Connective Tissue Disease 1 - SLE Flashcards

Dr S Silburn

1
Q

where can SLE affect?

A

any part of the body

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2
Q

in whom is SLE more common?

A

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

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3
Q

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

A

auto-antibodies

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4
Q

outline some clinical criteria of SLE

A
cutaneous manifestations
oral or nasal ulcers
alopecia
arthritis
renal
leukopenia
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5
Q

outline some immunologic criteria of SLE

A

ANA
Anti-DNA
Anti-Sm

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6
Q

name some mucocutaneous features seen in SLE

A
photosensitivity
malar rash
discoid lupus erythematosus
subacute cutaneous lupus
mouth ulcers
alopecia
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7
Q

where is there sparing of in malar rash?

A

nasolabial folds

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8
Q

name some musculoskeletal features seen in SLE

A

Non-deforming polyarthritis/polyarthralgia

Deforming arthropathy - Jaccoud’s arthritis

Myopathy - weakness, myalgia & myositis

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9
Q

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

A

Jaccoud’s arthritis - x ray is normal

rheumatoid arthritis - x ray is not

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10
Q

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

A

urinalysis

protein and/or blood

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11
Q

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

A

renal biopsy

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12
Q

name some neurological features seen in SLE

A

Depression/psychosis

Migrainous headache

Seizures

Cranial or peripheral neuropathy

Mononeuritis multiplex

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13
Q

name some haematological features seen in SLE

A

Lymphadenopathy

Leucopenia

Lymphopenia

Haemolytic anaemia

Thrombocytopenia

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14
Q

what does anti-phospholipid syndrome cause?

A

blood clots

miscarriage

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15
Q

are people with SLE more susceptible to infection?

A

yes

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16
Q

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

A

To confirm/establish diagnosis

To determine degree of organ involvement

17
Q

name the important antibodies in SLE

A
ANA
Anti-dsDNA
Anti-Sm
Anti-Ro
Anti-RNP
18
Q

which antibody is associated with neonatal SLE?

A

Anti-Ro

19
Q

which autoantibody is most specific to SLE?

A

anti-double-stranded-DNA

20
Q

name the anti-phospholipid antibodies

A

Anti-cardiolipin antibody
Lupus anticoagulant
Anti-beta 2 glycoprotein

Must be positive on 2 occasions 12 weeks apart

21
Q

does CRP increase in SLE?

A

no

22
Q

what is the drug treatment in SLE?

A

NSAIDs and simple analgesia

anti-malarials - hydroxychloroquine

steroids

immunosuppressives

biologics

23
Q

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

A

increase

24
Q

name some immunosuppressives

A

azathioprine
Cyclophosphamide
Methotrexate
Mycophenolate mofetil

25
Q

name the treatments for the spectrum of SLE:

mild -
moderate -
severe -

A

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