Lecture 8 Its actually lupus

Question 1

Who is the classic presentation?

Answer 1

female of reproductive age, african descent

Question 2

Certain HLA haplotypes such as ____ and ____ are increased in SLE with respect to the general population

Answer 2

DR2; DR3

Question 3

Which 2 drugs are most associated with SLE?

Answer 3

procainainamide, hyrdalazine

Question 4

What hormone may aggravate SLE symtpoms

Answer 4

estrogen

Question 5

The x chromosome was more often ______ in women with SLE than without

Answer 5

demethylated

Question 6

measurement of ANA:
tissue placed on slide–>patient’s ___ is placed on slide–>slide is washed, ___ tagged rabbit anti-human Ig is placed–>washed–>imaging

Answer 6

serum;

fluorecein

Question 7

anti-___ antibodies are highly specific for SLE

Answer 7

dsDNA

Question 8

Anti__ antibodies are an example of extractable nuclear antigens are are specific for SLE

Answer 8

smith (Sm)

Question 9

Anti-RNP is associated with _______

Answer 9

mixed connective tissue disease

Question 10

_____ antibodies and and lupus ____ can cause false positive VRDLs and a hypercoagulable state

Answer 10

anticardiolipin; anticoagulant

Question 11

In lupus, IL _ is increased while IL _ is decreased

Answer 11

10, 12

Question 12

____ of lymphocytes in patients with SLE has shown to be increased

Answer 12

apoptosis

Question 13

MQ’s have difficulty clearing ___ cells in SLE patients–>increase in ___ antigens–>auto-immunity

Answer 13

apoptotic; self

Question 14

2 areas most affected by immune complex disease:

Answer 14

kidney, blood vessels

Question 15

Antiphospho lipid syndrome is due to lupus ____. It is associated with a ___- PTT and venous and arterial ____

Answer 15

anticoagulant; prolonged; thrombosis

Question 16

Classic presentation:

Answer 16

rash, joint pain, fever

Question 17

The arthritis is typical ____ but is not as ___ as RA

Answer 17

symmetric, erosive

Question 18

___ sensitivity is very common, with rashes seen after exposure

Answer 18

sun

Question 19

Which kind of rash in lupus leaves scars?

Answer 19

discoid

Question 20

In a discoid rash, the central area becomes ___ while edges remain ___ and ____

Answer 20

atrophic;

edematous, erythematous

Question 21

____ ulcers are common, but are generally ____

Answer 21

oronasopharyngeal; painless

Question 22

What are osler nodes?

What is livedo reticularis?

Answer 22

local vasculitis;

fine lacy rash

Question 23

____ such as pleurisy and pericarditis is very common

Answer 23

serositis

Question 24

What is libman-sacks endocarditis?

Answer 24

wart-like vegetations on both sides of a heart valve; typically mitral

Question 25

leuko____ is very common

Answer 25

penia

Question 26

membranous glomerulonephritis is a ____ syndrome and is characterized by ____

Answer 26

nephrotic;

proteinuria

Question 27

diffuse proliferative glomerulonephritis is a _____ syndrome and is characterize by ____

Answer 27

nephritic; hypertension, hematuria

Question 28

____ is often seen and is due to vasospasm, causing decreased blood flow.

Answer 28

raynaud phenomenon

Question 29

What is the most important criteria for diagnosis?

Answer 29

positive ANA test

Question 30

The ANA test has high ___. The anti-dsDNA and anti-Smith antibodies have high ____

Answer 30

sensitivity;

specificity

Question 31

Complements are typically _____ due to immune complex formation

Answer 31

depressed

Question 32

____ exposure must be limited in SLE patients

Answer 32

sun

Question 33

Antimalarial drugs such as ____ are useful in treatment

Answer 33

hydroxychloroquine

Question 34

What 2 cytotoxic drugs are sometimes used?

Answer 34

azathioprine, cyclophosphamide

Question 35

_____ ____ (cellcept) has been shown to be useful in cyclophosphamide resistant renal disease

Answer 35

mycophenolate mofetil

Question 36

_____ is the greatest cause of death in SLE patients (According to his notes)

Answer 36

infection