Connective Tissue Disorders - Lupus Flashcards

1
Q

What type of Hypersensitivity is Systemic Lupus Erythematosus (SLE)?

A

Type 3

= Immune complex deposition

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2
Q

Skin and Hematologic symptoms of SLE?

A
  • Malar “butterfly” rash and photosensitivity

- Fever, Anemia, Thrombosis

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3
Q

Bone/CNS/Eye symptoms of SLE?

A
  • Arthritis (bilateral and non-erosive)
  • Seizures
  • Retinopathy with cotton wool spots
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4
Q

Cardiac issues with SLE?

A
  • Pericarditis

- Libman-Sacks Endocarditis

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5
Q

What are the symptoms/exam findings with pericarditis in a SLE patient?

A

Chest pain that is worse with cough, deep inspiration and laying down
– Pericardial friction rub and diffuse ST elevation

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6
Q

SLE patients are at an increased risk for MI due to?

A

Accelerated Atherosclerosis

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7
Q

SLE serology

A
  • Antibodies to dsDNA

- Antibodies to Smith (sm)

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8
Q

With SLE, dsDNA antibodies correlate with? What else can suggest disease activity?

A

Disease activity

– Decreased C3 and C4 of complement can also suggest disease activity

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9
Q

Treatment options for SLE?

A

Avoid sun exposure, NSAIDs for pain,
Glucocorticoids
Hydroxychloroquine

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10
Q

Preventive measures for those with SLE?

A
  • Minimize conventional risks for Atherosclerosis (lower cholesterol, lipids, obesity and smoking)!!
  • Influenza and pneumococcal vaccinations
  • Cancer screenings
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11
Q

In the early years after SLE diagnosis, what things cause mortality?

A

Infections

Kidney and CNS diseases

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12
Q

In the later years after SLE diagnosis, what things cause mortality?

A

Accelerated Atherosclerosis with MI

Thromboembolic events

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13
Q

Antiphospholipid Antibody Syndrome is a risk factor for what 2 things to occur?

A

Venous/Arterial thrombosis

Miscarriage

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14
Q

What are the 3 Antiphospholipid Antibodies?

A
  1. Anticardiolipin Antibodies (aCL)
  2. Lupus Anticoagulant (LA)
  3. Beta 2 Glycoprotein 1
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15
Q

What are the 3 Antiphospholipid Antibodies?

A
  1. Anticardiolipin Antibodies (aCL)
  2. Lupus Anticoagulant (LC)
  3. Beta 2 Glycoprotein 1
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16
Q

Which Antiphospholipid antibody can cause a false (+) for Syphilis?

A

Anticardiolipin Antibody (aCL)

17
Q

Which Antiphospholipid Antibody prolongs PTT clotting time even with normal plasma in vitro?

A

Lupus Anticoagulant (LA)

18
Q

When should Antiphospholipid Antibodies be measured?

A

On 2 separate occasions at least 12 weeks apart

19
Q

Treatment for Antiphospholipid Antibody Syndrome?

A

INDEFINITE systemic anticoagulation

20
Q

What causes Lupus-like Syndrome/Drug-Induced Lupus and what will resolve it?

A

Meds induce it

– Stopping medication will resolve it

21
Q

Lupus-like Syndrome/Drug-Induced Lupus presents similarly to SLE. What symptoms does it NOT have though?

A

Renal and CNS symptoms

22
Q

What antibodies will be (+) with Lupus-Like Syndrome/Drug-Induced Lupus?

A

Anti-Histone Antibodies

23
Q

(+) Anti-Histone Antibodies

A

Lupus-like Syndrome/Drug-Induced Lupus

24
Q

(+) dsDNA antibodies

(+) Sm antibodies

A

SLE

systemic lupus erythematosus

25
Q

Who does Neonatal Lupus affect?

A

Children born of mothers with Anti-RO (SSA) antibodies ONLY

26
Q

Who does Neonatal Lupus affect?

A

Children born of mothers with Anti-RO (SSA) antibodies ONLY

27
Q

Does the Child have SLE with Neonatal Lupus?

A

NO

28
Q

What may or may not the mother have with Neonatal Lupus?

A

SLE and/or Sjogren due to (+) Anti-RO (SSA) antibodies

29
Q

Child symptoms with Neonatal Lupus?

A
  • Congenital heart block – life threatening

- Transient rashes, anemia/thrombocytopenia and arthritis

30
Q

Child symptoms with Neonatal Lupus?

A
  • Congenital Heart Block - life threatening

- Transient rashes, anemia, thrombocytopenia and arthritis

31
Q

If the child in utero with Neonatal Lupus is detected to have heart block, what should the mother be given?

A

Dexamethasone

32
Q

If fetal distress occurs in utero with Neonatal Lupus, what is the treatment option?

A

Delivery of the fetus

33
Q

Where does Discoid Lupus most commonly occur?

A

Head

34
Q

Discoid Lupus

A

Well-defined inflammatory plaques that turn into atrophic and disfiguring scars

35
Q

Well-defined inflammatory plaques that turn into atrophic and disfiguring scars

A

Discoid Lupus

36
Q

Test and Treatment for Discoid Lupus?

A
  • Biopsy

= Sun protection and topical anti-inflammatory agents

37
Q

Prevention/Management of SLE?

A
  • Minimize conventional risk factors for Atherosclerosis (lower cholesterol, lipids, smoking, obesity)
  • Influenza and Pneumococcal vaccinations
  • Cancer screenings
38
Q

If a patient is on Glucocorticoids, what should you watch for?

A

Osteoporosis/Avascular Necrosis