OnlineMedEd - Rheumatology: Lupus

Question 1

Lupus results from the formation of ______________.

Answer 1

autoimmune complexes

Question 2

Go through the MD SOAP BRAIN mnemonic.

Answer 2

• Malar rash
• Discoid rash
• Serositis
• Oral ulcers
• Arthritis
• Photosensitivity
• Blood disorders (anemia and thrombocytopenia)
• Renal failure
• ANA positive
• Immune disorders
• Neurologic (cerbritis, AMS, psychosis)

Question 3

What things are not captured in the MD SOAP BRAIN mnemonic?

Answer 3

• Alopecia
• Libman-Sacks endocarditis
• Miscarriages

Question 4

Lupus has a predilection for which joints?

Answer 4

Large joints (knees, hips, shoulders, elbow)

Question 5

Which autoantibody is most associated with lupus nephritis?

Answer 5

Anti-dsDNA

Question 6

What markers are used to assess potential lupus flares?

Answer 6

C3 and C4

These markers typically go down during lupus flares, so if you are questioning whether a patient has lupus flare up versus another disorder (like encephalitis or pneumonia), then C3 and C4 are useful.

Question 7

Which two agents can help treat lupus nephritis?

Answer 7

IV cyclophosphamide and oral mycophenolate mofetil

Question 8

Drug-induced lupus is caused by which antibody?

Answer 8

Anti-histone antibody

Question 9

What is a key difference between drug-induced lupus and regular lupus?

Answer 9

Drug-induced lupus has no visceral symptoms (like cerebritis or nephritis).

Question 10

List the agents that can cause drug-induced lupus.

Answer 10

• Hydralazine
• Isoniazid
• Phenytoin
• Procainamide
• Etanercept
• Methyldopa

Question 11

In most nephritic syndromes, you don’t obtain a kidney biopsy for diagnosis. With suspected lupus nephritis, however, you do. Why?

Answer 11

The treatment for lupus nephritis is so toxic (IV cyclophosphamide), that you want to be sure before you give it to them.