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Flashcards in Week 4 Deck (136)
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What is systemic lupus erythematosus?

An autoimmune disease that can affect any tissue or organ in the body, but most often affects the skin, kidneys, and joints


What is the cause of systemic lupus erythematosus?

It is unknown, but it occurs as a result of genetics and the environment


____ is an environmental risk factor for lupus

*UV radiation/sunlight* is an environmental risk factor for lupus


____ are present in in the body in almost all cases of lupus

*Antinuclear antibodies* are present in the body in almost all cases of lupus


Antigens and antibodies bind to another in the body in a case of lupus to create an antigen-antibody complex. After binding together, what do they do?

They get into the blood, drift away, and deposit/stick to the vessel wall in all organs and tissues


What are the organs and tissues that antigen-antibody complexes stick to their vessel walls?

- Kidneys
- Skin
- Joint
- Heart


Antigen-antibody complexes that deposit/stick to the vessel walls of organs and tissues lead to what?

The initiation of local inflammatory reactions


What chain of events is caused by the initiation of local inflammatory reactions, as caused by the antigen-antibody complexes that deposit/stick to the vessel walls of organs and tissues?

The initiation of local inflammatory reactions causes damage to the activation of the complement system, which after a huge cascade of enzyme activation, leave cell membrane with channels that let food and molecules pass through with no problems, causing the cell to burst and die


What is a type 3 hypersensitivity reaction?

When there is tissue damage that occurs as a result of immune complexes


What are the other potential triggers that has been associated with lupus?

- Cigarette smoking
- Viruses
- Bacteria
- Use of certain medications, like procainamide, hydralazine, and isoniazid
- Sex hormones, particularly estrogen


True or False

Lupus is more common in women

True, lupus is more common in women due to estrogen being a trigger. Hence why it is more common in women during reproductive years, than it is during non reproductive years


What is a type 2 hypersensitivity reaction?

When antibodies target red and white blood cells, and molecules like phospholipids, which can mark them for phagocytosis and destruction, which leads to additional symptoms of lupus


What is the classic presentation of lupus?

- Fever
- Joint pain
- Rash

**In a woman of childbearing age**


Why is the diagnosis of lupus difficult?

It can affect a wide variety of people and has a wide variety of symptoms


What are the general symptoms of lupus?

- Fever
- Weight loss


What are the specific symptoms of lupus based on?

It is based on the organ/tissue being affected


When is a diagnosis of lupus given to a person?

Only when 4 or more of the 11 diagnostic criteria is met


What are the diagnostic criteria for lupus?

1. Malar rash: a rash on the cheek that spares the nasal, labial folds. Also called a butterfly rash
2. Discoid rash: plaque like, chronic rash found in sun exposed areas that can form a sort of patchy redness and scar
3. General skin photosensitivity: other rashes from sun exposed areas that typically last a couple of days
4. Ulcers in the mucous(inner) membranes of the mouth, and nose
5. Serositis which is the inflammation of the outer membrane of a cell and can lead to: pleuritis which is inflammation of the lining around the lungs or chest cavity. Or pericarditis: inflammation of the lining of the heart
6. Arthritis of 2 or more joints
7. Renal disorders like: abnormal amounts of urine protein, diffuse proliferative glomerulonephritis(inflammation of the glomeruli)
8. Neurological disorders like seizures and psychosis
9. Hematologic disorders: Anemia if RBCs are affected, thrombocytopenia if platelets are affected, leukopenia if WBCs(immune cells) are affected
10. Presence of antinuclear antibodies(very sensitive, but not specific, bcos it is seen in other diseases)
11. Other autoantibodies like, anti-smith which targets ribonucleoproteins, anti-dsDNA which targets double stranded DNA and is often seen during periods of active disease, and anti-phospholipid which targets protein that are bound to phospholipids


What other parts of the heart can lupus affect?

- Endocardium: which presents as libman-sacks endocarditis, where vegetations(made up of fibrin and immune cells) form on the mitral valve
- Myocardium


What are the types of other autoantibodies that are specific to lupus?

- Anti-smith which targets ribonucleoproteins
- Anti-dsDNA which targets double stranded DNA and is often seen during periods of active disease


What are the types of anti-phospholipids?

- Anticardiolipin: can cause a false positive for syphilis
- Lupus anticoagulant
- Anti beta2 glycoprotein 1


What is anti-phospholipid syndrome?

Where anti-phospholipid antibodies cause a hyper-coagulable state, meaning that they are more prone to developing clots and complications like DVTs, hepatic vein thrombosis, and a stroke


What do patients with anti-phospholipid syndrome end up needing?

Lifelong anticoagulant therapy


What is lupus characterized by?

Periods of flare ups and remittance


What is the treatment of lupus often aimed at?

Preventing flare ups or limiting their severity


What are some ways that may help prevent lupus flare ups?

Avoid sunlight


What are some ways that may help limit the severity of lupus flare ups?

- The use of corticosteroids to help limit immune responses
- The use of immunosuppressants when flare ups are really severe


What is HIV?

A type of virus that infects human immune cells. Over time, immune cells are lost, which weakens the immune system and allows patients to be infected by other viruses and develop several types of tumors


What is AIDS?

Acquired immuno-deficiency syndrome, which are the viruses and tumors that is acquired after the immune system weakness has been developed


What type of HIV is more commonly associated with AIDS in the US and worldwide?