Unit 3 - CVD Pt 2 Flashcards
lupus ratio/incidence
female:male 8:1
peak incidence in 40s
lupus etiology
Autoimmune etiology
Antigen-antibody Immune complexes formed
Antibodies formed to DNA
types of lupus
Discoid (skin)
Systemic (SLE-skin & Internal organs)
- 30% have Rheumatoid factor
skin
if on scalp - alopecia
- scarring, esp with sunlight
butterfly rash - 80%
- capillary dilations on skin: telangiectasis
joints
Polyarthritis, asymmetrical Inflammatory joint disease Pannus Cartilage Destruction Osteophytes Narrow joint space
kidneys
Nephrovasculitis
Nephritis
Renal Vessels are Partially Occluded
Renal induced hypertension
Decreased blood flow through the kidney causes the kidney to release renin
hypertensive crisis
Systolic BP >180 mmHg Diastolic BP >110 mmHg) Increased Intracranial pressure Seizures Intracranial hemorrhage Ventricular dysfunction Dysrhythmias
mucous membranes
autoantibodies have affected collagen, causing nodule and ulcer formation in mouth
CNS/PNS
localized nodules that result in memory loss, dementia, and seizures
involvement in PNS can cause both sensory and motor loss
liver
hepatic nodules with scarring can decrease liver function
can lead to liver failure
lungs/pleura
Pleural Fibrosis
Pleural inflammatory nodule formation
Interstitial Lung Disease
cardiovascular system
Valvulitis
Mitral Valve Nodule formation on the suggests a stenotic valve
Myocarditis-note the inflammatory lesions/nodules
Generalized Vasculitis
Vessel Occlusion
vascular system
Aneurysm: Abnormal blood flow, Thrombus (clot), Vessels may leak or Rupture
Abdominal Aortic Aneurysm (Triple A)
Most common site of Aneurysm Formation
Raynaud’s
40%
fingers become white from lack of blood flow, then blue as vessels dilate and red when blood returns
SLE evaluation criteria (3)
Most will have a blood dyscrasia Counts will be reduced < Normal 1. Anemia (hypochromic, microcytic) 2. Thrombocytopenia (low platelet count) 3. Leukocytopenia (low WBCs)
Skin lesions/rash
Butterfly rash
Arthralgia (due to arthritis)
Serological Findings
Rheumatoid factor (30%)
Antinuclear Antibody or ANA (95%)
Antibodies against proteins in cell nuclei
+LE cells (1948)
+ Anti-Smith (anti-Sm) antibodies: Bind to RNP in the cell nucleus
+ Anti-ribonuclear protein (anti-RNP) antibodies: Bind to RNP in the cell nucleus
LE cell
An LE cell is a neutrophil or macrophage that has phagocytized (engulfed) the nuclear material of another cell.
nucleus is pushed to one side and flattened against the cell membrane of the PMN
scleroderma
CVD that causes the skin to become dense, fibrous, thickened, and tight
F:M 3:1
types of scleroderma
Skin (Morphea) type Systemic Type (Systemic Sclerosis) Skin plus internal organs
drawn pursed lips, shiny skin over the cheeks and forehead, and atrophy of muscles of the temple, face, and neck.
appearance of scleroderma
Skin tightness
Mauskopf (Mouse head) face
Telangiectasias
Raynaud’s
Scleroderma variants:
Diffuse Systemic Sclerosis
Seen in some people with systemic sclerosis
Can be aggressive with poor prognosis
Scleroderma Variants:
C R E S T Variant
Variant-seen in most people with systemic sclerosis
CREST is an acronym for: Calcinosis Raynaud’s Esophageal dysfunction Sclerodactyly (sausage fingers/toes) Telangioectasias (dilation of small vessels causes flat red marks on skin)
Serological markers of scleroderma
\+Rheumatoid factor (<10%) \+ ANA (60-80%) Anti-topo-isomerase I antibody Anti-centromere antibody (CREST) Anti-Th/To antibody Anti-U3 small nuclear ribonucleoprotein (snRNP) antibody
