SLE Flashcards

1
Q

in someone with SLE what is a typical esr and crp reading

A

esr 100, crp is 0

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2
Q

describe whate you would expect to find in a person with sle when looking at blood cells and complement

A

cytopenia(low blood cells) and low complement c3/c4

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3
Q

list the targets of autoantibodies in SLE

A

dna, nucleosomes, C1q, a actinin, Sm, NDMA receptor

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4
Q

systemic lupus erthematosus is a multi system autoimmune is this statement true

A

yes

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5
Q

what environmental factors can trigger sle

A

sunlight, drugs smoking and viruses

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6
Q

how do genes contribute to SLE

A

the genes cause defective apoptosis, which creates autoantigens, stimulates immune response against self

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7
Q

what factors contribute to SLE as it’s direct cause is unknown

A
Female hormones
• Genetics
• Drugs
• Environmental factors
• Ethnic origin
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8
Q

who is most likely to get sle

A

females and individuals of african and asian

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9
Q

name some symptoms of sle in women aged 15-45

A

malaise, fatigue, hair loss, arthritis, aches and pains, mouth ulcers, rashes

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10
Q

what are the types of cutaneous lupus

A

discoid lupus(coin shaped lesions) and subacute acute cutaneous lupus

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11
Q

sle lesions feel cold to touch and are on the hands and feet what are they called

A

chillblain lupus

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12
Q

lupus can also cause lupus vasculitits name examples of small vessel vasculitis

A
  • Splinter haemorrhages
  • Digital infarcts
  • Palpable purpura
  • Vasculitic ulcers
  • Urticarial vasculitis
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13
Q

medium or large vessel vasculitis can result in …

A

Digital ischaemia/gangrene

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14
Q

course of sle follows three stages, pre clinical, clinical disease, comorbididties. state what each stage is represented by

A

pre clinical just autoantibodies, clinical disease involves organs and flare ups and damage.

comorbidities comes last and involves infections, malignancies and atherosclerosis

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15
Q

what can peripherial vascular disease cause in SLE

A
  • Critical limb/digital ischemia
  • Gangrene
  • Amputations
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16
Q

how can lupus affect the pulmonary system

A

lupus pnemonitis or lupus serositis

17
Q

lupus can affect the heart causing pericarditis how is it treated

A

Common
Rapidly resolves with corticosteroids
Rarely leads to tamponade

18
Q

list the ways in which lupus can effect the cardiac system

A

pericarditis, endocarditis,myocarditis,

19
Q

name some features of Neuropsychiatric lupus

A
  • Psychosis
  • Seizures
  • Strokes
  • Psychological disorders
  • Transverse myelitis
20
Q

SLE can affect the kidneys cause lupus nephritis what are some of the presenting features

A
Asymptomatic proteinuria
Nephrotic syndrome
Renal failure
Rapidly progressive glomerulonephritis
Dysmorphic / fragmented red cells
Granular casts
21
Q

Because SLE is a chronic condition what three things should be kept in mind when assessing it

A

disease activity, quality of life and damage

22
Q

how do you assess disease activity in sle

A

Bilag, SLEDAI

23
Q

how do you assess quality of life in lupus

A

LupusQoL

SF36, HAQ

24
Q

what are the aims of sle treament

A

prevent disease flares, avoid long term damage, Induction and maintenance of durable remission
-Minimise toxicity and treatment related damage

25
how can you treat sle
first off avoiding sun, using sunscreen, topical steroids, stop smoking and analgesics (not NSAIDS contra), then cortico steroids after these steps, then after that monoclonal antibodies such as belimumab
26
why should caution be used when treating sle with corticosteroids
Excessive doses: 1mg/kg/day NOT evidence based! Major contributor to damage Use the lowest effective dose for the shortest period of time
27
name some antimalarials used to treat sle
Hydroxychloroquine • Mepacrine/Quinacrine • (Chloroquine) • Combination antimalarials
28
indivudal has been given sle intial sle treatment but has renal issues and fertility issues what treatments should they be given
severe treatment cyclophosphamide,Mycophenolate , iv methylprednisolone
29
what is The Antiphospholipid syndrome in SLE
antiphospholipid antibodies which can cause thrombosis or pregnancy morbidity
30
cns lupus can cause strokes and tias how can we treat this
anti coagulation
31
how do you treat systemic sclerosis form sle in early stage
Treatment | • Early: low dose steroids immunosuppressives
32
how do you treat systemic sclerosis form sle in late stage
Late: Symptomatic Rx | BP control