Lecture 128

Question 1

Systemic lupus erythematosus (SLE) is generally characterized by:

Answer 1

Formation of antibody-antigen complexes that deposit in capillaries of organs, causing inflammation and tissue damage

Question 2

SLE predominantly affects ____

Answer 2

Females

Question 3

SLE age of onset:

Answer 3

20-40 years old

Question 4

Most common presentation of SLE:

Answer 4

Malar (butterfly) rash

Question 5

Non-bacterial vegetations on cardiac valves seen in SLE:

Answer 5

Libman-Sacks endocarditis

Question 6

____ labs are highly sensitive, but not very specific for lupus

Answer 6

ANA (antinuclear antibody)

Question 7

What two antibodies are more specific for SLE?

Answer 7

Anti-dsDNA and anti-Sm antibodies

Question 8

Antiphospholipid antibodies found in SLE are associated with:

Answer 8

clotting complications

Question 9

What complement levels are often decreased in active SLE?

Answer 9

C3 and C4

Question 10

What treatment for SLE is beneficial for skin manifestations and arthralgias?

Answer 10

Hydroxychloroquine

Question 11

What SLE drug reduces incidence of severe relapses?

Answer 11

Hydroxychloroquine

Question 12

High dose corticosteroids for SLE are used for:

Answer 12

severe disease (end-organ involvement, hematologic complications)

Question 13

What class of medications is reserved for refractory SLE?

Answer 13

Immunosuppressants

Cyclophosphamide, mycophenolate mofetil, belimumab, rituximab, etc.

Question 14

Is hydroxychloroquine safe during pregnancy?

Answer 14

Yes

Question 15

Systemic sclerosis is also known as:

Answer 15

Scleroderma

Question 16

What condition is characterized by excessive collagen deposition leading to fibrosis of skin and internal organs?

Answer 16

Systemic sclerosis

Question 17

What phenomenon is present in nearly all scleroderma patients?

Answer 17

Raynaud phenomenon

Question 18

Systemic manifestations of systemic sclerosis commonly affect:

Answer 18

GI tract, lungs, kidney, and cardiovascular system

Question 19

What racial population has earlier onset and more severe systemic sclerosis?

Answer 19

African American patients

Question 20

What are the two clinical subsets of systemic sclerosis?

Answer 20

Limited cutaneous systemic sclerosis & diffuse cutaneous systemic sclerosis

Question 21

Limitied cutaneous systemic sclerosis is often associated with what syndrome?

What are the symptoms of CREST?

Answer 21

CREST syndrome

Calcinosis cutis, Raynaud, esophageal dysmotility, sclerodactyly, telangiectasis

Question 22

What are the typical findings of diffuse cutaneous systemic sclerosis?

Answer 22

Widespread skin involvement (including the trunk) and higher risk of early visceral involvement

Question 23

ANA is ____ in systemic sclerosis

Answer 23

Highly positive

Question 24

Anti-SCL-70 (anti-topoisomerase I) is associated with what form of systemic sclerosis?

Answer 24

Diffuse form

Question 25

Anti-centromere antibodies are associated with which form of systemic sclerosis?

Answer 25

Limited cutaneous form (CREST)

Question 26

Anti-RNA polymerase III correlates with ____ in relation to systemic sclerosis

Answer 26

diffuse disease and higher risk of renal crisis

Question 27

Pharmacological treatments for Raynaud phenomenon

Answer 27

Calcium channel blockers to prevent vasospastic attacks ## Footnote Amlodipine, nifedipine

Question 28

Pharmacological treatments for esophageal dysmotility

Answer 28

Proton pump inhibitors for acid reflux and prokinetic agents (metoclopramide, erythromycin) for motility support

Question 29

Interstitial lung disease associated with systemic sclerosis may require:

Answer 29

Cyclophosphamide or other immunosuppressants

Question 30

Renal crisis in systemic sclerosis presents with

Answer 30

Malignant hypertension and rapidly progressive renal failure

Question 31

Thickenin/tightening of skin on fingers and toes is called:

Answer 31

Sclerodactyly

Question 32

____ are not typically central to systemic sclerosis therapy because it may increase the risk of renal crisis

Answer 32

Corticosteroids

Question 33

Diffuse treatment of systemic sclerosis involves:

Answer 33

Methotrexate (skin, joint, muscle involvement) and cyclophosphamide (pulmonary fibrosis)

Question 34

Sjogren's syndrome primarily targets ____, leading to ____

Answer 34

exocrine glands, leading to decreased secretory function

Question 35

Sjogren's syndrome affects

Answer 35

Lacrimal and salivary glands

Question 36

Dry eyes, AKA:

Answer 36

Keratoconjunctivitis

Question 37

Dry mouth, AKA:

Answer 37

Xerostomia

Question 38

Peak incidence of Sjogren's syndrome in

Answer 38

20-30 years old

Question 39

Salivary gland biospy in patients with Sjogren's syndrome shows:

Answer 39

Lymphocytic infiltration/inflammation

Question 40

Sjogren's syndrome serology shows:

Answer 40

Anti-Ro (SSA) and/or Anti-La (SSB) antibodies

Question 41

Schirmer's test is used to diagnose

Answer 41

Sjogren's syndrome

Question 42

Reactive arthritis is triggered by

Answer 42

Genitourinary or gastrointestinal infections

Question 43

Reactive arthrisis is characterized by ____, often in ____

Answer 43

monoarthritis or aligoarthritis, in lower extremities

Question 44

What is the most common urogenital infection to trigger reactive arthritis?

Answer 44

Chlamydia trachomatis

Question 45

What HLA gene is positive in the majority of patients with reactive arthritis?

Answer 45

HLA-B27

Question 46

Clinical feature triad of reactive arthritis:

Answer 46

Arthritis, urethritis/cervicitis, conjunctivitis

Question 47

Extra-articular manifestations of reactive arthritis include:

Answer 47

Oral ulcers, keratoderma blennorrhagica, enthesitis, and uveitis

Question 48

First treatment for reactive arthritis triggered by chlamydial infection

Answer 48

Antibiotics

Question 49

First-line therapy for reactive arthritis w/o current infection:

Answer 49

NSAIDs

Question 50

Reactive arthritis treamtnet if first-line therapy is insufficient

Answer 50

DMARDs (sulfasalazine, methotrexate, etc.)

Question 51

How long for reactive arthritis symptoms to resolve?

Answer 51

Within 6-12 months