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ICM Infectious Disease > Lupus > Flashcards

Lupus Flashcards

1
Q

What is Systemic Lupus Erythematous?

A

Chronic inflammatory disease of unknown cause.

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2
Q

What does SLE affect?

A

Skin, joints, kidneys, lungs, nervous system, serous membranes

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3
Q

What is SLE in origin?

A

Autoimmune

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4
Q

Clinical course of SLE characterized by what?

A

Periods of remission and chronic/acute relapses

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5
Q

What factors play a role in pathogenesis?

A

Genetics and environmental factors

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6
Q

Who has higher incidence?

A

Blacks and indian tribes

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7
Q

Which genetic HLA haplotypes are increased in SLE population?

A

HLA DR2 and DR3

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8
Q

Which Haplotypes on chromosome 2 are associated with increased incidence of rheumatoid and lupus?

A

STAT4 haplotypes

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9
Q

What do STAT4 haplotypes code for?

A

Cytokines

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10
Q

Deficiencies of which complements are associated with SLE and discoid lupus?

A

Complements C2 and C4

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11
Q

What do twin studies show about SLE?

A

Monozygotic twins both more commonly develop SLE than dizygotic twins

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12
Q

What is the estimated number of susceptibility genes needed for development of SLE disease?

A

4

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13
Q

Which drugs can cause an SLE like illness?

A

Procainamide and hydralazine

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14
Q

What are three other environmental factors than can start SLE?

A

1) Hairy dye
2) Smoking
3) UV light

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15
Q

Women of what age are at greatest risk?

A

Childbearing years

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16
Q

Estrogen effect on SLE?

A

Prolongs survival of autoimmune cells

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17
Q

Effects of prolonged autoimmune cells in SLE?

A

Increases T-helper cell cytokine production

Stimulates B-cell to produce autoantibodies

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18
Q

Correlation between CD40 ligand in women?

A

More X chromosomes express CD40 ligand in women with lupus than women without

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19
Q

Is a low level of auto reactivity pathologic?

A

No, physiologic

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20
Q

Activated T cells stimulate B cells to produce what?

A

Autoantibodies

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21
Q

Total T cells are what in lupus?

A

Decreased

22
Q

T cell function is skewed toward what in lupus?

A

B-cell help

23
Q

Direction of IL-10 and 12 in SLE?

A

IL-10 increased

IL-12 decreased

24
Q

Problems with immune regulation in SLE?

A

Phagocytes defective in clearing immune complexes

T-cell CD8 suppressor cells deficient in function

25
Q

What happens to lymphocytes in patients with SLE?

A

Apoptosis

26
Q

Increased apoptosis in SLE can lead to what?

A

Leakage on intracellular antigens which triggers further autoimmune response

27
Q

Where does tissue damage in blood vessels and kidneys come from?

A

Deposition of antigen-antibody complexes

28
Q

Antibodies to phospholipids is known as what?

A

Lupus anticoagulent

29
Q

Lupus anticoagulent is associated with what?

A 
Prolonged PTT
Venous/arterial thrombosis 
Fetal distress
Thrombocytopenia
Livedo reticularis
30
Q

Most common systemic symptom of SLE?

A

Fatigue (Too nonspecific)

31
Q

How does arthralgia present in SLE?

A

Symmetric, mimics RA
Not as erosive as RA
WBC

32
Q

SLE patients have what reaction to sun?

A

Rashes or activation of systemic disease

Butterfly rash

33
Q

Erythematous maculopapular eruption is what?

A

SLE pruritic eruption that can occur after sun exposure

34
Q

What is Discoid lupus?

A

Sharply defined papule and plaques that become atrophic in the center while edges remain edematous and erythematous. Scars

35
Q

Difference between subacute cutaneous lupus and discoid lupus?

A

Looks like discoid but no scarring

36
Q

Where are oral ulcers commonly found in SLE?

A

Hard and soft palate

37
Q

How common is alopecia in SLE?

A

Greater than 50%, can be patchy

38
Q

Cardiac problems due to SLE?

A

Libman-Sacks (Valve replacement due to bacteria)
Resting tachycardia, abnormal EKG
Coronary artery disease due to immune complex
Conduction deficits

39
Q

What is a big clue for SLE diagnosis?

A

Leukopenia

40
Q

How will erythrocyte sedimentation rate present in SLE?

A

Elevated

41
Q

Four pathologic types of Kidney damage in SLE?

A

1) Mesangial glomerulonephritis
2) Focal proliferative nephritis
3) Diffuse proliferative glomerulonephritis
4) Membranous glomerulonephritis

42
Q

How does Cerebrospinal fluid look in SLE?

A

Usually normal

43
Q

Abnormal EEG common or uncommon in SLE?

A

Common 80%

44
Q

What is Raynaud’s phenomenon?

A

3 color change of fingers on exposure to cold. White-> blue -> red

45
Q

Lupus anticoagulant is associated with what?

A

Frequent miscarriages

46
Q

Bone most frequently damaged by avascular necrosis

A

Hip

47
Q

Most important lab diagnostic?

A

ANA

48
Q

Key to SLE treatment?

A

Patient education

49
Q

Mild SLE treated with?

A

Antimalarial hydroxychloroquin

50
Q

Major organ disease from SLE treated with?

A

Corticosteroids and cytotoxic agents

51
Q

Greatest cause of death in SLE patients?

A

Infection

ICM Infectious Disease (19 decks)

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