Systemic Lupus Erythematosus (Msq Drill 184)

1. Can patients with SLE develop a skin rash after exposure to sunlight?

Yes

No

2. Can patients with SLE also have arthritis?

No, they never have SLE

Yes, but it is not erosive or inflammatory

3. Systemic Lupus Erythmatosus is an autoimmune multisystem disease. True or false?

True

False

4. In general SLE is more common in men or women?

Men

Women

5. Do we know exactly what causes SLE?

Yes

No

6. Are there any neurological disorders associated with SLE?

No, there is no CNS involvement

Yes, they can have seizures

7. Patient with SLE can also have new onset psychosis?

Yes

No

8. Do connective tissue disorders usually isolate themselves to one organ or they usually involve multiple organs?

One organ

Multiple organs

9. What is the most common presentation of SLE?a

Rhabdomyolisis

Skin eruptions

Seizures

10. What is the antimalarial drug that is used to treat SLE?

Doxycycline

Mefloquine

Hydroxychloroquine (plaquenil)

Primaquine

200mg bid, can cause retinal toxicity, so also have opthalmology exam before starting.

Explanation

200mg bid, can cause retinal toxicity, so also have opthalmology exam before starting.

11. Are there triggers for SLE?

Yes. eg UV light and sulfa drugs

No, it is an autoimmune disease so there are no triggers.

12. What is the main cause of SLE?

Photosensitivity

Low folic acid

Immune complex deposition

13. If a patient with lupus has raised patches, adherent keratotic scaline, perifollicular pugging and scarring from older lesions, you would document this as a:

Malar rash

Discoid rash

A malar rash is erythematic, flat or raised.

Explanation

A malar rash is erythematic, flat or raised.

14. The diagnois of SLE is a clnical diagnosis?

Yes

No

15. One of the earliest manifestations of patients with SLE with renal inolvment is:

Oliguria

Foul smelling urine

Peristent proteinuria

16. Jacob's arthropathy is:

SLE - nonerosive arthritis

SLE - erosive arthritis

17. The butterfly rash seen in SLE is kown as the ________ rash.

Malar

Atopic

Contact dermatitis

Lichen planus

18. The basic problem in patients with CTD diseases is the presence of:

An elevated ESR

An elevated PSA

Metastasis

Antinuclear antobodies (ANA)

19. The malar rash of SLE spares which part?

Temporal area

Eyelids

Nasolabial folds

20. There are 11 criteria for the diagnosis of SLE. In order to diagnose how many criteria out of the 11 do you have to have?

2

3

4

5

6

21. Can hair dyes and lipstick cause SLE?

Yes

No

22. SLE patients can also have oral or nasopharyngeal ulcers. Are these painful or painless?

Painful

Painless

23. The larynx and trachea can also be nvolved in patients with SLE. Is this common or uncommon?

Common

Uncommon

24. The prevalence of antinuclear antibodies in women is about 1 in every ______ women.

50

100

1000

10 000

25. Which of the following are also presentations that can be seen in patients with SLE?

Photosensitive skin eruptions

Serositis

Pneumonitis

Myocarditis & nephritis

CNS involvement

Submit

26. Which common symptoms are shared by most connective tissue diseases?

General systemis features such as malaise, fever or weight loss

Evidence of multiple organ system involvement

Musculoskeletal involvement-arthritis, myalgia

Immune alterations that leads to pathologic inflammation

Submit

27. A positive ANA means a patient has LUPUS?

Yes

No

Lupus is a clinical diagnosis, you have to correlate the positive ANA to the clinical symptoms.

Explanation

Lupus is a clinical diagnosis, you have to correlate the positive ANA to the clinical symptoms.

28. Is SLE more common in white or black populations?

White

Black

29. Is the deformitiy seen in SLE nonerosive arthiritis reversible?

Yes

No

30. A patient cannot be diagnosed with a CTD in the absence od antinuclear antibodies. True or false?

True

False

31. Which of the following diseases are examples of connective tissue diseases?

SLE & RA

Mixed connective tissue disease

Sjorgrens Syndrome & systemic sclerosis

Diabetes

Polymyositis/dermatomyositis

Submit

32. Anti-histone antibody is a sub serologic test goes along with:

Systemis lupus

Rheumatoid arthritis

Osteoporosis

Drug induced lupus

33. About _____ % of patients with antinuclear antibodies will NOT have a CTD?

2

3

5

15

25

34. UV light & sulfa driugs are definite, probable or possible cause of lupus?

Definite

Probable

Possible

35. What other medications can be used in the treatment of SLE?

Low dose methotrexate

Aziothioprine (imuran)

Cyclophsophamide

High dose steroid for serious visceral involvement

Topical and low dose steroids and NSAIDS

Submit

36. So, if 1000 women are tested and 51 are ANA positive, about how many of these 51 women will have Systemic lupus erythmatosus?

1

5

15

25

37. What percentage of patients with SLE have ANAs?

50%

75%

99%

100%

ANA's antinuclear antibodies

Explanation

ANA's antinuclear antibodies

38. What is the peak age of the onset for SLE?

15-25

5-15

18-36

30-55

39. Does an ANA negative lupus exist?

Yes

No

40. Which of the following tests specifically go along with SLE.

Positive ANA

Antibodies to ds-DNA

Antibodies to Smith antibody

Anticardiolipin antibodies

IgM or IgG, leukopenia, anemia

Submit

41. The immune system basically attacks the body in connective tissue dieases. True or false?

True

False

Self directed immune mechanisms.

Explanation

Self directed immune mechanisms.

42. Drug induced Lupus can be caused by the following drugs:

Hydralazine

Loperamide

Procainamide

Hydrochlorothiazide

Submit

43. Although rare - What are the three most common life threatening consequences of SLE?

Nephritis

Respiratory depression

Thrombocytopenia

Cerebritis

Submit

44. What would you tell you patient who has lupus?

Avoid the sun

Use suncscreen

Postprandal rinse or hydrogen peroxide

Use salivary substitutes

Lower your fluid intake

Submit