Rheumatology

Question 1

While typically a slowly progressive disease presenting with relatively unimpressive systemic and joint symptoms, SLE can present dramatically with what disease processes?

Answer 1

1. MAS
2. Significant thromboembolic events
3. Sudden onset of severe kidney disease.
4. Neuropsychiatry disease

Question 2

In children, what are the three most common initial manifestations of SLE?

Answer 2

1. Hematologic disorders (anemia, thrombocytopenia, leukopenia)
2. Mucocutaneous changes (including ulcer, malar rash)
3. Joint pain

Question 3

You are caring for a 16 year old female who presents with a platelet count of 56,000. There is no evidence of bleeding. Other cell lines are normal. You follow CBCs over several months but the thrombocytopenia persists. What rheumatologic disease should be on your differential?

Answer 3

SLE

Question 4

What is the first line laboratory screen for SLE?

Answer 4

ANA

Question 5

What are second line laboratory tests to follow up a positive ANA when SLE is clinically suspected?

Answer 5

anti-dsDNA
anti-Rho
anti-Smith
anti-La
anti-RNP
direct Coomb’s
Lupus anticoagulant
anti-cardiolipin

Question 6

What are the mainstays of SLE therapy?

Answer 6

1. Hydroxychlorine
2. Steroids
3. Mycophenalate
4. Other immunomodulators