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Rheumatology > Systemic Lupus Erythematosus > Flashcards

Systemic Lupus Erythematosus Flashcards

1
Q

What is SLE?

A

multisystemic autoimmune inflammatory disorder fo connective tissues

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2
Q

What are the leading causes of mortality in SLE?

A
  • Chronic Renal Failure (first)
  • infection
  • CVD
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3
Q

What are the RF for SLE?

A
  • F
  • afro-caribbean
  • Asians
  • HLA B8
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4
Q

What is the pattern of clinical features of SLE?

A
  • Relapsing (becomes more severe) and remitting (becomes less severe)
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5
Q

What type of hypersensitivity is SLE?

A
  • Type 3 (immune Complex mediated)
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6
Q

What is the Px of SLE?

A
  1. B-cells produce anti nuclear antibodies
  2. Target nuclear antigens on cells - inflammatry response
  3. antibody-antigen complex formed and stick to vessel walls of skin, kidneys, heart, joints
  4. Deposition of complexes initiate local inflammation to occur
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7
Q

What are the 11 key findings of SLE?

*remember the 4 groups (skin, membranes, extraglandular, blood)

A
  • Skin (rashes appear after sun exposure)
    • Malar rash - nasolabial fold spared
    • Discoid rash
    • Photosensitivity of skin
  • Membranes
    • ulcers in mouth and nose
    • serositis
  • Extraglandular
    • arthritis
    • diffuse proliferative glomerulonephritis - kidney damage
    • neuropsychiatric disorders
  • Blood
    • anaemia
    • thrombocytopenia
    • leukopenia
    • ANA - sensitive but not specific
    • Anti-Smith - specific but not sensitive
    • Anti dsDNA
    • Anti phospholipid
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8
Q

What are the non specific sx of SLE?

A
  • fever
  • Weight loss
  • Fatigue
  • lymphadenopathy
  • SOB
  • Raynaud’s phenomenon
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9
Q

What are the diagnostic criteria for SLE?

*remember SOAP BRAIN MD

A
  • Seroritis
  • Oral ulcers
  • Arthritis
  • Photosensitivity
  • Bloods (all low)
  • Renal (protein)
  • ANA
  • Immunologics
  • Neurologic Malar rash
  • Discoid rash
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10
Q
A
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11
Q

What Ix would you order for SLE?

A
  • autoantibodies (ANA): Sensitive but not specific
  • dsDNA & anti smith: more specific
  • FBC
  • Inflammatory markers
  • C3 & C4: low
  • C3d & C4d: high
  • urineanalysis - urine protein:creatinine ratio
  • renal biopsy
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12
Q

What drugs causes drug-induced SLE?

*remember SHIPP

A
  • Sulfonamide
  • Hydralazine
  • Isoniazid
  • Procanamide
  • Pheytoin
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13
Q

Who are at risk of drug induced lupus?

A
  • genetically predisposed individuals who are slow acetylators
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14
Q

What are the Cx of SLE?

A
  • Kidneys
    • lupus nephritis
  • Heart
    • CAD
    • Pericarditis, Myocarditis, endocarditis
  • Lungs
    • Pleuritis
    • ILD
  • Infection
  • Anaemia of chronic disease
  • recurrent miscarriage
  • venos thromboembolism - caused by aniphospholipid syndrome
  • Neuropsychiatric SLE
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15
Q

How does neuropsychiatric SLE present?

A
  • optic neuritis
  • transverse myelitis
  • psychosis
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16
Q

Whata are the Tx for SLE?

A
  • First line
    • NSAID
    • Steroid
    • Hydroxychloroquin
    • Sunscream and sun avoidance
  • Maintenance
    • Methotrexate
    • Azathioprine
    • Mycophenelate Mofetil
  • Severe
    • Rituximab
    • Belimumab
17
Q

What is Belimumab?

A
  • monoclonal antibody that targets b cell activating factor
18
Q

What does antiphospholipid syndrome cause?

*rememeber CLOT

A
  • Coagulation defect
  • Livedo reticularis
  • Obstetric (recurrent miscarriage)
  • Thrombocytopenia
19
Q

What skin disorders is commonly seen in SLE?

A
  • Alopecia
  • Livedo reticularis
  • Photosensitivity
  • Butterfly rash
20
Q

What antibody is associated with drug induce lupus?

A
  • anti-histone antibodies
21
Q

What drug causes drug induced lupus?

A
  • hydralazine
  • procanamide
  • isoniazid
  • quinidine

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