CTD- SLE

Question 1

What is SLE (2)

Answer 1

chronic autoimmune disease

It mainly involves the skin, joints, kidneys, blood cells, and nervous system but can affect almost any organ system.

Question 2

Pathogenesis (4)

Answer 2

Immune system attacks cells and tissues resulting in inflammation and tissue damage, also involves the formation of immune complexes

(type III hypersensitivity)

disregulation of normal immune process - increased cell death

immune complex formation

Question 3

Risk factors (6)

think swaach

Answer 3

Smokers

Women age 20-40- Higher prev (9:1)

Afro-Caribbean

Asian

Chinese ethnicity

Hispanic American

Question 4

constitutional symptoms (3)

think wff

Answer 4

weight loss

fever

fatigue

Question 5

Musculoskeletal symptoms (5)

msk think miaaa

Answer 5

myalgia

arthralgia

inflammatory arthritis

arthropathy

increased prevalence of avascular necrosis- steriod use

Question 6

Muco-cutaneous (6)

think m drops

Answer 6

malar rash

discoid lupus

Raynauds phenomenon

oral/nasal ulceration

photosensitivity

subacute cutaneous lupus

Question 7

Renal symptoms

Answer 7

lupus nephritis

Question 8

Respiratory symptoms (6)

think i ppppp

Answer 8

interstitial lung disease

pleurisy

pleural effusion

pneumonitis

pulmonary embolism

pulmonary hypertension

Question 9

Haematological symptoms (4)

think tall

Answer 9

thrombocytopenia

anaemia (may be haemolytic)

leukopenia

lymphopenia

Question 10

Neuropsychiatric symptoms (4)

think haps

Answer 10

headache

aseptic meningitis

psychosis

seizures

Question 11

Cardiac symptoms (5)

think sappp

Answer 11

sterile endocarditis

accelerated iscahemic heart disease.

pericarditis

pericardial effusion

pulmonary hypertension

Question 12

Gastrointestinal symptoms (3)

think map

Answer 12

mesenteric vasculitis

autoimmune hepatitis

pancreatitis

Question 13

antibodies (6)

Answer 13

There is no one diagnostic

Anti-nuclear antibody - not spec

Anti-dsDNA antibody - spec

Anti-Sm - spec but low sensitivity

Anti Ro, anti-La and anti-RNP

Question 14

Imaging + bloods (6)

think FUCC EM

Answer 14

FBC

Urinalysis - glomerulonephritis

C3/4 levels low

CT chest for interstitial lung disease

echo for pericardial effusion.

MRI brain for cerebral vasculitis

Question 15

Monitoring (4)

Answer 15

check
-anti-dsDNA antibodies

-complement levels regularly

-urinalysis for blood or protein- may indicate glomerulonephritis.

-BP and cholesterol