SLE

Question 1

epi of lupus

Answer 1

10x more common in females
mostly dx in women of child bearing age

Question 1

define lupus

Answer 1

multisystem chronic autoimmune disease

Question 2

RF lupus

Answer 2

1. genetics
2. smoking
3. UV radiation
4. exposure: silica
5. female of child bearing age
6. drugs: procainamide and hydralazine
7. infectious: EBV

Question 3

patho of lupus

Answer 3

genetic predisposition where body is less effective at clearing out nuclear debris ➔ nuclear antigens that the body can now react to
- due to genetic sus, may also produce those autoreactive ab vs self antigens

T3 hypersensitivity rxn to nuclear antigens ➔ ab-ag complexes ➔ deposit in multiple different systems ➔ inflammation and damage

T2 hypersensitivity rxn ➔ autoab are produced vs blood cells ➔ cytopenias

Question 4

s/s of lupus

Answer 4

flares and remission
1. cutaneous: photosensitivity, malar rash, discoid, alopecia, petichiae
2. MSK: Jaccoud arthropathy, polyarthritis in joints of hands, wrist, and knees, rheumatoid nodules
3. lungs/heart: pleural effusion, pericarditis, Libman Sacks endocarditis
4. lupus nephritis
5. constitutional: fever, malaise, wt loss
6. GI: esophageal dismotility

Question 5

ix for lupus

Answer 5

ANA
anti-dsDNA
anti-Smith
C3 and C4
antiphospholipid syndrome antibodies

others to check for organ damage for s/s
- kidney + UA
- lytes
- RF - r/o RA
- consider imaging of joints – would see active synovitis (key characteristic for inflam arthritis)

Question 6

tx for lupus

Answer 6

refer to rheum!
1. hydroxychloroquine ➔ monitor for eye cx
2. steroids + bisphosphonates for LT use
4. consider immunosuppressants if not controled via hydroxychloroquine ➔ MXT

pt education: sun protection, avoid triggers if identified, smoking cessation