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P year haematology > SLE > Flashcards

SLE Flashcards

1
Q

who does SLE normally present in?

A

women of afro-caribeean origin

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2
Q

what are general features of sle?

A

Fatigue
fever
mouth ulcers
lymphadenopathy

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3
Q

what are skin features of lymphadenopathy?

A 
malar rash that spares the nasiolabal folds
discoid rash
photosensitivity
raynauds
livedo reticularis
alopecia
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4
Q

what are MSK signs of lupus?

A

arthralgia

non erosive arthritis

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5
Q

what are CVS signs of lupus?

A

pericarditis

myocarditis

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6
Q

what are renal signs of lupus?

A

proteinuria

diffuse proliferative glomerulonephritis

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7
Q

what is the WHO classification of glomerulonephritis/

A 
class one: normal kidney
class two: mesangial glomerulonephritis
class three: focal and segmental proliferative glomerulopnephritis 
class four: diffuse proliferative glomerulonephritis
class five: sclerosing glomerulonephritis
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8
Q

what does renal biopsy show in diffuse proliferative glomerulonephritis?

A

endothelial and mesangial proliferation in a wire loop appearance

thickened capillary wall from immune complex deposition

subendothelial immune complex deposits

granular appearance

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9
Q

what is the management of renal disease in SLE?

A

Manage blood pressure
corticosteroids
azathioprine

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10
Q

what antibodies are associated with SLE?

A

90% ANA positive
20% rheumatoid factor positive
anti-dsDNA highly specific but less sensitiive
anti Smith: most specific

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11
Q

how can you monitor SLE?

A

c3 and c4 levels are low during active disease

anti dsDNA titres

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12
Q

what type of illness is lupus?

A

type 3 autoimmune illness.

B cell hyperactivity with abnormal T cell function and inappropriate complement activation

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13
Q

what are environmental triggers?

A

uv light
infection
durgs

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14
Q

what genetic markers are linked with lupus?

A

HLA A1
HLA B8
HLA DR3

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15
Q

What are features for the diagnostic criteria of sle?

A
  1. Arthritis involving at least 2 peripheral joints
  2. proteinurea/hypertension
  3. ANA+
  4. serositis/ pleuritis/ pericarditis
  5. haem involvement:
    low WCC/low PLT
  6. photosensitivity
  7. oral/nasopharyngeal ulcers
  8. antii-dsDNA/anti-smith/ anti phospholipid
  9. seizures/psychosis
  10. malar butterfly rash
  11. well demarcated discoid rash
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16
Q

what is the management of SLE?

A
  1. hydroxychloroquine to reduce disease flare up
  2. naproxen for joint pain
  3. immune suppression with azathioprine/ cyclophosphamide
  4. rituximba

*flare ups managed with steroids

17
Q

what can cause drug induced lupus?

A

hydralazine
procainamide
isoniziad
methyldopa

18
Q

what antibody is in drug induced lupus?

A

anti histone

P year haematology (12 decks)

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