final lecture 1

Question 1

SLE is a major

Answer 1

collagen-vascular multi-system disease

Question 2

SLE hallmark

Answer 2

development of autoantibodies to cellular nuclear components that leads to a chronic inflammatory autoimmune disease

Question 3

criteria for identifying SLEis used primarily for

Answer 3

distinguishing SLE from other collagen-vascular diseases & doesnt include all clinical manifestations

Question 4

if ____ of the 11 criteria are documented, SLE diagnosis can be made w/ 95% sensitivity!

Answer 4

4 or more

Question 5

___susceptibility genes are required for the expression of lupus in humans

Answer 5

four

Question 6

most important genes are located

Answer 6

in the HLA region on chromosome 6

Question 7

targeted environmental agents that may induce SLE:

Answer 7

sunlight, chemicals (hydrzine, aromatic amines), infection

Question 8

androgens may___ the expression of autoimmunity

Answer 8

inhibit

Question 9

estrogens may ____ the expression of autoimmunity

Answer 9

enhance

Question 10

excessive autoantibody production results from

Answer 10

hyperactive B lymphocytes

Question 11

mechanisms that lead to B-cell hyperactivity

Answer 11

loss of immune self-tolerance & high antigenic load, shift from Th1->Th2 & defective B cell suppression

Question 12

antinuclear antibodies

Answer 12

autoantibodies directed against nuclear constituents (ssDNA, dsDNA, histones,)

Question 13

antibodies to dsDNA are____ for SLE

Answer 13

high specific

Question 14

two main types of autoantibodies

Answer 14

lupus anticoagulant & anticardiolipin antibodies (antiphospholipid antibodies)

Question 15

RNA-associated antigens seen in SLE

Answer 15

Smith (Sm), small nuclear ribonucleoprotein (snRNP), Ro & La

Question 16

what often precedes the clinical onset of SLE by many years?

Answer 16

anti-La, anti-Ro, & antiphospholipid antibodies

Question 17

associated with poor prognosis

Answer 17

lupus nephritis & SLE-associated pulmonary HTN

Question 18

what kind of anemia is most common in SLE

Answer 18

anemia of chronic inflammation- normochronic & normocytic

Question 19

serologic test used to aid in SLE diagnosis

Answer 19

fluorescent antinuclear antibody (ANA tesy

Question 20

the immunifluorescence of ANA present

Answer 20

a peripheral pattern of staining (RIM)- characteristic of dsDNA antibodies

Question 21

histone antibodies are characteristic of

Answer 21

drug-induced lupus

Question 22

ribonucleoprotein & dsDNA antibodies are characteristic of

Answer 22

SLE

Question 23

antimalarials used to help with

Answer 23

cutaneous manifestations, arthralgia, fatigue & fever & used long term

Question 24

corticosteroid pulse therapy is used

Answer 24

to induce remission of SLE pt with a life-threatening disease

Question 25

cytotoxic agents used in SLE

Answer 25

cyclophosphamine & azathioprine

Question 26

cyclophosphamide active metabolite

Answer 26

4-hydroxycyclophosphamide (by the liver)

Question 27

cyclophosphamide MOA

Answer 27

forms irreversible DNA crosslinks both between & w/in DNA strands->cell death

Question 28

cyclophosphamide is indicated for

Answer 28

lupus nephritis & severe lupus as pulse therapy in combo with methylprednisolone

Question 29

azathioprine active metabolite

Answer 29

6-mercaptopurine (liver)- purine synthesis inhibitor

Question 30

azathioprine MOA

Answer 30

blocks the de novo pathway for purine synthesis & T cell activation

Question 31

azathioprinehas a ____ effect

Answer 31

steroid-sparing