Lupus Flashcards
A 35 yo African American female presents with a butterfly-shaped rash on her face that is worse after she is in the sun. The flat, erythematous rash spares her nasolabial flolds. On exam you note oral ulcers, which she says are painless, and thombocytopenic purpura on her LE. She has a history of seizures and pericarditis. What do you suspect? What is the pathophys behind her condition?
SLE
Systemic autoimmune Dz (body attacks itself) which affects all organs
A 26 yo Hispanic female presents complaining of a flat, red, butterfly-shaped rash on her face that is worse with sunlight. The rash spares her nasolabial folds. She mentions that a couple months ago she had a similar rash on other parts of her body: red, raised patches and a couple adherent kerotic scales. She mentions her skin conditions usually occur after sun exposure. On exam you note oral ulcers and arthritis of 3 of her MCP joints. What diagnostic test do you want to do? How sensitive/specific is this test?
SLE
ANA
95% sensitive, low specificity
(sensitive but not specific)
A 40 yo female presents because she has had various, strange symptoms over the past year. She remembers a butterfly-shaped rash on her face, oral ulcers, arthritis, seizures, and small non-bleaching purplish spots on her lower legs. You check her ANA and it is positive. What treatment do you recommend?
SLE Counselling & education Adequate rest & activity Decrease inflammation Preserve renal function Sun protection UTD immunizations Medical Therapy
What are the 4 groups of medical therapy used to control SLE?
Steroid sparing agents
General immunosuppressants
Biologics
Other (IVIg)
What are the goals of managing SLE?
Manage infections
Minimize osteoporosis
Eye exams Q 6-12 mo for plaquenil toxicity
Thrombo-occlusive prophylaxis in at-risk pts
Evaluate & Tx ASHD & dyslipoproteinemia
Family planning/birth control issues
Support groups
What are the 11 sx that are associated with SLE?
(1) malar rash; (2) discoid rash; (3) photosensitivity; (4) oral ulcers; (5) athritic; (6) serositis; (7) renal disorder; (8) neurologic disorder; (9) hematologic disorder; (10) immunologic disorder; (11) ANA (antinuclear antibody)
A 32 yo female presents with arthritis, a malar rash, photosensitivity, nephropathy, oral ulcers, serositis, and seizures. What do you suspect?
SLE
A 24 yo presents with a fever and constitutional sx. She also has Raynaud’s, alopecia, and cutaneous vasculitis. What do you suspect?
SLE
What are the two clusterings of SLE sx?
Skin - Joint - Kidney
CNS - Muscular
A pt with a history of SLE presents with arthritis in her hands. She has reducible deformities, ligament laxity, and Swan neck deformities. Imaging shows no erosions. What complication does she have?
Jaccoud’s Arthropathy
A pt with a Hx of SLE presents with arthralgia, arthritis, and myalgia. She broke her scaphoid when she fell on her hand a few weeks ago, and she has just been diagnosed with avascular necrosis. What complication does she have?
SLE MSK Dz
An obese pt with a Hx of SLE presents with pericarditis, myocarditis, and accelerated atherosclerosis. What complication does she have?
SLE Cardiac Dz
A pt with a Hx of SLE presents with pleuritis, atelectasis, pulmonary hemorrhage, and subclinical restrictive disease. What complication does she have?
SLE Pleuropulmonary Dz
A pt with a Hx of SLE presents with gross hematuria, acute renal failure, and HTN. What complication does she have?
SLE Renal Involvement
What is the MC cause of death related to SLE?
Nephritis
