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Musculoskeletal > Lupus and Sjogrens > Flashcards

Lupus and Sjogrens Flashcards

1
Q

Systemic Lupus Erythematosus definition?

A

Multi-system inflammatory disorder

Autoantibodies to numerous self antigens

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2
Q

Discoid lupus

A

only involves the skin though these Discoid lesions CAN be seen in SLE

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3
Q

Drug induced Lupus

A

Less severe than SLE

Self-limiting once the offending drug is removed.

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4
Q

Neonatal lupus

A

Newborns of mothers with SLE

-skin rash, heart block (permanant), thrombocytopenia

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5
Q

What are the three problems of neonatal lupus

A

skin rash, heart block(which is permanent), and thrombocytopenia

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6
Q

Female to male ration in lupus

A

13:1

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7
Q

Peak incidence of lupus?

A

Childbearing years

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8
Q

Racial discrimination

A

Blacks 3-4 times more likely

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9
Q

Lupus is called the disease of a thousand faces. WHy

A

Can present in tons of different ways

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10
Q

Common general symptoms of lupus

A

Malaise, fever, fatigue

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11
Q

Cutaneous manifestations of lupus

A

Malar rash, alopecia

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12
Q

Malar rash, along with other symptoms, get worse upon exposure to what?

A

SUN

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13
Q

Discoid lesions heal with…..

A

scars

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14
Q

Musculoskeletal complaints

A

Arthralgias, arthritis, myalgias, myositis

Arthralgia and myalgia are just joint and muscle pain. The -itis’ are inflammation

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15
Q

Ulnar deviation that can be corrected occurs in what dz?

A

Lupus

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16
Q

Ulnar deviation that cannot be corrected (fixed ulnar deviation) occurs in

A

Rheumatoid Arthritis

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17
Q

DrP Key: what kind of genetic deficiency confers the highest risk of dz

A

Complement Deficiency

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18
Q

DrP Key: This mutation is important in lupus and it points to impaired regulation of endogenous nucleic acids

A

TREX1

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19
Q

DrP Key: The production and affect of …… has emerged as central to Lupus Pathogenesis

A

Type 1 Interferon

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20
Q

Renal Disorders in lupus are correlated with the presence of what?

A

anti-dsDNA antibodies

If renal dz is active the anti-dsDNA is high

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21
Q

What is the most common renal structure affected

A

Glomerulus….they all CAN be affected.

  • – RBC casts in Urine
  • – And proteinuria…….this is a glomerulonephritis, dawg
22
Q

Psychiatric abnormalities in Lupus?

A

Depression, psychosis, cognitive abnormalities

23
Q

Neurological dz

A

STROKE, myelitis,

24
Q

What do you first do if a pt presents with neurological disease like a seizure and they have lupus?

A

EXCLUDE OTHER CAUSES like a brain tumor

25
Q

Heme manifestation

A

Anemia, thrombocytopenia, leukopenia

26
Q

Most common pulmonary maifestation

A

pleuritis with pleural effusion

27
Q

Most common cardiac manifestation

A

pericarditis

28
Q

What can happen on the valves

A

Libman sacks endocarditis

29
Q

Obstetrical complications of Lupus?

A

Small babies, and receurrent fetal loss

30
Q

Anticardiolipin/ antiphospholipid antibody syndrome can cause what?

A

blood clots, can lead to multiple miscarriages.

31
Q

Lupus classification mnemonis

A 
RASH PAIN O MD!!
R- renal
A- Arthritis
S- erositis (inflammation of the serous tissues of the body, pericardium, pleura, inner lining of abdominal cavity)
H- hematologic

P- Photosensitivity
A- ANA positive
I- Immunologic
N- Neurologic

O- Oral ulcers

M– Malar rash
D- discoid rash

4/11 needed

32
Q

Neonbatal lupus is due to the transplacental transfer of

A

Ro (SSA) and La (SSB)

33
Q

WHat is the antibody that everyone with Lupus has?

A

ANA (anti-nuclear antibody)

34
Q

Lupus antibodies

A

ANA- everyone has it
dsDNA- renal disease in lupus
RoSSA- neonatal lupus
La SSB- neonatal lupus
Anti SM- (smith antibody) very sensitive for lupus
Anti phospholid (anticardiolipin)- clots, abortions

35
Q

Clinical lupus check-up

A

Are you having any problems with allopecia, rashes arthritis?

Do you have any trouble taking a deep breath (pleurisy)

We’re gonna do a urnalysis (rbc cast, proteinuria) CBC (-penia, complements)

36
Q

What is key in the lupus pathogenesis

A

DEFECTIVE CLEARING OF ANTIGEN-ANTIBODY COMPLEX

GOTTA KNOW THAT

We don’t know what really causes itCDomplement

37
Q

WHere are the autoantibodies coming from in SLE

A

B cells….these suckers avoid apoptosis and produce bad abs

T cells….increased helpers and decreased suppresors

38
Q

Complement activation is huge in Lupus, for example, in the kidney

A

Immune complexes can form in the circulation and then deposit in the kidney, they may also form in situ

39
Q

What is the major cause of the hemolytic anemia, thrombocytopenia, and vasculitis in SLE

A

Antibody directed Cell mediated Cytotoxicity (ADCC)

Basically, antibody binds to cells, Fc receptors on NATURAL KILLER CELLS bind, target cell dies

40
Q

Anytime you hear ADCC

A

think NK cells

41
Q

What the fuck is anti-phospholipid syndrome

A

You get antibodies to the phospholipids involved in clotting. Leads to a jacked up PTT time but somehow a hypercoaguable state.
It is significant because it can lead to thrombosis and recurrent fetal loss

42
Q

Sjogren’s syndrome is divided into what two types

A

primary and secondary

43
Q

What are teh three big clinical hallmarks

A

kerratoconjunctivitis sicca
parotid gland swelling
xerostima

44
Q

Extraglandular features of sjogrens

A

fatigue, Raynaud’s, polyarthritis, arthralgias, ILD, neuropathy, purpura

45
Q

Classic histological finding in Sjogren’s disease is?

A

mononuclear cell infiltrates in the lacrimal and salivary glands

46
Q

90% of sjogrens pts are what sex?

A

female

47
Q

What is Schirmer’s test?

A

a test which uses filter paper to document tear flow

48
Q

Sjogren’s disease leads to a 44 fold increase in

A

risk for non-hodgkins lymphoma

49
Q

What type of immune cell is the predominant player in sjogren’s syndrome?

A

T cells (CD4)

50
Q

Common lab findings in Sjogren’s syndrome?

A

ANA, high rheumatoid factor, Anti-RoSSA, Anti- LA/SSB

Musculoskeletal (23 decks)

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