Autoimmune Flashcards
Define sarcoidosis Give signs in the following in sarcoidosis: - General (3) - Pulmonary (2) - Musc (1) - Eyes (2) - Skin (2) - Cardio (2)
- Multisystem granulomatous inflammatory disorder characterised by presence of non-caseating granulomas.
- Fever, malaise, weight loss
- SOB, cough
- Arthralgia
- Uveitis, keratoconjunctivits
- Lupus pernio (pathognomic), erythema nodosum
- Arrhythmia, HF.
Give 3 blood test findings in sarcoidosis.
Give 2 CXR findings
Give biopsy finding.
Give 3 medical managements.
- high calcium, high ESR, high ACE
- Bihilar lymphadenopathy, pulmonary infiltration/ fibrosis.
- Non-caseating granuloma
- Steroids, NSAIDs, Steroid-sparing agents.
Give the symptoms of SLE according to mnemonic SOAP BRAIN MD
- Serositis
- Oral ulcers
- Arthritis
- Photosensitivity
- Bloods- low counts
- Renal- proteinuria, casts
- ANA antibodies
- Immunological: anti-dsDNA
- Neurological- psychosis, seizures.
- Malar rash
- Discoid rash
Give 3 blood tests for SLE.
Give 3 autoantibodies in SLE
- High ESR, U&E, FBC
- Autoantibodies: ANA, anti-dsDNA, anti-Cardiolipin.
What is anti-phospholipid syndrome a complication of?
What is the triad of symptoms?
Which autoantibody is present?
- Complication of SLE
- Thromboembolism, recurrent miscarriage, thrombocytopenia.
- anti-cardiolipin autoantibody.
Diffuse cutaneous systemic sclerosis (diffuse scleroderma). Give 3 signs
- Give antibody present.
- Raynaud’s phenomenon
- Trunk skin changes
- Tendon friction.
Also have GI, heart and renal and early lung disease. - Autoantibody: anti-topoisomerase II (anti-scl-70)
In Limited Cutaneous Systemic Sclerosis (limited scleroderma) what are the CREST symptoms?
What autoantibody is present?
- Calcinosis
- Raynaud’s phenomenon
- Esophageal dysmotility
- Sclerodactyly- thickening of finger skin
- Telangiectasia
Anti-centromere.
Which condition is Giant Cell arteritis (Temporal arteritis) associated with?
What type of vasculitis is it?
- Associated with polymyalgia rheumatica: shoulder/ pelvic girdle pain
- Large vessel vasculitis.
Give 5 symptoms of giant cell arteritis
- Unilateral headache
- Jaw claudication
- Scalp tenderness
- Loss of vision
- Systemic upset.
Give 2 investigations for temporal arteritis.
What is medical management of temporal arteritis.
- Raised ESR- check ESR before steroids.
- Temporal artery biopsy- not 100% sensitive.
- High dose oral prednisolone.
Give 2 symptoms of polymyalgia rheumatica
Give 2 blood test findings
What is the management?
- Bilateral shoulder or pelvic pain
- Morning stiffness
NB: no weakness, chronic. - Raised ESR/ CRP
- oral steroids.
What infection is polyarteritis nodosa associated with?
What type of vasculitis is PN?
Give up to 6 symptoms.
What sign is seen on angiogram?
- Associated with hepatitis B
- Medium vessel vasculitis.
- Constitutional upset
- Skin rash
- Abdominal pain
- Rectal bleeding
- Peripheral neuropathy
- Renal failure and HTN.
Rosary sign on angiogram.
Give the triad of symptoms of granulomatosis with polyangiitis (Wegener’s)
What happens to the face?
- Upper respiratory tract: rhinitis, nose bleeds
- Lower respiratory tract: haemoptysis
- Kidneys: glomerulonephritis
- Destruction of the face: saddle nose
Give antibody found in granulomatosis with polyangiitis (Wegener’s).
What is seen on CXR?
- cANCA
- Cavitating lesions.
Give the triphasic signs of Eosinophilic Granulomatosis with Polyangiitis- Churg-Strauss syndrome.
- Allergic: asthma/ rhinits
- Eosinophilic: high eosinophils, mainly lungs and GIT
- Vasculitic: can lead to organ damage and death.
Other symptoms: haemoptysis, rash, focal neuropathy, kidney damage.
