Systemic Lupus Erythematosus (Msq Drill 184)

1. Can patients with SLE also have arthritis?

No, they never have SLE

Yes, but it is not erosive or inflammatory

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

Yes

No

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

Yes

No

4. Are there any neurological disorders associated with SLE?

No, there is no CNS involvement

Yes, they can have seizures

5. Do we know exactly what causes SLE?

Yes

No

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

Men

Women

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

True

False

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

Oliguria

Foul smelling urine

Peristent proteinuria

15. The diagnois of SLE is a clnical diagnosis?

Yes

No

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

Common

Uncommon

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

Painful

Painless

23. Can hair dyes and lipstick cause SLE?

Yes

No

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. 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.

27. 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

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

Yes

No

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

White

Black

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

Definite

Probable

Possible

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

2

3

5

15

25

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. Does an ANA negative lupus exist?

Yes

No

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

15-25

5-15

18-36

30-55

39. What percentage of patients with SLE have ANAs?

50%

75%

99%

100%

ANA's antinuclear antibodies

Explanation

ANA's antinuclear antibodies

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

Hydralazine

Loperamide

Procainamide

Hydrochlorothiazide

Submit

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

Nephritis

Respiratory depression

Thrombocytopenia

Cerebritis

Submit

43. 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.

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

Systemic Lupus Erythematosus (Msq Drill 184)

1. Can patients with SLE also have arthritis?

2.

What first name or nickname would you like us to use?

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

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

4. Are there any neurological disorders associated with SLE?

5. Do we know exactly what causes SLE?

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

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

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

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

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

11. Are there triggers for SLE?

12. What is the main cause of SLE?

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:

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

15. The diagnois of SLE is a clnical diagnosis?

16. Jacob's arthropathy is:

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

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

19. The malar rash of SLE spares which part?

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?

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

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

23. Can hair dyes and lipstick cause SLE?

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

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

26. A positive ANA means a patient has LUPUS?

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

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

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

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

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

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

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

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

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

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

37. Does an ANA negative lupus exist?

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

39. What percentage of patients with SLE have ANAs?

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

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

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

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

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