SLE and vasculitis random teaching

Question 1

Common presentation SLE

Answer 1

• Painful joints with no swelling

Question 2

Diagnosing SLE

Answer 2

3 of 11 domains + serology

Question 3

Serology for SLE

Answer 3

anti-dsDNA - if high, high risk of damage to kidney
Complement too

Question 4

Serositis - what is it?

Answer 4

• Mouth ulcers
• Pleural effusion
• Pericardial effusion

Question 5

Treatment for any life or organ threatening disease

Answer 5

Cyclophosphamide

Question 6

What can vasculitis be secondary to?

Answer 6

Stimuli such as infection or solid tumours

Question 7

Male or female more common for vasculitis?

Answer 7

Women - all rheum more common in women other than Ank Spond, GPA, gout

Question 8

Granulomatosis with polyangitis triad

Answer 8

• Upper airway effects
• Lung effects
• Renal effects

Can also get proptosis and cranial nerve palsy

Question 9

Treatment for GPA

Answer 9

Avacopan - very EXPENSIVE
For ANCA positive

Question 10

Polymyalgia rheumatica symptoms

Answer 10

• Difficulty getting out of chair and combing hair - proximal muscle weakness
• Raised ESR/CRP

Question 11

Differentials for polymyalgia rheumatica

Answer 11

• Infection - TB, subacute bacterial endocarditis
• Lymphoma or Myeloma

Question 12

Side effects of steroids

Answer 12

• Osteoporosis
• Weight gain
• Hyperglycaemia
• High BP
• Cushings syndrome - high cortisol
• Adrenal suppression
• Muscle loss
• Decreased wound healing
• Oedema
• Immunocompromised
• Cataracts
• Thinning of skin

Question 13

Signs/symptoms of SLE

Answer 13

Head to toe:
* Headache
* Hair loss
* Rash (malar?)
* Dry eyes/mouth ulcers
* Respiratory
* GI and urinary symptoms

Question 14

Associated conditions of SLE

Answer 14

Raynauds
Photosensitive rash

Question 15

Most common cause of malar rash

Answer 15

Acne
Can be mitral flush - stenosis of mitral valve