SLE

Question 1

Internal factors contributing to SLE include:

Answer 1

women 15-45, africans, hispanics, asians

Question 2

External factors contributing to SLE include:

Answer 2

Sun exposure, hormone, reproductive factors, virus, drugs, smoking

Question 3

what is the effect of UV on epidermal DNA?

Answer 3

inflammation, cytokine and free radical production

Question 4

Can OCP increased the risk of flares in women w stable SLE?

Answer 4

no

Question 5

Why is EBV seropositivity higher in pts w SLE?

Answer 5

molecular mimicry between Ags of EBV and SLE

Question 6

where can L-canavanine be found?

Answer 6

alfalfa sprouts

Question 7

why is L-canavanine not recommended for SLE pts?

Answer 7

cause ANA/anti-dsDNA, low complement proteins, and hemolytic anemia

Question 8

what is the most common and earliest SLE manifestation?

Answer 8

inflammatory arthritis

Question 9

what are the common manifestations of Jaccoud arthropathy?

Answer 9

hand deformities, ulnar deviation, swan neck/boutonniere/Z deformity, non-erosive subluxation

Question 10

Acute CLE is most common in___and presents with____

Answer 10

sick, young, fair-skinned women w photosensitivity

butterfly/malar rash (cheeks, sparing nasolabial folds)

Question 11

chronic CLE is most common in___and presents with___

Answer 11

POC pts, higher risk of hyperpigmentation and scarring

discoid CLE (head and neck), destructive scaly plaques w follicular prominence

Question 12

what is the most common place to get ulcers in SLE?

Answer 12

buccal mucosa

Question 13

what is the strongest predictor of morbidity and mortality in SLE?

Answer 13

renal involvement

Question 14

what common eye conditions are associated with SLE?

Answer 14

dry eye/keratoconjunctivitis due to Sjogren syndrome, retinal vasculopathy

Question 15

what is the most specific Ab test for SLE?

Answer 15

Anti-Smith, followed by Anti-dsDNA

ANA not specific

Question 16

which Ab gives the clearest evidence of lupus nephritis?

Answer 16

Anti-dsDNA

Question 17

Does Anti-smith levels need to be monitored? why?

Answer 17

no. titre doesn’t change during flares (unlike anti-dsDNA)

Question 18

low levels of which complement proteins indicate activation of the complement in SLE?

Answer 18

C3/4

Question 19

hereditary deficiency of which complement pathway is associated w SLE development?

Answer 19

classical

Question 20

what Tx classes are available for SLE?

Answer 20

• physical/lifestyle
• infection prevention
• cancer prevention/screening
• CV tx
• emotional measures
• NSAIDS
• antimalarials
• immunosuppressants

Question 21

which NSAIDs are preferred for SLE?

Answer 21

aspirin, naproxen, celecoxib (thrombotic risk)

Question 22

what effects do antimalarials have on SLE?

Answer 22

• immune suppressing (inhibit Ag presentation, decrease cytokine, block TLR)
• antithrombotic (plt and APLA)
• CV: increase HDL and LDL, reduce DM risk, increase vascular resistance
• antimicrobial

Question 23

what are the most used biologics in SLE?

Answer 23

rituximab and belimumab

Question 24

what are the benefits of hydroxychloroquinone?

Answer 24

-prevent flares and skin manifestations
-thrombosis protection
-prevent cardiac neonatal lupus
-improve immunosuppressant response for lupus nephritis
prolong life

Question 25

what is the danger of using hydroxychloroquinone?

Answer 25

ocular toxicity

Question 26

when ordering serum anti-dsDNA, which form of Ig should you not order?

Answer 26

IgM, not specific for SLE