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7262 MS Block 2 > Lupus > Flashcards

Lupus Flashcards

1
Q

SLE is more common in women of what age range?

A

teens to early 50s

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2
Q

__ is a measurable increase in disease activity (>=1 organ system) involving new or worsening of clinical signs, symptoms or labs

A

SLE flare

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3
Q

Lupus nephritis:

What class is focal with < 50% glomeruli involvement?

A

class III

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4
Q

Lupus nephritis:

What class is diffuse with >= 50% glomeruli involvement?

A

class IV

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5
Q

Increased risk of VTE, arterial thrombosis, and fetal loss with what syndrome?

A

antiphospholipid syndrome

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6
Q

Antiphospholipid antibodies can cause thrombus formation by interfering with __ and endothelial cell fxn

A

protein c

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7
Q

Leukopenia with < __/mm3 is clinical criteria for lupus

A

4000

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8
Q

Lymphopenia with < __/mm3 is clinical criteria for lupus

A

1000

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9
Q

Thrombocytopenia with platelets < __/mm3 is clinical criteria for lupus

A

100,000

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10
Q

At least __ criteria, including at least __ clinical and __ immunologic criterion or biopsy proven lupus nephritis with positive ANA or anti-dsDNA is required for lupus diagnosis

A

4, 1, 1

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11
Q

Two autoantibody tests for lupus?

A

ANA

APA

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12
Q

4 main lab tests for lupus:

A

autoantibody: ANA and APA
CBC with differential
SCr
urinalysis with microscopy

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13
Q

Which is false?

a. it is chronic autoimmune disease that affects multiple organs
b. it affects more women than men
c. increased incidence in older pts
d. can be triggered by environmental factors like smoking and UV light

A

c. increased incidence in older pts

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14
Q

Reducing ___ use is a treatment goal for SLE

A

corticosteroid

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15
Q

Do not give live vaccines to pts receiving immunotherapy.

a. true
b. false

A

a. true

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16
Q

What drug is used for salvage therapy?

A

rituximab

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17
Q

Low dose aspirin is used in __

A

antiphospholipid syndrome (APS)

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18
Q

Steroids are given low potency for what areas?

A

sensitive areas like the face

given locally for skin manifestations

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19
Q

Do not exceed __mg/kg/day or __mg of hydroxychloroquine, whichever is lower

A

5, 400

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20
Q

Which med may reduce clotting, and may be used in all pts with lupus if tolerated?

A

hydroxychloroquine

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21
Q

What is the major AE of hydroxychloroquine?

A

retinal toxicity (cornea)

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22
Q

Methotrexate is given how often?

A

ONCE weekly

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23
Q

Methotrexate has dose adjustments for renal and hepatic impairment.

a. true
b. false

A

a. true

24
Q

Which med is used for maintenance therapy for nephritis?

A

azathioprine

25
Q

Lower azathioprine dose needed if pt is __ deficient

A

TPMT

26
Q

Azathioprine has DDIs with __ and __

A

allopurinol, febuxostat

avoid or decrease dose by 1/3 to 1/4 usual dose

27
Q

Which med is used for induction and maintenance therapy for nephritis?

A

mycophenolate

28
Q

With mycophenolate wait __ weeks after therapy d/c before attempting pregnancy

A

6

29
Q

Wait 6 weeks after therapy d/c before attempting pregnancy with what immunosuppressant?

A

mycophenolate

30
Q

Mycophenolate has low protein binding

a. true
b. false

A

b. false

HIGH protein binding

31
Q

Which immunosuppressant is used only as induction therapy for nephritis?

A

cyclophosphamide

NOT used for maintenance

32
Q

2 main aEs of cyclophosphamide?

A

hemorrhagic cystitis

bladder cancer

33
Q

Cyclophosphamide should be avoided in pregnancy

a. true
b. false

A

a. true

34
Q

Which immunosuppressant has teratogenicity concern

A

cyclophosphamide

35
Q

Which immunosuppressant can cause infertility in women and men?

A

cyclophosphamide

36
Q

__ is a recombinant antibody that promotes B cell apoptosis by binding to BLyS

A

belimumab

prevents B cell maturation

37
Q

Which drug is used in pts with autoantibody positive SLE as an adjunct therapy?

A

belimumab

38
Q

Do not give vaccines within __ days of belimumab therapy

A

30

39
Q

Do not give belimumab with other biologics or __

A

cyclophosphamide

40
Q

Which med is used for salvage therapy for SLE and lupus nephritis?

A

rituximab

41
Q

main AE of rituximab?

A

infusion rxns

premedicate to prevent infusion and hypersensitivity rxns

42
Q

ACE/ARBs are adjunctive therapies and should be avoided din pregnancy.

a. true
b. false

A

a. true

43
Q

Which two adjunctive therapies should not be used in pregnancy?

A

warfarin (contraindicated)

statins (avoid use)

44
Q

Warfarin is contraindicated in pregnancy.

a. true
b. false

A

a. true

45
Q

2 drugs for induction therapy?

A

mycophenolate

cyclophosphamide

46
Q

2 drugs for maintenance therapy ?

A

mycophenolate

azathioprine

47
Q

Topical agents are drugs of choice for cutaneous pts w/o systemic Sx

a. true
b. false

A

a. true

topical steroids
topical calcineurin inhibitors

48
Q

What is steroid of choice in pregnancy/

A

prednisolone

49
Q

Which can be used in pregnancy?

a. hydroxychloroquine
b. azathioprine
c. LMWH
d. UFH

select all that apply

A

all of them

50
Q

What must a pt be positive for to use belimumab?

A

autoantibodies

51
Q

SLEDAI score of <=__ is low disease activity

A

4

52
Q

Remission is SLEDAI score of what?

A

0

53
Q

cyclophosphamide lupus nephritis low dose induction dose?

A

every 2 weeks for 6 doses

54
Q

cyclophosphamide lupus nephritis high dose induction dose?

A

once a month for 6 months

55
Q

Use a higher or lower dose of azathioprine in Asian pts?

A

lower

2g

56
Q

What is primary prophylaxis for antiphospholipid syndrome?

A

hydroxychloroquine + low dose aspirin

in pts with positive lupus anticoagulants or persistent anticardiolipin antibody

7262 MS Block 2 (10 decks)

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