NUR 410 Exam 1 UPDATED ACTUAL
Exam Questions and CORRECT Answers
Lupus (SLE) defined - CORRECT ANSWER -Chronic inflammatory, multi-system
disorder of connective tissue
- autoimmune origin
- genetic influence
- environmental factor
- drug induces
- flare ups & remission (may not go back to baseline)
- no way to predict its progression
- variable
Lupus (SLE) environmental factors - CORRECT ANSWER -- physical/mental stress
- streptococcal/viral infections
- exposure to sunlight or ultraviolet light (vacay)
- pregnancy (after - hormones drop)
- estrogen -> lupus
Lupus (SLE) drug induced factors - CORRECT ANSWER -- icillin
- oral contraceptive
- thyroid meds
- INH
- some biologic response modifiers
- anticonvulsant (Dilantin)
- Hydralazine (Apresoline)
- Procainamide (Pronestyl)
,Lupus (SLE) patho - CORRECT ANSWER -production of large variety of autoantibodies
which results from hyperactivity of B-cells (protect from non-self) as a result of a disordered T-
cell function - antibodies form immune complexes which are deposited into CT which then
prompt inflammatory response leading to local tissue damage
Lupus (SLE) leading causes of death - CORRECT ANSWER -1. Renal failure
2. Cardiac failure
3. Neuro
Lupus (SLE) risk factors - CORRECT ANSWER -- genetic influence (HLA genes)
- women childbearing age (high estrogen)
- first symptoms seen at menarche
- more common in African Americans, Asians & Hispanic
- environmental factors (EBV: mono)
- drug induced
Lupus (SLE) clinical manifestations - CORRECT ANSWER -- extremely variable in
severity
- recurring remission & exacerbation
- no characteristic pattern of organ involvement
- most commonly affects: skin, muscle, kidney, lining of lungs, gut, heart, nervous tissue
Generally: fever, weight loss, anorexia, malaise, excessive fatigue may proceed exacerbation -
usually feel 10x when an exacerbation is coming
- exacerbations more common in spring & summer (pollen & vacay)
Lupus: musculoskeletal problem - CORRECT ANSWER -- arthritis, polyarthralgia
- osteoporosis
- joint & muscle swelling, pain/stiffness
,Lupus: gastrointestinal problems - CORRECT ANSWER -- abdominal pain
- diarrhea
- oral/nasopharyngeal ulcerations
- anorexia, heartburn, wt loss
- enlarged liver, splenomegaly
Lupus: cardiopulmonary problems - CORRECT ANSWER --
pericarditis/endocarditic/myocarditis
- tachypnea & cough (restrict lung dx)
- pleurisy (pain with coughing)/pleuritis/pleural effusion
- dysrhythmias (d/t fibrosis (unhealthy tissue) so SA & AV nodes)
- HTN
- hypercholesteremia
- vasculitis/increased risk atherosclerosis
- thrombic events (TIA, CVA, MI)
Raynaud's phenomenon
2ND LEADING CAUSE OF DEATH
- teach - smoking cessation, prevent obesity/hyperlipidemia, decrease salt, fat and cholesterol
intake
Lupus: ocular problems - CORRECT ANSWER -- transient blindness: due to retinal
vasculitis
- photophobia (painful to look at light)
- conjunctivitis
Lupus: renal problems - CORRECT ANSWER -- nephritis
- renal failure
treated with corticosteroids, cytoxic agents (Cytoxan) & immunosuppressive agents (Imuran,
cyclosporin)
, Lupus: nervous system problems - CORRECT ANSWER -- generalize or focal seizures
- peripheral neuropathy; cranial nerve palsies
- CVA
- headache/irritability
- aseptic meningitis
- psychosis/depression
- cognitive dysfunction
- organic brain syndrome (normal neurological function and then all of a sudden gets confused
and can't think as well - reversible)
Lupus: hematologic problems - CORRECT ANSWER -- anemia
- mild leukopenia
- thrombocytopenia
- clotting disorders
- irregular menstrual periods/increased risk of miscarriage
0 enlarged lymph nodes
Lupus: infection - CORRECT ANSWER -- pneumonia, cellulitis, pneumonitis etc
- increases susceptibilty, fever
AVOID LIVE VIRUS VAX
Lupus: dermatologic problems - CORRECT ANSWER -Rash: butterfly-shaped over
cheeks/bridge of nose
- cutaneous vascular lesions
- discoid rash (red/ with raised /oval patches)
- rash to UV/sun-exposed areas
photosensitivity
Exam Questions and CORRECT Answers
Lupus (SLE) defined - CORRECT ANSWER -Chronic inflammatory, multi-system
disorder of connective tissue
- autoimmune origin
- genetic influence
- environmental factor
- drug induces
- flare ups & remission (may not go back to baseline)
- no way to predict its progression
- variable
Lupus (SLE) environmental factors - CORRECT ANSWER -- physical/mental stress
- streptococcal/viral infections
- exposure to sunlight or ultraviolet light (vacay)
- pregnancy (after - hormones drop)
- estrogen -> lupus
Lupus (SLE) drug induced factors - CORRECT ANSWER -- icillin
- oral contraceptive
- thyroid meds
- INH
- some biologic response modifiers
- anticonvulsant (Dilantin)
- Hydralazine (Apresoline)
- Procainamide (Pronestyl)
,Lupus (SLE) patho - CORRECT ANSWER -production of large variety of autoantibodies
which results from hyperactivity of B-cells (protect from non-self) as a result of a disordered T-
cell function - antibodies form immune complexes which are deposited into CT which then
prompt inflammatory response leading to local tissue damage
Lupus (SLE) leading causes of death - CORRECT ANSWER -1. Renal failure
2. Cardiac failure
3. Neuro
Lupus (SLE) risk factors - CORRECT ANSWER -- genetic influence (HLA genes)
- women childbearing age (high estrogen)
- first symptoms seen at menarche
- more common in African Americans, Asians & Hispanic
- environmental factors (EBV: mono)
- drug induced
Lupus (SLE) clinical manifestations - CORRECT ANSWER -- extremely variable in
severity
- recurring remission & exacerbation
- no characteristic pattern of organ involvement
- most commonly affects: skin, muscle, kidney, lining of lungs, gut, heart, nervous tissue
Generally: fever, weight loss, anorexia, malaise, excessive fatigue may proceed exacerbation -
usually feel 10x when an exacerbation is coming
- exacerbations more common in spring & summer (pollen & vacay)
Lupus: musculoskeletal problem - CORRECT ANSWER -- arthritis, polyarthralgia
- osteoporosis
- joint & muscle swelling, pain/stiffness
,Lupus: gastrointestinal problems - CORRECT ANSWER -- abdominal pain
- diarrhea
- oral/nasopharyngeal ulcerations
- anorexia, heartburn, wt loss
- enlarged liver, splenomegaly
Lupus: cardiopulmonary problems - CORRECT ANSWER --
pericarditis/endocarditic/myocarditis
- tachypnea & cough (restrict lung dx)
- pleurisy (pain with coughing)/pleuritis/pleural effusion
- dysrhythmias (d/t fibrosis (unhealthy tissue) so SA & AV nodes)
- HTN
- hypercholesteremia
- vasculitis/increased risk atherosclerosis
- thrombic events (TIA, CVA, MI)
Raynaud's phenomenon
2ND LEADING CAUSE OF DEATH
- teach - smoking cessation, prevent obesity/hyperlipidemia, decrease salt, fat and cholesterol
intake
Lupus: ocular problems - CORRECT ANSWER -- transient blindness: due to retinal
vasculitis
- photophobia (painful to look at light)
- conjunctivitis
Lupus: renal problems - CORRECT ANSWER -- nephritis
- renal failure
treated with corticosteroids, cytoxic agents (Cytoxan) & immunosuppressive agents (Imuran,
cyclosporin)
, Lupus: nervous system problems - CORRECT ANSWER -- generalize or focal seizures
- peripheral neuropathy; cranial nerve palsies
- CVA
- headache/irritability
- aseptic meningitis
- psychosis/depression
- cognitive dysfunction
- organic brain syndrome (normal neurological function and then all of a sudden gets confused
and can't think as well - reversible)
Lupus: hematologic problems - CORRECT ANSWER -- anemia
- mild leukopenia
- thrombocytopenia
- clotting disorders
- irregular menstrual periods/increased risk of miscarriage
0 enlarged lymph nodes
Lupus: infection - CORRECT ANSWER -- pneumonia, cellulitis, pneumonitis etc
- increases susceptibilty, fever
AVOID LIVE VIRUS VAX
Lupus: dermatologic problems - CORRECT ANSWER -Rash: butterfly-shaped over
cheeks/bridge of nose
- cutaneous vascular lesions
- discoid rash (red/ with raised /oval patches)
- rash to UV/sun-exposed areas
photosensitivity
