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724: Medical Lectures > Systemic Lupus Erythematous > Flashcards

Systemic Lupus Erythematous Flashcards

(48 cards)

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1
Q

What can be defined as an inflammatory autoimmune disorder characterized by autoantibodies to nuclear atigens?

A

Systemic lupus erythematous

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2
Q

What are many of SLE symptoms secondary to what 2 things?

A
  • trapping of antigen-antibody complexes in capillaries of visceral structures
  • autoantibody-mediated destruction of host cells
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3
Q

What is the clinical course of SLE marked by?

A

spontaneous remission and relapses

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4
Q

What 3 factors influence the incidence of SLE?

A
  • gender
  • race
  • genetic inheritance
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5
Q

About __% of SLE patients are women and __% are men

A

85

15

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6
Q

When do the majority of cases begin in women?

A

After menarche and before menopause

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7
Q

SLE occurs in 1:____ white women and 1:_____ black women

A

1: 1000
1: 250
* More common in black women

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8
Q

If one identical twin has SLE there is a __-__% chance the other twin will as well

A

25-70

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9
Q

If a mother has SLE what are her daughter’s risks of developing the disease? What are her son’s?

A

1 in 40

1 in 250

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10
Q

What disorders are seen in asymptomatic relatives of those with SLE?

A

Rheumatic diseases (aggregation of serologic abnormalities)

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11
Q

Before making a diagnosis of SLE it is imperative to ascertain the symptoms are not secondary to what?

A

drug induced

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12
Q

What 3 drugs are considered to induce this type of lupus?

A
  • procainamide
  • hydralazine
  • isoniazid
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13
Q

What are the 4 features that separate drug-induced lupus from SLE?

A

1) the sex ratio is nearly equal
2) nephritis and CNS symptoms typically aren’t present
3) hypocomplementemia and antibodies to double-stranded DNA are absent
4) the clinical features and lab abnormalities usually revert to normal after the drug is withdrawn

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14
Q

When should the diagnosis of SLE be suspected?

A

In patients having a multisystem disease with a positive test for antinuclear antibodies

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15
Q

What are 8 differential diagnoses for SLE?

A
  • Rheumatoid arthritis
  • Systemic vasculitis
  • Scleroderma
  • Inflammatory myopathies
  • Viral hepatitis
  • Sarcoidosis
  • Acute drug reactions
  • Drug-induced lupus
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16
Q

The diagnosis of SLE can be made with reasonable probability if _ or the following 11 criteria are found.

  • Malar rash
  • Discoid rash
  • Photosensitivity
  • Oral ulcers
  • Arthritis
  • Serositis
  • Kidney disease
  • Neurologic disease
  • Hematologic disease
  • Immunologic abnormalitis
  • Positive ANA in serum
A

4

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17
Q

What are the systemic features of SLE?

A
  • Fever
  • Anorexia
  • Malaise (generalized feeling of discomfort)
  • Weight loss
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18
Q

What are the cutaneous manifestations of SLE?

A
  • Malar (butterfly) rash
  • Panniculitis: (inflammation of subcutaneous fat)
  • Discoid lupus
  • Fingertip lesions
  • Periungual erythema
  • Nail fold infarcts
  • Splinter hemorrhages
  • Alopecia (hair loss)
  • Raynaud phenomenon
  • Mucous membrane lesions
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19
Q

Raynaud phenomenon is present in __% of patient’s with SLE

A

20

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20
Q

When do mucous membrane lesions tend to occur?

Study These Flashcards
A

during periods of exacerbation

21
Q

Joint symptoms occur in over __% of patients and are often the _____ manifestation

22
Q

Arthritis associated with SLE leads to what?

Study These Flashcards
A

reversible swan-neck deformity

23
Q

What are the ocular manifestations of SLE?

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A
  • Conjunctivitis (pink eye)
  • Photophobia
  • Transient or permanent monocular blindness
  • Blurred vision
24
Q

What do cotton-wool spots on the retina represent?

Study These Flashcards
A

Degeneration of nerve fibers due to occlusion of retinal blood vessels

25
What are the pulmonary manifestations of SLE?
- Pleurisy - Pleural effusion - Bronchiopneumonia - Pneumonitis - Interstitial lung disease (rare) - Restrictive lung disease - Alveolar hemorrhage (rare)
26
What layer covering the heart is affected in the majority of patients?
pericardium
27
Heart failure associated with SLE may result from what?
- myocarditis | - hypertension
28
What are the neurological complications of SLE?
- Psychosis (delusions and hallucinations are very common) - Cognitive impairments - Seizures - Peripheral and cranial neuropathies - Transverse myelitis - Stroke
29
What 5 things can lead to SLE flare-ups?
- Stress (most common cause) - Exposure to the sun - Infections - Surgery - Pregnancy
30
Antinuclear antibody (ANA) tests are positive in virtually all SLE patients, but are also positive in what 4 nonlupus conditions?
- RA - autoimmune thyroid disease - sclerodoma - Sjögren's Syndrome
31
What are the 2 ways in which ANA is tested?
- Immunofluorescence (IFR) | - Enzyme Immunoassay
32
The IFR test is considered positive for lupus if the blood sample to diluting sample is ____ than 1:40
greater
33
What are the 3 types of antiphospholipid antibodies?
- Syphilis False Positive - Lupus Anticoagulant - Anti-Cardiolipin
34
Ultimately SLE lab studies should include data from what 3 parameters?
- renal - hematological - immunological
35
All SLE patients should wear SPF__ or greater when going outside
55
36
What do skin lesions associated with SLE often respond to?
local corticosteroid use
37
What are minor joint symptoms usually treated with?
rest and NSAIDs
38
What specific drug assists with treating the rashes, joint symptoms, and severity of symptoms?
Hydroxychloroquine (an anti-malarial drug)
39
What complex symptoms usually require systemic corticosteroids (prednisone)?
- glomerulonephritis - hemolytic anemia - pericarditis / myocarditis - alveolar hemorrhage - CNS involvement - thrombotic thrombocytopenic purpura
40
When are immunosuppressants used?
when the SLE is resistant to corticosteroid treatment
41
What is the treatment of choice for pateints with the antiphospholipid syndrome?
anticoagulants (Warfarin)
42
The 5 year survival rate is __% | The 10 year survival rate is __%
90 85
43
True or False SLE follows a relapsing and remitting course.
True
44
What are the leading cause of death in the early years? | What are the leading cause of death in the later years?
infections accelerated atherosclerosis
45
Patients with SLE have an incidence rate _ times higher than normal people for a myocardial infarction.
5
46
True or False SLE patients have a higher risk of developing malignancy.
True
47
Appropriate diagnosis and management of SLE requires the active participation of what HCP?
A rheumatologist
48
When should you admit a person with suspected lupus?
When they show signs of: - Rapidly progressive glomerulonephritis - Pulmonary hemorrhage - Transverse myelitis - Severe infection - Other severe manifestations

724: Medical Lectures (42 decks)

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