SLE

Question 1

pathogenesis of lupus

Answer 1

loss self tolerance

product of immune complexes - autoantibody and antigen deposition in affected organs

Question 2

constitutional symptoms

Answer 2

fatigue, fever and weight loss

Question 3

join symptoms

Answer 3

arthritis and arthralgia
early morning stiffness
jaccouds arthropathy

Question 4

skin

Answer 4

acute lupus malaria rash (granular deposition of IgG in basement membrane zone on direct immunofluorescence of lesions skin)

Question 5

hair

Answer 5

alopecia

Question 6

nail

Answer 6

vasculitis lesions around nail folds

Question 7

hands

Answer 7

raynauds

Question 8

vascular

Answer 8

palpable purpuric lesions on the shins in a patient with lupus and nectrosing vasculitis of the skin, kidney and brain

Question 9

renal

Answer 9

lupus nephritis - asymptomatic haematuria and/or proteinuriaa

nephrotic syndrome and rapidly progressive glomerulonephritis with loss of renal function

Question 10

pulmonary

Answer 10

pleuritis 
pneumonitis
ILD - honeycomb and reticular markings 
pulmonary HTN 
shrinking lung syndrome (restrictive lung defect)
alveolar haemorrhage

Question 11

cardiac

Answer 11

pericarditis (libman-sakcs) endocarditis
myocarditis
coronary artery disease

Question 12

neuropsychiatric

Answer 12

cognitive dysfunction
organic brain syndromes
delirium
psychosis
seizures
headache
peripheral neuropathies

Question 13

ophthalmogical

Answer 13

keratoconjunctivitis sick

Question 14

haematological

Answer 14

anaemia
leukopenia
thrombocytopenia
lymphadenopathy
splenomegaly

Question 15

GIT

Answer 15

oesophagitis
intestinal pseudo obstruction
protein losing enteropathy
lupus hepatitis
acute pancreatitis
mesenteric vasculitis or ischaemia
peritonitis

Question 16

antibodies

Answer 16

anti nuclear antibody
anti ds DNA anitbody
complement levels decrease
(Igs)
(antiphospholipid antibodies)

Question 17

specific investigations

Answer 17

• nailfold capilleroscopy - dilated or thrombotic nail folds in CTD
• thermography: raynauds
• schemers tear: sjogrens
• DEXA scan
• hand and foot X rays - arthropathy
• USS hands - arthropathy
• histology of kidneys shows IgG deposits