Autoimmune

Question 1

Sx of autoimmune disorder?

Answer 1

Joint pain, kidney sx, dry eyes, oral ulcers, myalgia, rash, fever NYD, SICCA

Question 2

Take an ANCA to evaluate for

Answer 2

Vasculitis

Question 3

Anti-histone to evaluate for

Answer 3

Drug induced lupus

Question 4

ANA to evaluate for?

Answer 4

SLE, dermato or polymyositis, sjogrens, RA, scleroderma - positive in up to 10% of the normal population. 1:320 or higher is most likely significant in the right clinical context.

IS ALMOST ALWAYS POSITIVE IN SLE

Question 5

RF and anti-CCP to evaluate for

Answer 5

RA

Other things can give you a positive RF - Hep C, endocarditis, anti-CCP is more specific

Question 6

Anti-DSDNA to evaluate for?

Answer 6

Very specific for active lupus (and levels correlate with the activity of the SLE

Question 7

C3/C4 to evaluate for

Answer 7

Used up in the inflammatory process, can be a sign of active disease in the body

Question 8

What is ENA and when should you get one?

Answer 8

It is a panel of multiple Ab (SSA, SSB, JO-1, smith, RNP, centromere), only run if the ANA is positive (it is the counterpart),

SSA/SSB - sjogrens/SLE most common - congenital complete heart block associated with SSA from lupus 
Anti-JO1 - poly or dermato 
Anti-centromere - systemic sclerosis 
Anti-smith - lupus 
RNP - mixed connective tissue disease

Question 9

Anti-phospholipid antibodies evaluate for

Answer 9

Anti-phospholipid syndrome - miscarriages and thrombosis, often associated with lupus.

Question 10

Low C3/C4 is classically seen in?

Answer 10

Classically lupus (consumptive disease for complement)