Unit 3 - CVD Pt 2

Question 1

lupus ratio/incidence

Answer 1

female:male 8:1

peak incidence in 40s

Question 2

lupus etiology

Answer 2

Autoimmune etiology
Antigen-antibody Immune complexes formed
Antibodies formed to DNA

Question 3

types of lupus

Answer 3

Discoid (skin)
Systemic (SLE-skin & Internal organs)
- 30% have Rheumatoid factor

Question 4

skin

Answer 4

if on scalp - alopecia
- scarring, esp with sunlight
butterfly rash - 80%
- capillary dilations on skin: telangiectasis

Question 5

joints

Answer 5

Polyarthritis, asymmetrical
Inflammatory joint disease
Pannus
Cartilage Destruction
Osteophytes
Narrow joint space

Question 6

kidneys

Answer 6

Nephrovasculitis
Nephritis
Renal Vessels are Partially Occluded

Question 7

Renal induced hypertension

Answer 7

Decreased blood flow through the kidney causes the kidney to release renin

Question 8

hypertensive crisis

Answer 8

Systolic BP >180 mmHg
Diastolic BP >110 mmHg)
Increased Intracranial pressure
Seizures
Intracranial hemorrhage
Ventricular dysfunction
Dysrhythmias

Question 9

mucous membranes

Answer 9

autoantibodies have affected collagen, causing nodule and ulcer formation in mouth

Question 10

CNS/PNS

Answer 10

localized nodules that result in memory loss, dementia, and seizures
involvement in PNS can cause both sensory and motor loss

Question 11

liver

Answer 11

hepatic nodules with scarring can decrease liver function

can lead to liver failure

Question 12

lungs/pleura

Answer 12

Pleural Fibrosis
Pleural inflammatory nodule formation
Interstitial Lung Disease

Question 13

cardiovascular system

Answer 13

Valvulitis
Mitral Valve Nodule formation on the suggests a stenotic valve
Myocarditis-note the inflammatory lesions/nodules
Generalized Vasculitis
Vessel Occlusion

Question 14

vascular system

Answer 14

Aneurysm: Abnormal blood flow, Thrombus (clot), Vessels may leak or Rupture
Abdominal Aortic Aneurysm (Triple A)
Most common site of Aneurysm Formation

Question 15

Raynaud’s

Answer 15

40%

fingers become white from lack of blood flow, then blue as vessels dilate and red when blood returns

Question 16

SLE evaluation criteria (3)

Answer 16

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)

Question 17

Serological Findings

Answer 17

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

Question 18

LE cell

Answer 18

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

Question 19

scleroderma

Answer 19

CVD that causes the skin to become dense, fibrous, thickened, and tight

F:M 3:1

Question 20

types of scleroderma

Answer 20

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.

Question 21

appearance of scleroderma

Answer 21

Skin tightness
Mauskopf (Mouse head) face
Telangiectasias
Raynaud’s

Question 22

Scleroderma variants:

Diffuse Systemic Sclerosis

Answer 22

Seen in some people with systemic sclerosis

Can be aggressive with poor prognosis

Question 23

Scleroderma Variants:

C R E S T Variant

Answer 23

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)

Question 24

Serological markers of scleroderma

Answer 24

\+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