Autoimmune and Musculoskeletal Disorders Flashcards
Lupus Erythematosis
can affect any organ system
triad of fever, joint pain, malar rash (butterfly pattern)
mainly in women but severe in men
Etiology of Lupus
unknown
has antinuclear Abs (ANAs) and immune complexes that cause tissue damage
Systemic Lupus
70%
Discoid Lupus
10%
only affects skin
chronic eruptions and scarring
Drug Induced Lupus
10%
symptoms stop after stop taking drug
Causes of Death in Lupus
cardiovascular disease
renal failure
infections
ANA Test
sensitive to lupus but not specific
Anti-dsDNA Test
specific to lupus, bad prognosis
Anti-Sm
specific to lupus, not prognostic
Lupus can cause a false _________ test
RPR/ VDRL
FTA/ ABS
syphillis screeners
Lupus Ocular Findings
dry eye episcleritis keratitis photosensitivity uveitis CRAO
Drugs that can cause lupus
Quietly Induce Harmful Pathology Quinidine (Cardiac) Isoniazid (TB) Hydralazine (cardiac) Procainamide (cardiac)
What is unique about drug induced lupus?
transient ANA, so no anti- Sm
wont confirm on tests
Vasculitis
inflammed vessel wall that can occlude
Giant Cell Arteritis
affects large and medium arteries- aorta and ophthalmic a
blindness
Polyarteritis nodosum
lesions of small or medium aa
cotton wool spots on back of eye
Scleroderma
systemic fibrosis
tight/ shiny scarred skin
pulmonary issues can cause death
Scleroderma patients will test….
ANA +
Diffuse Scleroderma
widespread skin involvement, rapid progression to viscera
20% die in 10 years
Limited Scleroderma
skin, fingers, face
CREST Syndrome
CREST Syndrome
Calcinosis Raynaud phenomenon Esophageal Dysmotility Sclerodactyly Telangiectasia
Calcinosis
formation of calcium deposits on soft tissue
Raynaud Phenomenon
vasospasm in digits
white - blue - red
overreactive to cold
Sclerodactyly
thickening and tightening of skin on fingers and toes
Telangiectasia
small, dilated vessels near skin or mucus membrane surface
Diffuse/ Bad Scleroderma Test
Anti-Scl-70 +
Limited/ Benign Scleroderma Test
Anti- centromere AB
Ocular implications of scleroderma
lacrimal glands
Sjogren Syndrome
autoimmune disease causing destruction of exocrine glands
dry mouth, dry eyes, arthritis
Rheumatoid Arthritis
inflammatory disease of joints of hands, feet, wrists
affects PIPs
Hypersensitivity for RA
4- TNF and IL-2
3- osteoclasts destroy bone and PMN destroy hyaluronic acid
Rheumatoid Factor (RF)
diagnose RA- in joints
Ab (IgM) specific to Fc
RA Ocular Manifestations
Keratoconjunctivitis sicca (15-25%) Scleromalacia perforans (15%)
Juvenile Idiopathic Arthritis
ANA +; RNF - in 50%
most common cause of uveitis in children (80%)
Seronegative Spondyloarthropathies
arthritis w/o RA
associated with HLA-B27
causes back pain and uveitis
Psoriatic Arthritis
skin psoriasis and nail bed pitting
red plaque-like lesions on scalp, elbows, knees
uveitis
Ankylosing Spondylitis
bamboo spine
uveitis
Inflammatory Bowel Disease
20% have if have spondyloarthritis
Reactive Arthritis
conjunctivitis/ uveitis, urethritis, arthritis
postvenereal and postdysenteric
Sarcoidosis
uveitis and hypercalcemia
mainly in african americans
granuloma skin lesions, pulmonary infiltrates
