Systematic Lupus Erythematosis Flashcards
SLE is a chronic inflammatory/multisystem disease that primarily affects ___ and ___. May also effect kidneys, lungs, heart, brain
Skin and joints
What are risk factors of SLE?
Infections, hypertension, dyslipidemia, atherosclerosis, diabetes
What is the clinical presentation of SLE?
Fever, joint pain, rash/ulcers around nose or mouth primarily
Could also have renal failure, HTN, edema, weight gain, photosensitivity
True or False? 35% of SLE-related deaths occur in patients <45 years old
True
What are drugs that can induce SLE?
Procainamide or hydralazine
What is needed in order to diagnose SLE?
Complete blood count:
Leukopenia, hemolytic anemia, thrombocytopenia
Increased SCr
Urinanalysis with microscopy
What is nonpharmacologic therapy for SLE?
Sun protection, tobacco cessation, exercise/weight control, pregnancy prevention, treating comorbid conditions
What is Lupus Nephritis (LN)?
Persistent proteinuria > 0.5g/day or >3+ by dipstick and/or cellurar casts
Can also be defined based on renal biopsy
What are the 6 classes of LN?
- Minimal mesangial LN
- Mesangial proliferative LN
- Focal LN (< 50% of glomeruli)
- Diffuse LN (> 50% of glomeruli)
- Membranous LN (can be class 3+5 or 4+5)
- Advanced sclerosing LN
How do you treat the 6 classes of LN?
1/2: no immunosuppression needed
3/4: steroids + immunosuppression
5/6: prednisone + mycophenolate mofetil (MMF)
All SLE patients with LN will receive what medication?
Hydrochloroquine
In a patient with LN, if proteinuria > 0.5g/24, you add what medication?
ACE-I or ARB
What is the BP goal of SLE patients?
< 130/80
Initiate a statin in an SLE patient if their LDL > ___
100mg/dL
What medication may exacerbate SLE?
Sulfonamides
There is a sulfa allergy in up to ___% of SLE patients
30%
What immunizations should be given to a patient with SLE once they are stable?
Pneumococcal, influenza, hepatitis B, HPV, haemophilus influenzae, and meningiococcal if splenectomized
Live vaccines must be administered at least 4 weeks prior to starting immunosuppressive drugs or 1 month after stopping (varicella, MMR, yellow fever)
What type of counseling is critical for a patient with SLE?
Contraception counseling
True or False? Pregnancy in a patient with SLE has a low risk of flares and lower complication rates
False. High risk of flares and higher complication rates
A patient with SLE should avoid pregnancy within ___ months of a flare up, acute LN, or stroke
6
Teratogenic drugs should be stopped ___ months prior to contraception
3
How do you manage SLE flares for a pregnant patient?
Azathioprine < 2mg/kg/day
Steroids
Cyclophosphamide (last line)
What medications are used to manage HTN in a pregnant patient?
Methyldopa or labetalol
What medications should be avoided in a pregnant patient with SLE?
ACE-Is, ARBs, diuretics, NSAIDs
