Antiphospholipid Syndrome

Question 1

APL syndrome is the presence of ? that have a specificity for ?, leading to a ? tendency.
This can be a primary syndrome, or occur secondarily to ???.

Answer 1

autoantibodies
phospholipids
thrombotic
SLE

Question 2

Features;

? thrombosis: most commonly in the ?/legs, leading to a risk of ?.
Arterial ?: ? common than venous thrombosis.
o ?% of strokes in those under 45 are due to APL syndrome.

Answer 2

vv
arms
PE
thrombosis
less
20

Question 3

Features:

? loss: particularly in the second/ third ?.
Livedo ?: classical ‘?-like’ rash.
There may also be a ?-penia, ?, and ?.

Answer 3

pregnancy
trimester
reticularis
lace
thrombocyto
migraines
epilepsy

Question 4

Investigations;
ESR: usually ?,
ANA: usually ?.
????: increased.
? test: positive.

Answer 4

normal
negative
APTT
coombs

Question 5

Investigations;
? antibodies: diagnostic.
o High titres required on ?occasions, at least ? weeks apart.
? anticoagulant antibodies: present in 20%.
o Represent an increased risk of ?.

Answer 5

anticardiolipin
two
12
lupus
thrombosis

Question 6

Treatment;
Those with a history of ? thrombosis;
o Warfarin: target INR ?-? to stop ? thrombosis

? and ? are given in pregnancy, and an ? delivery is often planned for under specialist care.

Answer 6

severe
3-4
arterial
lmwh
aspirin
early

Question 7

Those without a thrombotic history;
o ? (? dose).
o Lifestyle advice to avoid prolonged ?, and ?containing drugs.

Answer 7

aspirin
low
immobilization
oestrogen

Question 8

Long-term prognosis is ?, with 1/3rd having ? damage within ? years of
diagnosis.

Answer 8

poor
organ
10