Most connective tissue diseases are ___ diseases.
Connective tissue diseases often affect multiple ___.
What are some examples of CTDs?
Do connective tissue diseases affect connective tissue?
autoimmune disease - antibodies
In connective tissues diseases, the immune system attack cells (in one place / all over the body).
all over the body
Connective tissue diseases are more common in (men / women).
as with all autoimmune diseases
What four factors are thought to cause connective tissue diseases?
Faulty immune system
Which hormone is linked to the onset of CTDs?
Which virus is associated with lupus?
What environmental factors are linked to lupus?
Although lupus is less common in men, it tends to be more ___.
Which immune cells are antigens presented to?
In lupus, apoptotic cells aren't cleaned up and their contents float around for longer than normal.
What is the consequence of this?
Immune system recognises nuclear material as foreign antigen
Nuclear material presented to T cells, which activate B cells
Production of autoantibodies
In lupus, the immune system treats self nuclear material as an antigen.
Which processes occur?
Which system is asymptomatic when it's being messed up by lupus?
What are deposited in the kidneys and the skin in lupus?
In lupus, immune complexes get lodged in endothelial walls - what happens next?
Immune response - complement released, acute inflammation
What is a very common symptom of lupus?
What are general symptoms of lupus?
What does a malar rash look like?
Butterfly rash on face associated with UV exposure
What aspect of the face is spared by lupus?
___ - the tendency to burn easily - is a skin symptom of SLE.
What hair condition is associated with lupus?
Which lesions appear in the oral and nasal mucosa in some cases of SLE?
An MSK symptom of lupus is ___ ___ with no actual joint damage.
What is serositis?
Inflammation of a lining e.g pleura, pericardium...
Serositis secondary to lupus often presents as what?
Pericarditis / Pericardial effusion
Pleurisy / Pleural effusion
What is a renal sign of lupus?
elevated levels of protein in the urine
After a positive urinalysis, what is done to confirm that someone has renal disease secondary to lupus?
Lupus can also cause what brain-related disease?
Name three haematological signs of lupus you might see on a FBC.
Anaemia - low RBCs
Thrombocytopaenia - low platelets
Leukopaenia - low white blood cells (i.e immune cells)
Which structures are often enlarged in lupus?
Which syndrome, associated with lupus, causes hypercoagulability and may result in thrombosis and recurrent miscarriage?
People with lupus are more susceptible to ___.
through the haem effects of the disease itself AND the immunosuppressive drugs used to treat it
How is suspected SLE diagnosed?
Most people with lupus are positive for which antibody?
Anti-nuclear antibody (ANA)
ANA is a (specific / non-specific) antibody for lupus.
found in other autoimmune diseases, RA, HIV, Hep C....
Apart from ANA, what other autoantibodies are associated with lupus?
Anti-dsDNA (anti double stranded DNA antibody)
Anti-Ro (non-specific for lupus but uncommon)
Which antibodies are highly specific for lupus?
The higher the titre of anti-dsDNA, the more (active / inactive) the disease.
Babies of mothers who are anti-Ro positive may present with what?
of which heart block is a significant feature
Which autoantibodies are found in anti-phospholipid syndrome?
Anti-beta 2 glycoprotein
Once you've diagnosed someone with lupus, what must you do?
Screen every other system
What's the most appropriate first screening test in someone newly diagnosed with lupus?
for renal disease
What are the two inflammatory markers which rise in people with rheumatoid conditions?
Does CRP rise in flare ups of lupus?
When may CRP be raised in a lupus patient?
Co-existing inflammatory disease e.g RA
Which changes in two markers indicate a flare up of lupus?
INCREASED anti-dsDNA (antibody associated with active disease)
DECREASED in C4 (complement being used up)
In a flare up of lupus, the level of anti-dsDNA (increases / decreases).
In a flare up of lupus, the level of complement (increases / decreases).
SLE tends to get (better / worse) during pregnancy.
Patients with lupus are advised to avoid excessive __ __.
because it causes photosensitivity
Which drugs are used to treat lupus?
1. NSAIDs, analgesics, HYDROXYCHLOROQUINE
Immunosuppressants (mycophenolate mofetil, cyclophosphamide, methotrexate, azathioprine)
If all your drugs aren't controlling lupus symptoms, which drugs can you use?
Which DMARD is used first to treat lupus?
What are the immediate tests for someone who has suspected SLE?
Antibodies and complement
Does a positive ANA guarantee lupus?
What is the most common presentation of SLE and who has it?
Fever, joint pain and a rash
In a woman of childbearing age
What is the typical distribution of joint pain seen in SLE?
Symmetrical polyarthritis affecting the small joints of hands and feet