4: SLE

Question 0

11C- Malar rash

Answer 0

Fixed erythema, flat or raised over the cheeks

Question 1

Genetic factors

Answer 1

• HLA

- Compliment deficiencies (C1q)

Question 2

11C- Discoid rash

Answer 2

Erythematous raised patches of skin asso w/ scaling and plugging of the hair follicles

Question 3

11C- Photosensitivity

Answer 3

Rash after exposure to UV light

Question 4

11C- Mucosal ulcers

Answer 4

Small nasopharyngeal and oral sores that occurs in mucosal lining

Question 5

11C- Serositis

Answer 5

Pleuritis and pericarditis- documented by ECG or rub or pericardial effusion

Question 6

11C- Arthritis

Answer 6

Very common in lupus. Non erosive arthritis of 2 or > peripheral joints with tenderness, swelling or effusion

Question 7

11C- Renal disorders

Answer 7

Proteinuria>0.5g/dL or cellular casts

Question 8

11C- Neurological disorder

Answer 8

Seizures or psychosis

Question 9

11C- Hematological disorder

Answer 9

Hemolytic anemia, leukopenia, thrombocytopenia in absence of offending drugs

Question 10

11C- Immunologic disorder

Answer 10

Anti-dsDNA, anti-Smith, and/or antiphospholipid antibodies

Question 11

11C- Anti-nuclear antibody (ANA blood test)

Answer 11

An abnormal titer by immunofluorescence at any point of time in absence of drugs known to induce ANAs
-best screening test**

Question 12

11C- info

Answer 12

If 6 or more of these 11 features are present; 98% sensitivity, 95% specificity

Question 13

Lab tests

Answer 13

CBC
BUN, Creatinine, Electrolytes
Liver function tests
ESR- increased

Question 14

rx

Answer 14

• Avoid UV exposure
• symptomatic
• NSAIDs
• Corticosteroids
• Anti-malarials (Hydroxychloroquine)
• Immuno-supressants
• Rituximab

Question 15

Neonatal lupus

Answer 15

Rash appearing 1-2 weeks post partum

- spontaneuously resolve in 6 month except for Congenital Heart Block sx