Final Exam - Lupus

Question 1

describe DILE (drug induced lupus)

Answer 1

overrxn to certain meds –> Sx 3-6 months after med initiation –> resolution occurs within weeks of drug D/C

Question 2

Drugs that cause DILE acronym

Answer 2

My………………………methimazole
Pretty………………….propylthiouracil
Malar …………………methyldopa
Marking………………minocycline
Probably …………….procainamide
Has……………………..hydralazine
A…………………………Anti-TNF (infliximab, etanercept)
TransIent ……………Terbinafine, Isoniazid
Quality………………..quinidine

Question 3

S/Sx of lupus

Answer 3

butterfly rash (malar rash)
Raynaud’s
discoid rash
joint pain
N/V
wt loss
photosensitivity
fever
fatigue

Question 4

SLICC diagnostic criteria rqrmts

Answer 4

must meet 4 or more total features with 1 from each group

OR

biopsy proven lupus nephritis WITHH systemic lupus (positive anti-dsDNA antibodies or positive ANA)

Question 5

EULAR/ACR diagnostic criteria rqrmts

Answer 5

pts score is 10 or more and at least one clinical criterion is fulfilled

Question 6

list which ones are specific for lupus and which are not:

ANA
anti-dsDNA
anti-SM

Answer 6

not specific
specific
specific

Question 7

Pharm Tx options for lupus

Answer 7

hydroxychloroquine (HCQ)
NSAIDs
Glucocorticoids (GC)
immunosuppressants (IS)
biologics

Question 8

main therapy for lupus
-given to all pts

Answer 8

HCQ

Question 9

HCQ SE

Answer 9

retinal toxicity: bullseye maculopathy
hypoglycemia
G6PD deficiency (don’t give to pts if they have this)

Question 10

potency for topical glucocorticoids and place on body to use

Answer 10

low: fluocinolone valerate and hydrocortisone butyrate (face
medium: triamcinolone acetonide and betamethasone valerate (trunk and extremities)
high: clobetasol (scalp sores and palms)

Question 11

immunosuppressants options

Answer 11

methotrexate (BMS)
azathioprine (BMS, TPMT deficiency)
cyclophosphamide
mycophenolate mofetil

Question 12

non pharm tx

Answer 12

balance of rest and exercise
smoking cessation
limit sun exposure