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Duke PA Systemic Lupus Erythematosus

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
with SLE any __ can be involved   organ system  
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cells and organs damaged by __ and immune complexes   autoantibodies  
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__% of all patients with SLE are women   90  
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in the US the highest incidence of SLE is in   African American females  
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ultraviolet light: triggers photosensitivity, rashes, drugs: sulfonamides, cigarette smoking, infections: EBV, ?parvo B-19, hormones   environmental factors for SLE  
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systemic/constitutional clinical manifestations of SLE   fatigue, malaise  
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cardiopulmonary clinical manifestations of SLE   pleuritis/pleural effusion, pericarditis/pericardial effusions  
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neuropsychiatric clinical manifestations of SLE   cognitive impairment  
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gastrointestinal clinical manifestations of SLE   hepatitis, pancreatitis  
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dermatologic clinical manifestations of SLE   photosensitivity, malar rash, discoid lesions, alopecia  
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most serious manifestation of SLE   Renal (nephritis)  
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__% of patients with SLE develop nephrotic syndrome as well   50  
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in SLE, untreated nephritis can lead to ESRD in __ years   2  
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classical arthritis presentation of SLE   polyarthritis similar distribution to RA  
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Fixed erythema, flat or raised over the malar eminences   Malar rash  
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Raised patches with scaling, follicular plugging; scarring of older lesions   discoid rash  
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Unusual rash triggered by sunlight; by history or observation   Photosensitivity  
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Oral or nasopharyngeal; usually painless   oral ulcers with SLE  
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Non-erosive involving ≥2 or more peripheral joints; + tenderness, ± effusion   arthritis with SLE  
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Persistent proteinuria (>0.5g/d or 3+)OR cellular casts   renal disorder with SLE  
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Seizures or psychosis (no other known causes of either)   neurologic disorder with SLE  
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Hemolytic anemia OR leukopenia OR lymphopenia   hematologic disorder with SLE  
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Anti-DNA OR anti-Sm OR+ antiphospholipid antibodies   immunologic disorder with SLE  
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+ ANA titer in the absence of any drug known to be associated with drug-induced lupus syndromes   antinuclear antibody  
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order first; best screening test for SLE. 98% prevalence   ANA-antinuclear antibodies  
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high titers diagnostic; may correlate with disease activity. 70% prevalence   dsDNA-double stranded DNA  
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causative drugs: many= antiarrhythmics, antihypertensives, antibiotics, anticonvulsants: hydralazine, procainamide, quinidine, isoniazid, diltiazem, minocycline   Drug-induced Lupus Erythematosus (DILE)  
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Syndrome of + ANA associated with constellation of symptoms including malaise, fever, arthritis (± myalgias), rash, serositis, autoimmune-mediated response more common in Caucasians, renal/CNS symptoms are rare   Drug-induced Lupus Erythematosus (DILE)  
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cimetidine, hydralazine, HCTZ, penicillin, sulfonamides, terbinafine (lamisil)   drugs that precipitate flares of SLE for those that already have it  
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__ occur almost universally in SLE patients   skin lesions  
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annular or papulosquamous   subacute cutaneous lupus  
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discoid lupus   chronic cutaneous lupus  
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Patients with DLE have a __% risk of developing SLE which tends to be mild   10-15  
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common sites for Discoid Lupus   face, neck, scalp  
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__ are mainstay treatment of life-threatening manifestations   Systemic glucocorticoids  
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__ used for cutaneous and mild-mod musculoskeletal symptoms   Anti-malarials (mostly hydroxychloroquinine)  
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