Antibodies

Question 1

ANA pattern in SLE

Answer 1

Homogenous

(dsDNA, DNA histone)

Question 2

ANA pattern in dSSC

Answer 2

Nucleolar

(bomb)

Question 3

ANA pattern in lSSc

Answer 3

Centromere

Question 4

ANA pattern in SS

Answer 4

Diffuse speckled

Question 5

Diseases w/ homogenous ANA

Answer 5

SLE
(RA 20%)
Abs targeting DNA & histones

Question 6

Diseases w/ speckled ANA

Answer 6

Abs to ENA
Any - can be healthy

Question 7

Diseases w/ nucleolar ANA

Answer 7

dSSc

(RNA polymerase, Scl-70)

Question 8

Diseases w/ centromere ANA

Answer 8

lSSc

(Abs along c/s)
PBC & other odd AI

Question 9

ANA pattern in RA

Answer 9

Speckled, homogenous

Question 10

Homogenous staining pattern results from which Abs

Answer 10

DNA & histones

Question 11

Speckled staining pattern results from which Abs

Answer 11

ENA

Question 12

Antisynthetase Abs - types & implications

Answer 12

Jo-1, (PL-7, PL-12)

Assoc w/ ILD (UIP)
DM rash also common: mechanics, heliotrope rash etc
Some can be amyopathy - but otherwise proximal myopathy

Question 13

Malignancy assoc Abs in IDIM

Answer 13

TIF-Y (gamma)
NXP2
(MDA5 is ILD & melanoma)
If >40 LOOK FOR CaNCER!

Question 14

IMNM Abs

Answer 14

HMGCR
Anti SRP

Question 15

DM Abs

Answer 15

Malignancy assoc: TiF-Y, NXP2
Mi2 classic/mild
MDA5: ILD rapid, can be amyopathic, classic DC rash, bad

Question 16

IBM

Answer 16

cN1A - weakness, assoc w/ bulbar
Insidious
Dysphagia common
Assoc w/ other AI dis

Question 17

Overlap IMIN Abs

Answer 17

Ro52 - SS? most common non spec, ILD
PM-SCL - SSc (skin & lung)
U1RNP - mixed CTD
Anti Ku - SSc

Question 18

Muscle bx in IDIM types

Answer 18

• DerM: capillaries (vasculitis), perifasicular myofibre atrophy, keratinocytes
• PM: diffuse mm fibre injury, CD8 invade myofibres, MHC Class I
• IMNM: myofibral necrosis w/ no inflammation (no immune cell invasion of myofibres ie Ø lymphocytic infiltrates)
• Antisynthetase syndrome: perifasicular necrosis, perimysium fragmentation & ↑ perimysial ALP activity
• IBM:more like PM

Question 19

RA - genetic assoc

Answer 19

HLA-DRB1

esp if ACPA+ (anti-CCP)

Question 20

dSSc Abs

Answer 20

Anti-Scl 70 (ENA)
- assoc w/ ILD

Anti-RNA polymerase
- assoc w/ SRC

Question 21

lSSC Abs

Answer 21

Anti-centromere

Question 22

PBC Abs

Answer 22

AMA - anti mitochondrial Abs

Question 23

SLE dx

Answer 23

• ANA 1:80 (speckled)
• anti-dsDNA (specific)
• anti-Smith (renal & CNS dis specific)
• APLS (LAC, antiCardiolipin, beta2)
• Low C’ - predicts flares w. Abs

Question 24

Seroneg arthritis

Answer 24

• Ank Spond
• OA
• PsA
• Infectious - gonoccocal, septic
• Gout/pseudogout
• Haemaochromatosis

Question 25

Seropositive arthritis & markers

Answer 25

* Lupus: ANA, ENA, (RF) - no erosions on XR * Reactive: HLAB27+ * RA: RF+, CCP+ * Sjogrens