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IBI Test 2 Leesy > B3.020 - Lupus > Flashcards

B3.020 - Lupus Flashcards

1
Q

What joints does RA spare

A

DIPs

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2
Q

What can lupus cause in the lymph nodes

A

inflammation

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3
Q

On an H&E stain what would indicate lupus

A

Mesangial proliferation

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4
Q

What is full house staining

A

Indirect immunofluorescence for IgG, IgA, IgM, C3, C1q, Kappa, and lambda

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5
Q

What is the most common presenting symptom for lupus

A

joint pain

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6
Q

What disease feature non destructive arthritis

A

Lupus

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7
Q

What is jaccouds arthropathy

A

Ligament laxity, looks like a deformity but can correct on exam

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8
Q

What can constitute serositis

A

Pleural effusion
Pericardial effusion
Pleurisy/pleuritic chest pain

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9
Q

What is something unique about oral ulcers associated with lupus

A

Can involve hard palate and typically not painful

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10
Q

What are the 3 types of rash associated with lupus

A

Butterfly
Subacute cutaneous lupus rash
Discoid lupus rash

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11
Q

Differentiate between the 3 types of rash

A
  1. butterfly is due to photosensitivity, appearing days after exposure
  2. Subacute cutaneous is ornate and not due to photosensitivity
  3. Discoid is scarring that doesnt heal fully
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12
Q

What are hematologic manifestations of lupus

A

Anemia
Thrombocytopenia
Leukopenia

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13
Q

What are the renal manifestations of lupus

A

Glomerulonephritis, aka lupus nephritis

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14
Q

What are symptoms of lupus nephritis

A

Hematuria, proteinuria, hypertension, edema

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15
Q

What type of hypersesitivity leads to lupus nephritis

A

3 - antibody/antigen complexes form in blood and deposit in tissues

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16
Q

What can be measured to loo for lupus nephritis and why

A

C3 and C4, because IgG containin immune complexes activate complement in tissues leading to damage

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17
Q

What are the cardiac manifestations of lupus nephritis

A

Pericarditis

Libman-sacks endocarditis (noninfectious vegetations)

18
Q

What neurologic clinical manifestations are there for lupus

A

Seizures

Psychosis

19
Q

What is Antinuclear antibody

A

Antibody with specificity to components of nucleus

20
Q

How do you test for antinuclear antibodies and what does it test for

A

ANA - indirect immunofluorescence

Reflects dilution

21
Q

What are limitations of ANA

A

False positives
Variability in results
quantitative value doesn’t have clinical significance

22
Q

What is a positive of ANA diagnostics for lupus

A

Its sensitive

23
Q

What are anti double stranded DNA antibodies

A

Specific to lupus, felt to be pathogenic, trend with disease activity

24
Q

What are specific antinuclear antibodies

A

Anti-Smith
Anti-RNP
Anti-SSA
Anti-SSB

25
Q

What are antiphospholipid Abs

A

Anti cardiolipin Ab IgM and IgG

Anti beta 2 glycoprotein 1 IgM and IgG

26
Q

Activation of which complement pathway is associated with Lupus flares and what Cs does it lead to a decline in

A

Classical - C1, C2, C3, C4

27
Q

Which Igs participate in the classical pathway

A

IgM and IgG

28
Q

What are Anti-Histone Antibodies associated with

A

Drug induced lupus

29
Q

What are common medications that can cause drug induced lupus

A

Hydralazine
Procainamide
Isoniazid
Minocycline

30
Q

How long before disease clinically do autoantibodies present

A

5 years

31
Q

What is the mnemonic for diagnosing lupus

A 
SOAP MD BRAIN
Serositis
Oral Ulcers
Arthritis
Photosensitivity
Malar rash
Discoid rash
Blood abnormalities
Renal abnormalities
Positive ANA
Immunologic abnormalities
Neurologic
32
Q

what age is lupus most commonly diagnosed

A

16-55

33
Q

What are the 3 general steps leading to lupus

A
  1. Inefficient clearance of apoptotic debris
  2. Breach of tolerance
  3. Immune complex deposition and complement activation
34
Q

What is the increase in mortality of lupus patients

A

3 fold

35
Q

What does Hydroxychloroquine do

A

Interferes with antigen processing as a result of peptide-MHC protein complexes

36
Q

What does Belimumab do

A

Blocks binding of soluble B Cell activating factor

37
Q

What does Azathioprine do

A

Inhibits purine synthesis leading to inhibition of DNA and RNA leading to reduced cellular proliferation

38
Q

What does Mycophenolate mofetil do

A

Inhibits inosine monophosphate dyhedrogenase which leads to reduced B and T cell proliferation

39
Q

What does cyclophosphamide do

A

Attaches to an alkyl group to DNA which leads to apoptosis

Classic chemo drug

40
Q

What are consequences of corticosteroids like prednisone

A 
Weight gain
Bone health
DM
Infection 
Mood
41
Q

What drugs are contraindicated for pregnancy

A

Cyclophosphamide

mycophenolate mofetil

IBI Test 2 Leesy (13 decks)

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