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Flashcards in Week 4 Deck (136)
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1

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

2

What is the cause of systemic lupus erythematosus?

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

3

____ is an environmental risk factor for lupus

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

4

____ 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

5

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

6

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

- Kidneys
- Skin
- Joint
- Heart

7

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

The initiation of local inflammatory reactions

8

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

9

What is a type 3 hypersensitivity reaction?

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

10

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

11

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

12

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

13

What is the classic presentation of lupus?

- Fever
- Joint pain
- Rash

**In a woman of childbearing age**

14

Why is the diagnosis of lupus difficult?

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

15

What are the general symptoms of lupus?

- Fever
- Weight loss

16

What are the specific symptoms of lupus based on?

It is based on the organ/tissue being affected

17

When is a diagnosis of lupus given to a person?

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

18

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

19

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

20

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

21

What are the types of anti-phospholipids?

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

22

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

23

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

Lifelong anticoagulant therapy

24

What is lupus characterized by?

Periods of flare ups and remittance

25

What is the treatment of lupus often aimed at?

Preventing flare ups or limiting their severity

26

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

Avoid sunlight

27

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

28

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

29

What is AIDS?

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

30

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

HIV-1