Diagnosing systemic lupus erythematosus

4/11 criteria
Serositis
oral ulcers oral ulcers
arthritis
photosensitivity
cytopenias autoimmune hemolytic anemia
renal failure, glomerulonephritis RBC casts
antiglare antibiotic titers double-stranded DNA titers, anti-Smith titers
immunologic phenomenon
neurologic phenomenon psychosis seizure
malar rash
discoid rash



Overheard in rounds "bursas don't do well when you put needles in them" meaning don't ever drain and inflamed bursa if you do they can be complicated by chronic nonhealing and drainage

Autoimmune polyglandular endocrine disorders specifically adrenal and thyroid- be very careful if you treat a thyroid disorder first you may cause cardiovascular collapse from adrenal insufficiency.


Anti-emetics

Compazine promethazine Thorazine - dopaminergic antagonism cholinergic antagonism is to monarchic antagonism, good to use in the setting of a small bowel obstruction because they are not pro-motility agents

Haloperidol – powerful dopaminergic antagonism with very little anticholinergic activity. Special mention because this is a medication that is great for renal failure because it is not clear by the kidney.

Metoclopramide - dopaminergic antagonism and at high doses serotonergic antagonism, this agent has promotility so avoided the setting of small bowel obstruction. Good to double cover in people with gastroparesis.

Antihistamines great antinausea if you're trying to double cover motion sickness or a vestibular component.

Anticholinergics – scopolamine, atropine. Okay to use in the setting of small bowel obstruction because they do not increase gastrointestinal motility

Cannabinoids -have been used for chemotherapy induced nausea and also helps with appetite stimulation, dysphoria in the elderly has been observed clinically

Ondansetron granisetron, alosetron -best pick for chemotherapy induced nausea

Corticosteroids -useful for nausea and also covering appetite stimulation as well as increased intracranial pressure, major con are the long-term side effects