus-like dermatitis
  • bullae,
  • panniculitis (“lupus profundus”)
33
Q
  • most serious manifestation of SLE, particularly since this and infection are the leading causes of mortality in the first decade of disease
  • urinalysis should be ordered in any person suspected of having SLE
  • is asymptomatic in most lupus patients
  • renal biopsy is recommended with clinical evidence of this in SLE px
A

Nephritis

34
Q

Classification of Lupus Nephritis (International Society of Nephrology and Renal Pathology Society)

Normal glomeruli by light microscopy, but mesangial immune deposits by immunofluorescence.

A

Class I: Minimal Mesangial Lupus Nephritis

35
Q

Classification of Lupus Nephritis (International Society of Nephrology and Renal Pathology Society)

Purely mesangial hypercellularity of any degree or mesangial matrix expansion by light microscopy, with mesangial immune deposits. A few isolated subepithelial or subendothelial deposits may be visible by immunofluorescence or electron microscopy, but not by light microscopy

A

Class Il: Mesangial Proliferative Lupus Nephritis

36
Q

Classification of Lupus Nephritis (International Society of Nephrology and Renal Pathology Society)

  • Active or inactive focal, segmental or global endo- or extracapillary glomerulonephritis involving <50% of all glomeruli, typically with focal subendothelial immune deposits, with orwithout mesangial alterations.
  • Class Ill (A): Active lesions - focal proliferative lupus nephritis
  • Class Ill (A/C): Active and chronic lesions - focal proliferative and sclerosing lupus nephritis
  • Class III (C): Chronic inactive lesions with glomerular scars - focal sclerosing lupus nephiritis
A

Class Ill: Focal Lupus Nephritis

37
Q

Classification of Lupus Nephritis (International Society of Nephrology and Renal Pathology Society)

  • Active or inactive diffuse, segmental or global endo- or
    extracapillary glomerulonephritis involving 50% of all glomeruli, typically with diffuse subendothelial immune deposits, with or without mesangial alterations.
  • This class includes cases with diffuse wire loop deposits but with little or no glomerular proliferation.
A

Class IV: Diffuse Lupus Nephritis

38
Q

Classification of Lupus Nephritis (International Society of Nephrology and Renal Pathology Society)

  • Global or segmental subepithelial immune deposits or their morphologic sequelae by light microscopy and by immunofluorescence or electron microscopy, with or without mesangial alterations. - may occur in combination with class Ill or IV, in which case both will be diagnosed.
  • may show advanced sclerosis
A

Class V: Membranous Lupus Nephritis

39
Q

Classification of Lupus Nephritis (International Society of Nephrology and Renal Pathology Society)

> 90% of glomeruli globally sclerosed without residual activity

A

Class VI: Advanced Sclerotic Lupus Nephritis

IM IMMUNO/RHEUMA (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions