Hot Topics Flashcards
what drugs are associated w/ drug induced Lupus
“My Two HIPS”: Methyldopa/Minocycline, TNF-α inhibitors, Hydralazine, Isoniazid, Procainamide/Phenytoin, and Sulfa drugs are triggers for DILE.
what infection is a/w SLE
EBV
what are the main abs for SLE
Anti nuclear ab (requirement for SLE dx) at a ratio of 1:80 (ANA test can pick up on anti-dsDNA, anti-histones, anti-ribonucleoprotein (anti-Smith), anti-nucleolar antigens). It is sensitive but not specific (many other conditions have this)
Anti-dsDNA antibody
Positive in 60–70% of patients and highly specific for SLE
Levels correlate with disease activity.
Associated with lupus nephritis
Anti-Sm antibody is present in only 30% of SLE cases but is highly specific for SLE
most common cause of death in SLE
cardiovascular disease d/t atherosclerosis or chronic renal failure (from lupus glomerulonephritis)
Antibodies directed against _________are found in nearly 95% of patients with drug-induced lupus. T
histones (i.e., antihistone antibodies)
Which ab is A/W recurrent abortions and strokes
anti-phospholipid antibody
Antibodies directed against phospholipid-binding proteins (i.e., antiphospholipid antibodies) are found in 30–40% of patients with SLE. Of those with antiphospholipid antibodies, about 20% will go on to develop antiphospholipid antibody syndrome. Screening for this type of antibody is therefore important in patients with SLE. However, it does not have any diagnostic value for SLE.
what are the characteristics of a discoid lupus lesion
solid, raised, flat topped, greater than 1cm, usually discoid shaped, present on sun exposed skin, can progress to SLE (10%)
In patients with SLE, is increased partial thromboplastin time (PTT) or Increased PT expected? due to the presence of antiphospholipid antibodies would be expected rather than increased PT.
increased partial thromboplastin time (PTT) due to the presence of antiphospholipid antibodies would be expected rather than increased PT.
describe the biochemical steps in cell senescence
DNA damage –> excessive oxidant stress or short telomers that activate persistent DNA Damage Response (DDR) system –> DDR induces signaling by ATM and ATR which activate p53/p21 and p16/pRB pathways –> cell cycle arrest and senescence or apoptosis.
*If p16/p21 and/or p53 fail, then the cell may escape senescence and at risk of transforming to cancer.
what are the cholinesterase inhibitors and when are they indicated
donepezil, galantamine, and
Rivastigmine
they are indicated for mild to moderate alzheimers *not for vascular dementia
what is Memantine and when is it indicated
Memantine, an NMDA receptor antagonist, modulates the activity of glutamate in the brain. It is indicated for treatment of moderate to severe Alzheimer disease
indicated for moderate to severe alzheimers *not for vascular dementia
T/F: none of the drugs for alzheimers drugs have been shown to be effective in slowing progression of dementia
TRUE, you only prescribe them when patients have the disease
The earliest sites of neurodegeneration in Alzheimer disease are what?
structures in the medial temporal lobe such as the hippocampus and parahippocampal cortex, which are critical for memory formation.
explain the transmission of inherited Alzheimers
Mutations in presenilin 1 are associated with early-onset Alzheimer disease. The trait is autosomal dominant and leads to unusually high production of beta-amyloid, which results in the early formation of amyloid plaques.
what gene allele is a risk factor for late onset alzheimers
The presence of the ε4 allele of ApoE is associated with an increased risk for late-onset AD but not early-onset AD, as seen in this patient. The protein product of this gene binds to amyloid β and is thought to initiate a series of events that accelerate neurodegeneration.
