SLE

Question 1

Hx 1

Answer 1

• F, 20-40yo
• Hx of CNS involvement
• psychosis
• seizures
• cognitive dysfunction
• HA
• Hx of GIT involvement
• Bleeding
• Diarrhoea
• Fatigue
• LoW
• Fever

Question 2

SSx- Vitals

Answer 2

• Fever

* Incr. HR (d/t haemolytic anaemia)

Question 3

SSx- Skin & Hair

Answer 3

• Malar Rash:
• Fixed erythema; flat or raised; spares the nasolabial folds
• Discoid rash (30% of patients):
• Red raised patches with adherent keratosis & scarring
• Photosensitivity
• Skin ulceration (d/t vasculitis & basement membrane Ag-Ab complex deposition)
• Evidence of haemorrhage:
• Purpura i.e. nonblanching red lesions on fingers & palms (d/t to vasculitis)
• Petechial haemorrhage - thrombocytopenia
• Bruising (larger) - Clotting factor deficiency
• Alopecia: (40%) non-scarring, usually reversible

Question 4

SSx- Mouth

Answer 4

• oral / nasopharyngeal ulcers

* bleeding gums (pupuric lesion)

Question 5

SSx- MSK

Answer 5

• Mm Pain (d/t inflammatory myopathy)
• Synovitis
• non-erosive
• 2 peripheral joints
  (Most common: fingers, wrists, knees, toes; less common: elbows, shoulders, ankles)
• symmetrical
• morning stiffness

Question 6

SSx- Serositis

Answer 6

• Pleuritis:
• pain
• pleural rub
• effusion
• Pericarditis:
• rub
• effusion
• precordial pain

Question 7

SSx- Kidneys

Answer 7

• lupus nephritis

- palpation of kidneys if renal involvement suspected

Question 8

SSx- CNS & PNS

Answer 8

• affected by vasculitis &/or direct Ab attack
• PNS
• CN Exam for nerve palsy
• CNII, III, IV, VI
• Upper MN Exam

Question 9

SSx- Haematological

Answer 9

• Haemolytic Anaemia
• Lymphopaenia
• Thrombocytopaenia
• Leukopaenia

Question 10

SSx- Vasculitis

Answer 10

• Haemorrhage main manifestation
• Pupuric skin lesion (gums, retinal haemorrhage)
• digital gangrene
• telangiectases in nail fold
• Reynauds

Question 11

SSx- Cardiac 1

Answer 11

• Endocarditis
• Symptoms
• fatigue
• Fever
• Chills
• HA
• SOB
• Signs
• Anaemia
• SOB
• heart murmurs
• LEX oedema

Question 12

SSx- Cardiac 2

Answer 12

• Myocarditis
• Symptoms:
• Precordial pain
• SOB
• fatigue
• Signs:
• arrythmia
• LEX oedema
• Murmurs

Question 13

SSx- Lymphoid System

Answer 13

• hyperplasia, resulting in:
• lymphadenopathy
• splenomegaly