SLE Flashcards
which population of people usually gets lupus?
- women in reproductive years
low physiologic level of self-reactivity plays an essential role in what
- lymphocyte selection and maintenance of normal immune system
problem with B cells in SLE
- defective selection/signaling
- autoantibody production
problem with T cells in SLE
- increased numbers of Th17 and Th2
- decreased Tregs
- less susceptible to activation-induced death
problem with PDCs in SLE
- produce large amount of interferon
- stimulation activation and proliferation of auto reactive T and B cells
natural autoantibodies are Ig__
pathogenic autoantibodies are Ig_
- IgM
- IgG
pathogenic autoantibodies directly target cells through cross-reactivity with
- other antigens
ANA in SLE is sensitive or specific
- sensitive
what is the most reliable method for detection of ANA
- immunofluorescence
because of low specificity, ANA usefulness increases with the pretest probability for lupus is (high/low)
- high
anti-ds DNA is specific in lupus for ____-
- nephritis
Anti-Smith is specific in lupus for _____
- no specific organ
- against snRNPs
why is the crithidia assay felt to be more specific because of the kinetoplast
- because kinetoplast contains only dsDNA
SLE is characterized by periods of ____ and periods of ____
- periods of flare
- periods of remission
predictors of SLE flare include:
- new evidence of ______ consumption
- rising _____ titers
- increased ____ (marker)
- new _____ (hematologicL
- complement
- anti-dsDNA
- increased ESR
- new lymphopenia
if you have a young woman presenting with a stroke, what condition should you think of?
- lupus!
mucocutaneous system in SLE symptoms
- malar rash
- discoid rash
- oral ulcers
- photosensitivity
musculoskeletal symptoms in SLE
- arthralgia
- jaccoud’s arthropathy (deforming inflammatory arthritis)
- inflammatory myopathy (inc CPK/aldolase)
- fibromyalgia
- avascular necrosis
avascular necrosis has an increased risk with what medications
- high dose steroids
neuropsychiatric symptoms of SLE
- altered mental status
- CVA
- depression
- seizure
- mononeuritis multiplex
- neuropathy
- Gillian barre, myasthenia gravis
the major risk for a CVA in SLE is in the first ___ years of disease
90% of CVAs are what type
10% are what type
- 5
- ischemic
- hemorrhagic
GI symptoms of lupus
- nonspecific symptoms of n/v/anorexia
- dysphagia or pain with swallowing
- GERD
- mesenteric vasculitis
- lupus enteritis
hematologic symptoms of lupus
- anemia (ACD, iron deficiency, AIHA)
- leukopenia (lymphopenia)
- thrombocytopenia (ITP)
what is an acquired disorder associated with circulating autoantibodies to anionic phospholipids and their protein binding complexes
- antiphospholipid antibody syndrome
the primary clinical manifestations of antiphospholipid syndrome are
- thromboses
secondary antiphospholipid syndrome is often associated with which disease
- SLE
autoantibodies to test for antiphospholipid syndrome
- anticardiolipin
- anti-beta 2-glycoprotein
- lupus anticoagulant
treatment for antiphospholipid syndrome
- anticoagulation
pulmonary disease of SLE
- restrictive pulmonary disease
- lupus pleuritis
- pleural effusion
- pulmonary hemorrhage
lupus pneumonitis occurs during a ____
- flare
lupus pneumonitis looks like ____-
- infectious pneumonia
a patient who has an abrupt onset of dyspnea, cough, fever, infiltrates, and a dramatic fall in hemoglobin most likely has what
- pulmonary hemorrhage
heart diseases in SLE
- pericarditis
- myocarditis
- Libman sacks endocarditis
which antimalarial do we use in treating SLE
MOA
- hydroxychloroquine
- antagonist on TLR 3,7,8,9
- decreases innate activation of innate immune system
- also has anticoagulant properties
what is the first FDA approved treatment for SLE
- Belimumab
