Term
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Definition
| An inflammatory disease characterised by autoantibody to nuclear material and can involve almost any organ or system of the body. |
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Term
| What is the prevalence of SLE? |
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Definition
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Term
| Which gender is more likely to be affected by SLE and by how much? |
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Definition
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Term
| Is SLE more common in indian and afrocaribbean people than caucasians? |
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Definition
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Term
| Give three drugs that can induce SLE. |
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Definition
| Minocycline, oral contraceptives or hydralazine. |
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Term
| Describe the severity of drug induced lupus. |
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Definition
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Term
| What organ does drug induced lupus tend to spare? |
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Definition
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Term
| When does drug induced lupus tend to settle? |
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Definition
| When the offending drug is withdrawn. |
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Term
| What light is associated with SLE? |
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Definition
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Term
| In SLE, what does T-cell and B-cell dysfunction cause? |
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Definition
| B-cell hyperactivity and impaired immune complex clearance from tissues. |
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Term
| What does dysfunction of the complement system and abberant programmed cell death result in in SLE? |
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Definition
| Intracellular material is not disposed of correctly, allowing autoantibody production to develop against nuclear material. |
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Term
| Name two autoantibodies in SLE that are directly pathogenic. |
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Definition
| Anti-Ro and anti-double-standed DNA. |
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Term
| What does the vasculopathy in SLE result from? |
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Definition
| CLotting cascade antibodies. |
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Term
| What age range does SLE normally develop in? |
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Definition
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Term
| Give two life-threatening problems that a severe lupus flare can result in. |
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Definition
| Renal failure, cerebral vasculitis. |
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Term
| Give 5 things that are capable of triggering a flare of SLE. |
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Definition
Overexposure to sunlight
Oestrogen-containing contraceptive therapy
Drugs
Infection
Stress |
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Term
| Give 4 constitutional features of SLE. |
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Definition
Fatigue
Malaise
Fever
Weight loss |
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Term
| Is hypothyroidism more common in the general population or in those with SLE? |
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Definition
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Term
| What should you consider in a patient with SLE and severe lethargy? |
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Definition
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Term
| What percentage of patients with SLE experience arthralgia? |
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Definition
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Term
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Definition
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Term
| What is the normal pattern of arthralgia in SLE? |
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Definition
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Term
| What percentage of patients with SLE experience a non-erosive arthritis? |
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Definition
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Term
| Is the arthritis in SLE errosive? |
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Definition
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Term
| What is the deformity in SLE arthritis a result of? |
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Definition
| Tenosynovitis and fibrosis. |
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Term
| Is myalgia a common symptom of SLE?` |
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Definition
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Term
| In SLE, what are avascular necrosis of bone and osteoporosis usually a result of? |
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Definition
| Corticosteroid treatment and vasculopathy. |
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Term
| Give the 4 main musculoskeletal features of SLE. |
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Definition
Arthralgia.
Non-errosive arthritis
Myalgia
Myositis |
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Term
| Roughly what percentage of those with SLE experience photosensitivity? |
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Definition
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Term
| How is the shape of the rash over the nose and cheeks in SLE classically descibed? |
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Definition
|
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Term
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Definition
| A chronic photosensitive skin erruption which can be either localised or widespread. |
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Term
| Can discoid lupus arise with no systemic features? |
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Definition
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Term
| Does hairloss reflect disease activity in SLE? |
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Definition
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Term
| In SLE, where might be affected by mucosal ulceration? |
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Definition
| The nose, mouth and vagina. |
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Term
| Give four signs that can present with cutaneous vasculitis in SLE. |
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Definition
| Urticarial lesions, livedo reticularis, palpable purpura and splinter haemorrhages. |
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Term
| What is the most common cardiac manifestation in SLE? |
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Definition
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Term
| Is serositis common is SLE? |
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Definition
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Term
| In SLE, what may accompany myositis? |
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Definition
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Term
| In SLE, what can myocarditis present with? |
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Definition
| Arrhythmias or cardiac failure. |
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Term
| Roughly what percentage of patients with SLE suffer from raynaud phenomenon? |
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Definition
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Term
| In SLE, what causes peripheral ischaemia? |
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Definition
| Vasospasm provoked by the cold. |
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Term
| Where can peripheral ischaemia in SLE be found, an what would be seen? |
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Definition
| The digits, tip of the nose and earlobes. They become pale and numb, before turning blue. |
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Term
| What is seen in the final phase of peripheral ischaemia due to vasospasm in SLE? |
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Definition
| Redness and flushing due to the eventual vasodilation. |
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Term
| What may vasculitis in SLE present with? |
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Definition
| Digital infarcts, skin rashes or skin ulcers. Rarely it can affect the internal organs. |
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Term
| What are two common pulmonary features of SLE? |
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Definition
| Pleurisy and pleural effusions. |
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Term
| In SLE, what can mimic pneumonia? |
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Definition
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Term
| In SLE, what can pneumonitis mimic? |
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Definition
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Term
| What does chronic pneumonitis in SLE cause? |
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Definition
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Term
| Is pulmonary hypertension common in SLE? |
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Definition
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Term
| What is the commonest cause of SLE related deaths? |
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Definition
|
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Term
| When does Glomerulonephritis cause clinical symptoms? |
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Definition
| When there is significant renal damage. |
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Term
| What is important to monitor in SLE patients to detect renal disease early. |
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Definition
| Check blood pressure and check the urine for protein and red cells. |
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Term
| Give 5 neurological features of SLE. |
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Definition
| Headaches, psychiatric problems, seizures, neuropathies, chorea. |
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Term
| Are headaches common in SLE? |
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Definition
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Term
| Give three well recognised psychiatric effects of SLE. |
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Definition
| Anxiety, depression and psychosis. |
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Term
| What haematological feature is very common in SLE? |
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Definition
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Term
| Is neutropenia common SLE? |
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Definition
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Term
| What is more common is SLE, neutropenia or lymphopenia? |
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Definition
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Term
| What percentage of SLE patients suffer from autoimmune haemolysis? |
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Definition
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Term
| Give two causes of anaemia in SLE. |
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Definition
| Chronic inflammation or autoimmune haemolysis. |
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Term
| How can aseptic peritonitis present in SLE? |
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Definition
| Abdominal pain and nausea. |
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Term
| What must you always consider as a cause of arthralgia in young women? |
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Definition
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Term
| What percentage of patients are detected as having antinuclear antibodies? |
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Definition
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Term
| What proportion of patients with SLE have anti-double-standed DNA antibodies? |
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Definition
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Term
| How specific are anti dsDNA antibodies in SLE? |
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Definition
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Term
| What type of SLE are antihistone antibodies often positive in? |
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Definition
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Term
| How sensitive are antihistone antibodies to SLE? |
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Definition
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Term
| Give 3 serological indicators of high disease activity in SLE. |
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Definition
Raised ESR
high anti-DsDNA titres
Low C3 and C4 complement levels. |
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Term
| In roughly what percentage of patients with SLE are antiphospholipid and anticardiolipin antibodies positive? |
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Definition
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Term
| In SLE, what are anti-Ro and anti-La antibodies associated with? |
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Definition
| Sjogren syndrome and pulmonary fibrosis, mothers having babies with neonatal SLE and congenital heart block. |
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Term
| Can ESR be raised in a person with SLE, even if they are feeling well? |
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Definition
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Term
| What must regularly be screened for in an FBC for someone with SLE? |
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Definition
| Anaemia, Leukopenia and thrombocytopenia. |
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Term
| In SLE, what is the normal state of CRP? |
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Definition
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Term
| WHen might CRP be elevated in SLE? |
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Definition
| During infection, synovitis or serositis. |
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Term
| What complement proteins can be depressed in active SLE? |
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Definition
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Term
| What test will be positive in patients with auto-immune haemolytic anaemia. |
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Definition
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Term
| What will skin biopsy in patients with lupus rashes show? |
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Definition
| Deposition of immunoglobulin G and complement at the dermal-epidermal junction. |
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Term
| Give two pieces of lifestyle advice for someone with SLE. |
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Definition
Avoid precipitating factors, for example wearing long sleeves and suncream.
Infections should be dealt with promptly. |
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Term
| Give two types of medication that may help patients with mild symptoms of SLE. |
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Definition
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Term
| Give two types of medication that may help patients with moderate symptoms of SLE. |
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Definition
| Corticosteroids and steroid sparing agents. |
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Term
| Give three types of medication that may help patients with severe symptoms of SLE. |
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Definition
Cytotoxic drugs
Corticosteroids
Biologic Drugs |
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Term
| What treatment might be used in SLE to treat immune thrombocytopenia or neutropenia? |
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Definition
| Intravenous immunoglobulin infusions. |
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Term
| What drugs are required for patients with antiphospholipid antibody syndrome? |
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Definition
| Antiplatelet drugs or warfarin. |
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|
Term
| What is the 10 year survival rate in SLE? |
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Definition
|
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Term
| What three things are associated with increased vascular morbidity and mortality in patients with SLE? |
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Definition
Poorly controlled SLE
High doses of steroids
The patient smoking. |
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Term
| Are malignancy and infection rates high or low in SLE? |
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Definition
|
|
Term
| What is antiphospholipid syndrome characterised by? |
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Definition
| Recurrent vascular thrombosis, fetal loss and thrombocytopenia, associated with persistently elevated levels of antiphospholipid antibodies. |
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Term
| Give 7 associated clinical features of APS. |
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Definition
Livedo reticularis
Leg ulcers
Cardiac valve abnormalities
Chorea
Epilepsy
Migrane
Haemolytic anaemia |
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Term
| What are the two main antiphospholipid antibodies? |
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Definition
| Lupus anticoagulant and anticariolipin. |
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Term
| What is the diagnosis of APS based upon? |
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Definition
| The detection of anticardiolipin antibodies or a positive lupus anticoagulant assay. |
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Term
| Does APS produce clotting and thrombosis? |
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Definition
|
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Term
| Give two points of general advice given to someone with APS. |
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Definition
Avoid the oral contraceptive pill.
Avoid smoking. |
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