Systemic lupus erythematosus

Question 1

classic clinical presentation of SLE

Answer 1

rash, joint pain and fever

Question 2

SLE is MC in (sex, age, origin)

Answer 2

female of reproductive age and African descent

Question 3

Lupus endocarditis - name

Answer 3

Lidman - Sacks endocarditis

Question 4

Lidman - Sacks endocarditis of lupus?

Answer 4

nonbacterial, wart-lile (verrucous) vegetations on both sides of valve (mitral) or aortic valve

Question 5

Lupus nephritis is a result of

Answer 5

type III hypersensitivity

Question 6

Lupus nephritis - MC

Answer 6

nephritic - diffuse proliferative glomerulonephritis
nephrotic - membranous glomerulonephritis
MC and severe type is diffuse proliferative

Question 7

Common causes of death in SLE

Answer 7

1. cardiovascular disease
2. Infection
3. Renal disease

Question 8

SLE symptoms/findings/treatment etc

Answer 8

mnemonic: RASH OR PAIN
Rash, Arthritis, Soft tissues/Serositis, Hematologic disorders, Oral and nasopharyngeal ulcers, Renal disease/Raynaud phenomenon, Photosensitivity, Antinuclear antibodies, Immunologic disorfer (anti-dsDNA, anti-SM, antiphospholipids), Neurologic disorders

Question 9

SLE - neurologic disorders - examples

Answer 9

seizures, psychosis

Question 10

SLE - hematologic disorders - example

Answer 10

pancytopenia

Question 11

SLE - heart

Answer 11

it can affect any layer of the heart (endo,myi,pericarditis)

Question 12

SLE - rash

Answer 12

malar or discoid

Question 13

SLE - treatment

Answer 13

1. NSAID 2. Steroids 3. immunosuppressants

4. hydroxychloroquine

Question 14

SLE - lab findings

Answer 14

1. antinuclear antibodies (ANA)
2. anti-dsDNA antibodies
3. anti-Smith antibodies
4. decreased C3, C4, CH50
5. Anti-histone antibodies

Question 15

SLE -decreased C3, C4, CH50 due to

Answer 15

immune complex formation

Question 16

SLE- sensitive, not specific test

Answer 16

ANA

Question 17

SLE - specific, poor prognosis test

Answer 17

anti-dsDNA (renal disease)

Question 18

SLE - specific, not prognostic test

Answer 18

anti-Smith

Question 19

SLE - sensitive for drug induced lupus

Answer 19

antihistone antibodies

Question 20

Anti-Smith antibodies - against ….

Answer 20

snRNPs

Question 21

antiphospholipid syndrome is a …. or …. disorder

Answer 21

1ry or 2ry autoimmune disorder

Question 22

antiphospholipid syndrome as a 2ry autoimmune disorder is MC in

Answer 22

SLE

Question 23

antiphospholipid syndrome - autoantibodies against

Answer 23

phospholipids

Question 24

diagnosis of antiphospholipid syndrome is based on

Answer 24

clinical criteria and lab findings

Question 25

clinical criteria of antiphospholipid syndrome

Answer 25

1. history of thrombosis (arterial or venous) | 2. recurrent spontaneous abortion

Question 26

antiphospholipid syndrome arterial or venous thrombosis includes

Answer 26

1. DVT 2. hepatic vein thrombosis 3. placental thrombosis

Question 27

antiphospholipid syndrome - lab findings

Answer 27

1. lupus anticoagulants 2. anticardiolipin 3. anti-β2 glycoprotein antibodies

Question 28

Lupus anticoagulant is an

Answer 28

immunoglobulin that binds to phospholipids and proteins associated with the cell membrane.

Question 29

antiphospholipid syndrome - lupus anticoagulants and anticardiolipin antibodies can cause .... (lab)

Answer 29

false positive VDRL/RPR | falsely elevated PTT

Question 30

antiphospholipid syndrome - treatment

Answer 30

systemic anticoagulation

Question 31

Drug induced lupus - drugs

Answer 31

1. Hydralazine 2. Procainamide 3. Isoniazid

Question 32

Lupus endocarditis - valves

Answer 32

1. mitral | 2. aortic

Question 33

Mixed connective tissue disease - clinical presentation

Answer 33

Feature of SLE, systemic sclerosis, and/or polyomyositis

Question 34

Mixed connective tissue disease - Labs

Answer 34

anti-U1 RNP antibodies (speckled ANA)

Question 35

SLE - lab findings (and their characteristics)

Answer 35

1. antinuclear antibodies (ANA) - sensitive, Not specific 2. anti-dsDNA antibodies - Specific, poor prognosis (renal disease) 3. anti-Smith antibodies - Specific, not prognostic (directed against snRNPs) 4. decreased C3, C4, CH50 - due to immune complex formation 5. Anti-histone antibodies - sensitive for drug-induced lupus)