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68 Cards in this Set
- Front
- Back
What am I:
tough, glue-like protein that represents 30% of body protein It shapes the structure of tendons, bones, and connective tissues |
collage
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What am I:
disease in which problems with the immune system affect collagen |
collagen vascular disease
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What are the complications associated with collagen vascular disease?
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pleural effusions
heart problems lupus nephritis arthritis raynaud's phenomenon |
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What are the criteria for diagnosing lupus?
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malar (butterfly) rash
discoid rash photosensitivity oral ulcers arthritis serositis renal disorder neurological disorder hematologic disorder antinuclear antibody |
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How many of the criteria for diagnosing lupus must a patient have to be diagnosed with lupus?
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4
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What other information is needed, other than the diagnosis criteria, is needed to rach a diagnosis?
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epidemiologic characteristics
clinical signs/symptoms lab abnormalities |
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What labs are specific for SLE?
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anti-double stranded DNA
anti-SM antibody |
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What are the common causes of death from SLE?
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CAD
infection |
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What are the musculoskeletal clinical presentation of SLE?
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arthritis
arthralgia |
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what are the constitutional clinical presentation of SLE?
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fatigue
fever weight loss |
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What are the CNS clinical presentation of SLE?
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psychosis
seizures |
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What are the hematologic clinical presentation of SLE?
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anemia*
leukopenia thrombocytopenia antiphospholipid antibodies |
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What are the pulmonary clinical presentations of SLE?
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pleuritis
pleural effusion |
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What are the cardiovascular clinical presentation of SLE?
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pericarditis
endocarditis myositis murmur HTN |
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What are the renal clinical presentation of SLE?
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increased Cr
proteinuria nephritis |
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What are the GI clinical presentation of SLE?
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nausea
abdominal pain bowel hemorrhage |
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What am I:
sign/symptom of SLE in which there is raised patches with keratotic scaling on the cheek and neck |
discoid lesion
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What am I:
sign/symptom of SLE in which there is raised patches with keratotic scaling on face, forehead, and neck |
butterfly rash
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What am I:
sign/symptom of SLE in which there is constricted digital arteries |
raynaud's syndrome
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What drugs aggravate raynaud's syndrome?
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any vasoconstrictor
BB nicotine narcotics cyclosporine cocaine |
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What drugs help to alleviate raynaud's syndrome?
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vasodialators
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What am I:
A disorder of coagulation in which there are clots in both the artery and veins. Occurs due to autoimmune production of anticardiolipin antibodies or lupus anticoagulant |
secondary antiphopholipid antibody syndrome
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What are the complications associated with secondary antiphospholipid antibody syndrome?
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thrombosis
neurologic disease thrombocytopenia fetal loss |
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What drug is used as prophylaxis for secondary antiphospholipid antibody syndrome?
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asa
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If thrombotic event occurs in secondary antiphospholipid antibody syndrome, what is the target of warfarin therapy?
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2.5-3.5
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What is the goal of SLE treatment?
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manage symptoms
induce remission maintain remission |
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What are the non-drug treatment of SLE?
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rest
exercise tobacco cessation fish oil to prevent miscarriage avoid alfalfa sprouts limit sun exposure |
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In SLE treatment, what drug is given for inflammation?
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NSAID or Cox-2 inhibitor
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Which NSAIDs have a higher risk for hepatotoxicity?
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Diclofenac
sulindac |
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In SLE treatment, what drug is given to relieve arthralgia, pleuritis, mild pericarditis, fatigue, and leukopenia?
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antimalarial - hydroxychloroquine
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When using antimalarial to treat SLE, what needs to be done to the dose to suppress cutaneous manifestations?
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titrate down 1-2 doses/week after 1-2 years
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When using antimalarial to treat SLE, how should the drug be administered?
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titrated up
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In the treatment of SLE, what drug is used to maintain suppression of symptoms?
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low dose (10-20mg/d) corticosteroids
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In the treatment of SLE, what drug is used for periods of more severe symptoms?
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high dose (1-2mg/kg/d) corticosteroids
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what are the cytotoxic agents used in the treatment of SLE?
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cyclophosphamide
azathioprine mycophenolate mofetil cyclosporine A |
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Of the cytotoxic agent used in the treatment of SLE, which agent may be used with steroids in worsening lupus nephritis?
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cyclosporine A
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Of the cytotoxic agents used in the treatment of SLE, which agents have increased incidence of herpes?
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cyclophosphamide
mycophenolate mofetil |
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What am I:
lupus-like syndrome after exposure to suspected drug no prior history of idiopath SLE antinuclear antibody development rapid improvement after drug D/C |
drug-induced lupus
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these drugs increase the risk of drug-induced lupus
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procainamide (slow acetylators)
hydralazine (dose over 100mg/d) |
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What drug will help to resolve symptoms associated with drug induced lupus?
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NSAIDs
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What am I:
massive deposition of collagen - skin thickening and tightening |
systemic sclerosis: scleroderma
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These organ involvement can be fatal in scleroderma
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GI
lung kidney heart |
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This drug is a classic drug used in the treatment of scleroderma
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D-penicillamine
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This drug can be used to treat scleroderma if there there renal involvement or HTN
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ACEI
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These drugs can be used to treat scleroderma but are not as effective as D-penicillamine
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NSAIDs
corticosteroids |
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What am I:
chronic, necrotizing inflammation of skeletal muscle with or without skin involvement |
polymyositis and dermatomyositis
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What symtoms are charactertic of polymyositis and dermatomyositis?
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gottron's papules
heliotrope rash |
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What drugs can be used to treat polymyositis and dermatomyositis?
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prednisone
azathioprine gamm-globulin |
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What am I:
can be primary or secondary to RA, SLE, or polymyositis is an immune-mediated destruciton of exocrine glands |
sjogren's syndrome
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What drug can be used to stimulate functional exocrine glands to treat sjogren's syndrome?
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pilocarpine
cevimeline |
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What drug can be used to treat thrush associated with sjogren's syndrome?
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nystatin
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Other than drug therapy, what can be used to treat sjogren's syndrome?
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sustitute secretions
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What am I:
destructive inflammation within blood vessels |
systemic vasculitis
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What am I:
vasculitis of mostly large blood vessels |
polymyalgia rheumatica and giant cell arteritis
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This symptom can occur in giant cell arteritis (temporal ateritis)
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headache
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What drug are polymyalgia rheumatica and giant cell arteritis highly repsonsive to?
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corticosteroids - prednisone
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What am I:
vasculitis of mostly medium sized blood vessels (small muscle arteries, skin, peripheral nerves, GI tract, kidneys) |
polyarteritis nodosa
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What drugs are used to treat polyarteritis nodosa?
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corticosteroids
cyclophosphamide |
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What am I:
vasculitis of small blood vessels (upper respiratory tract, lungs, kidneys, skin, digits) |
wegener's granulomatosis
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______ risk is higher in wegener's granulomatosis than SLE
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venous thromboembolism
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what drugs can be used to treat wegener's granulomatosis?
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corticosteroids
methotrexate |
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What am I:
vasculitis after being exposed to suspected drug antinuclear antibodies often present |
drug-induced vasculitis
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What drug is used for severe cases of drug-induced vasculitis?
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corticosteroids
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What drug can be used for life-threatening drug-induced vasculitis?
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immunosuppresive agents
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______ should bring resolution of drug-induced vasculitis in days to weeks
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withdrawal of drug
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What are the "side effects" of estrogens (either exogenous or endogenous)?
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Bloating, edema, and thrombosis develop due to:
1) Na+ and water retention 2) Increase in clotting factors 3) Lipid alterations (increased HDL, decreased LDL, decreased cholesterol) |
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_____ may take months to bring resolution of drug-induced vasculitis
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serum
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These drugs are implicated in drug-induced lupus
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chlorpromazine
hydralazine isoniazid methydopa minocycline procainamide quinidine |