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LAB DIAG > M1: SLE > Flashcards

M1: SLE Flashcards

0
Q

Strongest risk factor SLE

A

Female gender (more common in african than caucasian)

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1
Q

Chronic multisystem inflammatory disease. Associated with abnormalities of immune system. Results from interactions among genetic, hormonal, environmental and immunologic factors. Affects the skin, joints, serous membranes, renal, hematologic & neurologic.

A

Systemic Lupus Erythematosus

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2
Q

Pathophysiology: Autoimmune reactions directed against constituents of _____________. Antibody response related to ____ & ____ cells.

A

Cell nucleus & DNA. B & T cells.

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3
Q

SLE Classification Criteria: presence of biopsy proven __________ with ______ or anti-dsDNA antibodies.

A

Lupus nephritis. ANA.

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4
Q

SLE Classification Criteria: If ____ of the diagnostic criteria, including at least 1 _________ criterion has been satisfied.

A

Four. Immunologic.

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5
Q

Manifestations for SLE “SOAP BRAIN MD”

A

Serositis, Oral ulcers, Arthritis, Photosensitivity, Blood disorders, Renal dev’t, Antinuclear antibodies, Immunologic phenomena(dsDNA; anti smith sm antibodies), Neurologic, Malar rash & Discoid rash

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6
Q

Clinical Manifestations: cutaneous vascular lesion, butterfly rash, oral/nasopharyngeal ulcers & alopecia.

A

Dermatologic

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7
Q

Clinical Manifestations: Polyartharalgia, Arthritis, swan neck fingers, ulnar deviation & subluxation w/ hyperlaxity of joints.

A

Musculoskeletal

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8
Q

Clinical Manifestations: tachypnea, pleurisy, dysrhythmias, accelerated CAD & pericariditis.

A

Cardiopulmonary

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9
Q

Clinical Manifestations: ranging from mild proteinuria to glomerulonephritis.

A

Lupus nephritis Renal

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10
Q

Primary goal of treatment for lupus nephritis

A

Slowing the progression

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11
Q

Clinical Manifestations: generalized focal seizures, peripheral neuropathy, cognitive dysfunction like disorientation, memory deficits & psychiatric symptoms.

A

Nervous system

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12
Q

Clinical Manifestations: formation of antibodies against blood cells, anemia & leukopenia.

A

Hematologic

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13
Q

Clinical Manifestations: increased susceptibility to MO. Fever considered serious.

A

Infection

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14
Q

Common cause of death for SLE

A

Infections like PNA

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15
Q

Criteria for Dx of SLE: _____ & _____ rashes.

A

Malar & Discoid

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16
Q

Criteria for Dx of SLE: oral ______.

A

Ulcers

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17
Q

Criteria for Dx of SLE: nonerosive. Involvement of two or more joints characterized by tenderness, swelling and effusion.

A

Arthritis

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18
Q

Criteria for Dx of SLE: pleuritis or pericarditis.

A

Serositis

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19
Q

Criteria for Dx of SLE: renal disorder

A

Persistent proteinuria or cellular cast in urine

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20
Q

Criteria for Dx of SLE: neurologic disorder

A

Seizures/psychosis

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21
Q

Criteria for Dx of SLE: hemolytic anemia, leukopenia, lymphopenia & thrombocytopenia.

A

Hematologic disorder

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22
Q

Criteria for Dx of SLE: positive LE preparation, anti-DNA antibody, or antibody Sm nuclear antigen or false positive serologic test for syphilis.

A

Immunologic disorder

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23
Q

Criteria for Dx of SLE: _______ antibody.

A

Antinuclear

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24
Q

Is a type of antibody directed against the cell’s nuclei. It is present in nearly everybody with active lupus. Commonly use as a screening tool.

A

Antinuclear Antibody (ANA)

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25
Q

Limitations of ANA: a _______ doesn’t necessarily indicate Lupus. This result is often seem with some other diseases and in smaller percentage of people w/out lupus or other autoimmune disorders. Not enough for lupus diagnosis.

A

Positive

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26
Q

Screening test

A

Sensitive

27
Q

Confirmatory test

A

Specific

28
Q

Is also associated with Mixed Connective Tissue Dse & Rheumatoid Arthritis

A

ANA

29
Q

Techniques used to detect ANA

A

Agglutination, Enzyme immunoassay & Immunofluorescence “AEI”

30
Q

Indirect Immunofluorescence result in ANA: evenly stained (associated with anti-DNA antibody and histones)

A

Diffuse/Homogenous

31
Q

Indirect Immunofluorescence result in ANA: stains edge of nuclei(anti-DNA antibody & anti-lamins antibody)

A

Peripheral

32
Q

Indirect Immunofluorescence result in ANA: numerous evenly distributed stained within nuclei (anti-RNP or ribonucleoprotein and anti-Smith antibody)

A

Speckled

33
Q

Indirect Immunofluorescence result in ANA: stains two or three large fluorescent area within nuclei (anti-RNP antibody)

A

Nucleolar

34
Q

Indirect Immunofluorescence result in ANA: stains a discrete speckled pattern d/t anti C antibody.

A

Centromere

35
Q

Are a type of antibody directed against phospholipids. Present in up to 60% of people with lupus. A positive test is also used to help identify women with lupus that have certain risks that require preventive treatment and monitoring. Those risk include blood clots, miscarriage or preterm birth.

A

Antiphospholipid Antibodies

36
Q

Limitations of Antiphospholipid Antibodies: may also occur in people ____________. Their presence along is not enough for a lupus diagnosis.

A

Without lupus

37
Q

Is an antibody directed against a specific protein found in the nucleus. The protein is found in up to 30% of people with lupus. It’s rarely found in people without lupus. So a positive test may help confirm a lupus dx.

A

Anti-Sm

38
Q

Limitations of Anti-Sm: up to only 30% of people with lupus have a ___________ test, so relying on this results alone would miss a large majority of people.

A

Positive Anti Sm

39
Q

Is a diagnostic/confirmatory test for SLE and has high specificity if present, but has a low sensitivity, it is not enough for a lupus diagnosis and it should be done after a positive screening test.

A

Anti-Sm

40
Q

Is a protein directed against double stranded DNA. Between 70% and 90% of people with lupus has a positive anti-dsDNA test. Test is very specific for lupus. Therefore, a positive test can be useful in confirming a dx. The titer or level of antibodies rises as the disease becomes more active. Presence of anti-dsDNA indicates a greater risk for lupus nephritis.

A

Anti-dsDNA

41
Q

Limitations of anti-dsDNA: up to ____ of people have a negative test. So a negative test doesn’t mean a person doesn’t have lupus.

A

25%

42
Q

dsDNA is found in SLE as well as low titers in

A

RA & Sjogren sydrome

43
Q

Are two antibodies that are commonly found together. They are specific against RNA proteins. Associated with neonatal lupus.

A

Anti-Ro(SSA) & Anti-La(SSB)

44
Q

Is found anywhere from 24% to 60% of lupus patients. It is also found in 70% of people with another autoimmune disorder called ________.

A

Anti-Ro. Sjogren’s.

45
Q

Is found in 35% of people with Sjogren’s syndrome.

A

Anti-La

46
Q

In pregnant women, a positive Anti-RO(SSA) or Anti-La(SSB) warns doctor of the need to monitor the _______.

A

Baby

47
Q

Limitations of Anti-Ro & Anti-La: Like other antibodies, the fact that the test is not _______ in many people with lupus means it is not used to diagnosis of lupus. Also it is more indicative of _______ than lupus.

A

Positive. Sjogren.

48
Q

Is an inflammation of the salivary and lacrimal glands causing dryness of the mouth and eyes. Speckled or diffuse pattern in ANA.

A

Sjogren’s syndrome

49
Q

Against antigens in the cytoplasm of neutrophil & monocytes.

A

Antineutrophil Cytoplasmic Antibodies (ANCA)

50
Q

Wegener’s disease (60-90%)

A

c-ANCA

51
Q

Microscopic polyangitis(50-80%), UC(40-80%) & Chron’s(10-40%)

A

p-ANCA

52
Q

Is a protein in the body that can be a marker of inflammation which could be indicative of lupus. Are commonly used especially on the rural area because they are cheaper.

A

C-Reactive Protein (CRP)

53
Q

Limitations of CRP: Because there are many causes for an elevated result including _________. The test is not diagnostic for lupus nor can it distinguish a lupus flare from an infection. Also the level of CRP doesn’t directly correlate with lupus disease activity.

A

Infection

54
Q

Are involved in inflammation. The test can look for levels of specific complement proteins or total complement. The level of this are often low in patients with active disease, especially kidney disease.

A

Complement

55
Q

Limitations of Complement: Like other tests, complement must be taken in the context of ___________ and other test results. A ____ complement in itself is not a diagnostic of lupus.

A

Clinical findings. Low.

56
Q

Measures the speed of RBC moving toward the bottom of the test tube. Used as a marker of inflammation which could indicate of lupus activity.

A

ESR

57
Q

Limitations of ESR: like CRP, the ESR is not ______ to lupus. Because there are many causes for a positive result, including infection.

A

Specific

58
Q

To measure blood levels in different blood cells. Abnormalities in. Lood cell counts, including WBC & blood cells, may occur in people with lupus.

A

CBC

59
Q

In CBC, Is found in about 50% of people

A

Leukopenia & Thrombocytopenia (same with Lupus)

60
Q

Is a test to assess kidney and liver function. Abnormalities may indicate the development of complications from lupus.

A

Chemistry panel

61
Q

Measures how effective the kidneys are at filtering the blood to eliminate waste products. It is conducted on urine collected over a 24hr period.

A

Measurement of GFR & Proteinuria

62
Q

Performed on one urine sample. It measures for protein loss, which is an indicator of kidney function.

A

Protein/Creatinine ratio

63
Q

Can be used in screening for kidney disease. The presence of protein, RBC, WBC and cellular casts may all indicate kidney disease.

A

Urinalysis

64
Q

1 occassion

A

Leukopenia

65
Q

1 occasion

A

Lymphopenia

66
Q

<100x10^3 cells/uL in the absence of offending medications

A

Thrombocytopenia

LAB DIAG (6 decks)

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