SLE

Question 1

History

Answer 1

• 15-40 years
• Increased frequency among polynesians Asians and Africans
• Female
• History of CNS involvement
  • Psychosis
  • Seizures
  • Headaches
  • Cognitive dysfunction
• History of GIT involvement
  • Bleeding
  • Diarrhea
• History of weight los and fever

Question 2

Hands

Answer 2

• Haemolytic anemia (mention lymphopenia, leukopenia and thrombocytopenia)
• Raynaud’s
• Talangiectasia
• Digital gangrene

Question 3

Wrist

Answer 3

• BP and HR changes due to fever and heart involvement

Question 4

Forearm

Answer 4

• Discoid rash (30%, raised red patches with scarring also seen on hands and face)
• Skin ulceration (vasculitis)
• Evidence of hemorrhage
  • Petechial
  • Purpura
  • Bruising
• Photosensitivity
• Alopecia (40%, may also see on head)

Question 5

Head and Eyes

Answer 5

• Retinal hemorrhage
• CNII III IV VI palsy (CN exam)
• CNS involvement required UMN exam

Question 6

Mouth

Answer 6

• Oral or nasophyaryngeal ulcers

- Bleeding gums

Question 7

Neck

Answer 7

• Lymphadenopathy

Question 8

Chest

Answer 8

Endocarditis
Symptoms;
- Fatigue, fever chills, headache, joint and muscle spasm, night sweats, SOB, anorexia/weight loss haemoturia
Signs;
- Anaemia, splenomegaly, tender spleen janeway lesions, osler’s nodes, purpuric/pertechial rash, heart murmurs, odema, arrhythmias
Myocarditis
Symptoms;
- Precordial pain, SOB, fatigue, fever
Signs;
- Arrhythmia, heart failure ssx eg lower limb odema, murmurs and pulmonary odema
Pleuritis = Pain, rub, effusion
Pericarditis = Precordial pain, pericardial rub, pericardial effusion

Question 9

Abdomen

Answer 9

• Splenomegaly

- Palpate kidney if renal involvement Is suspected

Question 10

Musculoskeletal

Answer 10

• Muscle pain (secondary to inflammatory myopathy)
• Synovitis (non-erosive)
• > 2 peripheral joints (fingers, wrists, knee, toes)
• Symmetrical
• Morning stiffness