Connective Tissue Disease 1 - SLE

Question 1

where can SLE affect?

Answer 1

any part of the body

Question 2

in whom is SLE more common?

Answer 2

females
9:1
asians, afro Americans and carribeans
uncommon in African blacks

Question 3

what does the nuclear material released from necrotic cells act as?

Answer 3

auto-antibodies

Question 4

outline some clinical criteria of SLE

Answer 4

cutaneous manifestations
oral or nasal ulcers
alopecia
arthritis
renal
leukopenia

Question 5

outline some immunologic criteria of SLE

Answer 5

ANA
Anti-DNA
Anti-Sm

Question 6

name some mucocutaneous features seen in SLE

Answer 6

photosensitivity
malar rash
discoid lupus erythematosus
subacute cutaneous lupus
mouth ulcers
alopecia

Question 7

where is there sparing of in malar rash?

Answer 7

nasolabial folds

Question 8

name some musculoskeletal features seen in SLE

Answer 8

Non-deforming polyarthritis/polyarthralgia

Deforming arthropathy - Jaccoud’s arthritis

Myopathy - weakness, myalgia & myositis

Question 9

what is the difference on X-ray in someone with Jaccoud’s arthritis and someone with Rheumatoid arthritis

Answer 9

Jaccoud’s arthritis - x ray is normal

rheumatoid arthritis - x ray is not

Question 10

to check kidneys in SLE, what test should you perform? what are you looking for?

Answer 10

urinalysis

protein and/or blood

Question 11

whats the next step after urinalysis of kidney showing high protein or blood?

Answer 11

renal biopsy

Question 12

name some neurological features seen in SLE

Answer 12

Depression/psychosis

Migrainous headache

Seizures

Cranial or peripheral neuropathy

Mononeuritis multiplex

Question 13

name some haematological features seen in SLE

Answer 13

Lymphadenopathy

Leucopenia

Lymphopenia

Haemolytic anaemia

Thrombocytopenia

Question 14

what does anti-phospholipid syndrome cause?

Answer 14

blood clots

miscarriage

Question 15

are people with SLE more susceptible to infection?

Answer 15

yes

Question 16

what are the 2 reasons you should look at autoantibodies for?

Answer 16

To confirm/establish diagnosis

To determine degree of organ involvement

Question 17

name the important antibodies in SLE

Answer 17

ANA
Anti-dsDNA
Anti-Sm
Anti-Ro
Anti-RNP

Question 18

which antibody is associated with neonatal SLE?

Answer 18

Anti-Ro

Question 19

which autoantibody is most specific to SLE?

Answer 19

anti-double-stranded-DNA

Question 20

name the anti-phospholipid antibodies

Answer 20

Anti-cardiolipin antibody
Lupus anticoagulant
Anti-beta 2 glycoprotein

Must be positive on 2 occasions 12 weeks apart

Question 21

does CRP increase in SLE?

Answer 21

no

Question 22

what is the drug treatment in SLE?

Answer 22

NSAIDs and simple analgesia

anti-malarials - hydroxychloroquine

steroids

immunosuppressives

biologics

Question 23

as complement levels decrease in SLE, anti-DNA levels _______

Answer 23

increase

Question 24

name some immunosuppressives

Answer 24

azathioprine
Cyclophosphamide
Methotrexate
Mycophenolate mofetil

Question 25

name the treatments for the spectrum of SLE:

mild -
moderate -
severe -

Answer 25

mild - HCQ, NSAIDs
moderate - steroids, AZ, MTX
severe - IV steroids, Cyclophosphamide and biologics