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Flashcards in SLE and CTD Deck (25):
1

Where can SE affect?

Any part of the body

2

Briefly, what occurs in SLE?

Immune syste attacks body resulting in inflam and tissue damage. Antibody-immune complexes precipitate and cause further immune response, Immune complexes get stuck in and damage the basement membrane of blood vessels.

3

What aspects of genetic, enviromental and hormonal affect the pathogenesis of SLE?

Females > males
urban > rural
Increased incidence in asains, hispanics, afro-carribeans and afro-americans
silica dust
UV light
EBV
oestrogen exposure

4

What are the cardinal features of SLE?

Fever
lethargy
weight loss
poor appetite
malaise

5

What mucocutaneous features are often present in SLE?

Photosensitivity
malar rash with sparing of nasolabial fold
mouth ulcers
alopecia areata
Raynauds

6

How can SLE present in the cardiovascular system?

Pleurisy
Infections
Pulmonary HTN
Pulmonary infarct
diffuse lung infiltration and fibrosis

7

Why do patients with SLE require frequent urinalysis?

Renal disease from SLE presens with few symptoms very late on once the patient is in severe renal failure so do not want to miss this

8

What haematological features can be present in SLE?

Lymphadenopathy
leucopenia
anaemia
thrombocytopenia

9

How do you differentiate severe SLE from mild SLE?

Mild - skin rash, fatigue, mouth ulcers
Moderate - Sinusitis, joint swelling
Severe - Renal or neurological impairment

10

What investigations are required for SLE?

FBC
urinalysis
ENA
complement levels
ANA
Anti-dsDNA

11

How useful are meauring autoantibodies in SLE?

Anti-nuclear antibody - gateway to CTD but not specific to SLE
Anti-dsDNA - highly specific to SLE and levels psitivelly correlate with disease activity

12

In anti-phospholipid syndrome, what autoantibodies are positive?

Anti-cardiolipin (also + in 30% SLE and 5% of healthy population)
lupus anticoagulant activity

13

What does anti-phospholipid syndrome cause?

Arterial/ venous thrombosis
Responsible for 15% of recurrent foetal loss
Responsible for 20% recurrent thrombosis in YP

14

Does anti-phospholipid syndrome affect men more than women?

No

15

What are other features of anti-phospholipid syndrome?

Superficial thrombophlebitis
mild/ moderate thrombocytopaenia
migrane
Libman Sachs endocarditis

16

What treatment is required for anti-phospholipid syndrome?

Life-long anticoagulation
aspirin and heparin during pregnancy
attention to vascular risk factors

17

Describe Sjogrens syndrome.

Lymphocyte infiltration of exocrine glands causing xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes)

18

Which auto-antibodies can be positive in Sjogren's syndrome?

anti-Ro
anti-La

19

Is Sjogren's syndrome more common in men or women?

Women

20

What treatment can be given for Sjogren's syndrome?

eye drope
punctal plugs
saliva replacement
Pilocarpine (cholinergic agonist)
HCQ
Steroids and immunosuppression
Attend to CV risk factors and dental hygiene

21

What auto-antibodies can be positive in systemic sclerosis?

anti-centromere antibodies
anti-Scl-70 antibodies

22

How is systemic sclerosis classified?

Limited or diffuse

23

What organs can systemic sclerosis involve?

skin
kidneys
gut
muscle
joints
heart

24

What are the management options available for systemic sclerosis?

CaCB
ACE inhibitor (HTN)
Prednisolone (acute)
Immunosuppression (inflammation)
Prostacyclin (Iloprost)
Bosentan, Sildenafil (pumonary HTN)

25

What auto-antibody is present in mixed connective tissue disease?

Anti-RNP