lupus

Question 1

basic definition

Answer 1

autoimmune, loss of tolerance, unknown cause. immune complexes lead to tissue damage

Question 2

Epi

Answer 2

rare, women, ethnic, genetic, environmental. Hormonal- women/kleinfelters

Question 3

path theories

Answer 3

lack of central tolerance. autoantibodies. defective apoptosis» persistent autoantibodies, virus> excess debris. TLR issue?

Question 4

B cell/T cell findings

Answer 4

excess B cells/autoantibodies. Increased T helper cells, decreased T reg supression»> increased bad cells without turnoff function

Question 5

Lab findings

Answer 5

high ANA (but some normal people have this!!), immune complexes high> low complement, anti DSDNA- 70% sens, antismith- specific

Question 6

most specific test

Answer 6

anti smith

Question 7

test that is marker for clin

Answer 7

anti dsdna

Question 8

current classification guidelines

Answer 8

2019 EULAR- increased sensitivity and specificity, ANA> 1:80 plus 10 points

Question 9

clinical musc.

Answer 9

myalgia, arthritis NON EROSIVE, myositis (labs positive but not enough for symptoms usually)

Question 10

clinical cutaneous

Answer 10

rash! discoid (scar), photosensitive, malar, allopecia, bullus, subacute

Question 11

clinical vascular

Answer 11

raynauds, vasc,

Question 12

NEPHRITIS

Answer 12

bad. immune complexes in glomeruli (capillary, sub epithelium, endothelium, mesangium> inflammation

Question 13

nephritis clinical

Answer 13

hematuria, proteinuria, casts, HTN, peripheral edema, renal failure

Question 14

nephritis classification

Answer 14

I/II: how much mesangium III/IV: percent proliferation in glomeruli, V: membrane deposits. VI: advanced, >90%

Membrane= capilary bAsemnt membrane

Question 15

nephritis treatments

Answer 15

cyclophosphamide (toxic, chemo), mycophenolate (inhibit b/T cells, less toxic)

Question 16

cardiac clinical

Answer 16

pericarditis, CAD, endocarditis from immune complex deposition (vs infections)

Question 17

neuro clincial

Answer 17

diffuse (mood, cognition..) or focal (stroke)

Question 18

treatment

Answer 18

1- hydroxychloroquine. 2-biologics. 3- control risk factors for vascular disease

Question 19

Tissue damage

Answer 19

Immune complexes and autoantibodies