Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Rheumatology > Autoimmune conditions > Flashcards

Autoimmune conditions Flashcards

(72 cards)

Start Studying
1
Q

What is Systemic lupus erythematosus

A
  • inflammatory autoimmune connective tissue disease
  • It presents with varying and non-specific symptom
  • more common in women and Asians
  • Presents in young and middle ages
  • Often takes a relapsing-remitting cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Prognosis of Systemic lupus erythematosus

A
  • Chronic inflammation of vital organs such as the heart and kidneys can lead to problems
  • Cardiovascular disease and infection are leading causes of death.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the presentation of Systemic lupus erythematosus

A 
Fatigue
Weight loss
Arthralgia (joint pain) and non-erosive arthritis
Myalgia (muscle pain)
Fever
Photosensitive malar rash
Lymphadenopathy and splenomegaly
Shortness of breath
Pleuritic chest pain
Mouth ulcers
Hair loss
Raynaud’s phenomenon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What rash is seen in Systemic lupus erythematosus

A

Photosensitive malar rash. This is a “butterfly” shaped rash across the nose and cheek bones that gets worse with sunlight.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which antibodies are mostly associated with Systemic lupus erythematosus

A
  • Anti-nuclear antibodies

- Anti-ds-DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the pathology behind Systemic lupus erythematosus

A
  • Anti-nuclear antibodies targets proteins in the nucleus in the cells
  • This generates an inflammatory response leading to many different types of symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What autoantibodies should be looked for if suspected Systemic lupus erythematosus

A
  • anti-nuclear antibodies (ANA) (85%)
  • Anti-double stranded DNA (anti-dsDNA): VERY specific (70%)
  • Anti-Smith (highly specific to SLE but not very sensitive)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which antibodies are mostly associated with limited cutaneous systemic sclerosis

A

Anti-centromere antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which antibodies are mostly associated with Sjogren’s syndrome

A

Anti-Ro and Anti-La

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which antibodies are mostly associated with systemic sclerosis

A

Anti-Scl-70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which antibodies are mostly associated with dermatomyositis

A

Anti-Jo-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you diagnose SLE

A
  • SLICC Criteria or the ACR Criteria
  • Confirming the presence of antinuclear antibodies and establishing a certain number of clinical features suggestive of SLE.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the complications of SLE

A
  • Cardiovascular disease: HTN and CAD
  • Infection (due to immunosupression)
  • Anaemia of chronic disease: normocytic anaemia (can be pancytopaenic)
  • Pericarditis
  • Pleuritis
  • Lupus nephritis
  • Pulmonary fibrosis
  • Neuropsychiatric SLE
  • Recurrent miscarriage (& other pregnancy complications)
  • VTE (anti-phospholipid syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is lupus nephritis

A
  • occurs due to inflammation in the kidney
  • can progress to end-stage renal failure
  • assessed via urine protein:creatinine ratio and renal biopsy
  • renal biopsy is often repeated to assess response to treatment.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Neuropsychiatric SLE

A
  • caused by inflammation in the central nervous system
  • optic neuritis (inflammation of the optic nerve),
  • transverse myelitis (inflammation of the spinal cord)
  • psychosis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the first line treatment of systemic lupus erythematous

A
  • NSAIDs
  • Steroids (prednisolone)
  • Hydroxychloroquine (first line for mild SLE)
  • Suncream and sun avoidance for the photosensitive the malar rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In resistant or more severe lupus, what is the second line treatment

A
  • Immunosupression e.g. methotrexate, azothioprine, tacrolimus, ciclosporin
  • Biological therapies e.g. rituximab or bulimumab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Discoid lupus erythematous

A
  • Non-cancerous chronic skin condition
  • Rarely the lesions can progress to squamous cell carcinoma
  • increased risk of developing systemic lupus erythematosus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What do discoid lupus erythematous lesions look like

A 
Inflamed
Dry
Erythematous
Patchy
Crusty and scaling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the management of discoid lupus erythematous

A
  • Skin biopsy confirms diagnosis
  • Sun protection
  • Topical steroids
  • Intralesional steroid injections
  • Hydroxychloroquine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Sjogren’s syndrome

A
  • autoimmune condition
  • affects the exocrine glands
  • Leads to dry mucous membranes, such as dry mouth, dry eyes and dry vagina
  • Can be primary or secondary (SLE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the Schirmer Test

A
  • folded piece of filter paper under the lower eyelid with a strip hanging out over the eyelid
  • left in for 5 minutes and the distance along the strip hanging out that becomes moist is measured
  • tears should travel 15mm in a healthy young adult
  • A result of less than 10mm is significant.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the management of Sjogren’s syndrome

A

Artificial tears
Artificial saliva
Vaginal lubricants
Hydroxychloroquine is used to halt the progression of the disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What systemic affects can Sjogren’s Occasionally have?

A 
Pneumonia and bronciectasis
Non-Hodgkins lymphoma
Peripheral neuropathy
Vasculitis
Renal impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What eye complications can Sjogren's cause
conjunctivitis and corneal ulcers
26
What oral complications can Sjogren's cause
dental cavities and candida infections
27
What vaginal compliactions can Sjogren's cause
candidiasis and sexual dysfunction
28
What does scleroderma mean
- hardening of the skin - shiny, tight skin without the normal folds in the skin. - most notable on the hands and face
29
What is Systemic sclerosis/scerloderma
- autoimmune inflammatory and fibrotic connective tissue disease - Cause is unclear - affects the skin in all areas but it also affects the internal organs.
30
What are two main patterns of disease in systemic sclerosis:
Limited cutaneous systemic sclerosis | Diffuse cutaneous systemic sclerosis
31
What is limited cutaeneuos systemic sclerosis/scleroderma
- more limited version of systemic sclerosis | - It used to be called CREST syndrome.
32
What does CREST stand for
``` C – Calcinosis R – Raynaud’s phenomenon E – oEsophageal dysmotility S – Sclerodactyly T – Telangiectasia ```
33
What id diffuse cutaneous systemic sclerosis/scleroderma
Diffuse cutaneous systemic sclerosis includes the features of CREST syndrome plus many internal organs causing: - Cardiovascular problems - Lung problems - Kidney problems
34
What cardiovascular problems does diffuse cutaneous systemic sclerosis/scleroderma cause
- HTN | - CAD
35
What lung problems does diffuse cutaneous systemic sclerosis/scleroderma cause
- pulmonary hypertension | - pulmonary fibrosis.
36
What renal problems does diffuse cutaneous systemic sclerosis/scleroderma cause
- glomerulonephritis | - scleroderma renal crisis.
37
What is Sclerodactyly
- As the skin tightens around joints in the hand restricting the ROM and function - As the skin hardens and tightens further the fat pads on the fingers are lost. - The skin can break and ulcerate.
38
What are Telangiectasia
dilated small blood vessels in the skin. They are tiny veins that have dilated. They have a fine, thready appearance.
39
What is calcinosis
- calcium deposits build up under the skin | - most commonly found on the fingertips.
40
What is Raynauds phenomenon
- fingertips go completely white and then blue in response to even mild cold - caused by vasoconstriction of the vessels supplying the fingers. - commonly occurs without any associated systemic disease, however it is a classical feature of systemic sclerosis.
41
What causes Oesophageal dysmotility
- connective tissue dysfunction in the oesophagus | - commonly associated with swallowing difficulties, acid reflux and oesophagitis.
42
What auto-antibodies should you check for if suspecting Systemic sclerosis/scerloderma
- ANA - Anti-centromere antibodies - Anti-Scl-70 antibodies
43
What is the management of systemic sclerosis
- MDT - Steroids and immunosuppressants are usually started with diffuse disease and complications such as pulmonary fibrosis - Treatment of symptoms e.g. nifidipine for Raynauds
44
What non-medical management is advised for systemic sclerosis
- Avoid smoking - Gentle skin stretching to maintain the range of motion - Regular emollients - Avoiding cold triggers for Raynaud’s - Physiotherapy to maintain healthy joints - Occupational therapy for adaptations to daily living to cope with limitations
45
What is polymyositis
An autoimmune condition of chronic inflammation of muscles.
46
What is dermatomyositis
Autoimmune connective tissue disorder where there is chronic inflammation of the skin and muscles.
47
What can causes a raised Createnine kinase
- Polymyositis/dermatomyositis - Rhabdomyolysis - Acute kidney injury - Myocardial infarction - Statins - Strenuous exercise
48
What investigations should you complete if suspecting dermatomyositis/polymyositis
Createnine kinase - <300 U/L. In polymyositis - >1000U/L in dermatomyositis
49
Polymyositis or dermatomyositis can be a result of paraneoplastic syndrome, which cancers is it most associated with
Lung Breast Ovarian Gastric
50
What is the presentation of dermatomyositis/polymyositis
Muscle pain, fatigue and weakness Occurs bilaterally and typically affects the proximal muscles Mostly affects the shoulder and pelvic girdle Develops over weeks (Polymyositis occurs without any skin feature)
51
Dermatomyositis Skin Features
Gottron lesions - Photosensitive erythematous rash on the back, shoulders and neck - Purple rash on the face and eyelids - Periorbital oedema - Subcutaneous calcinosis (calcium deposits in the subcutaneous tissue)
52
What are gottron lesions
(scary erythematous patches) on the knuckles, elbows and knees
53
What autoantibodies should you check for if ? dermatomyositis/polymyositis
Anti-Jo-1 antibodies: polymyositis (but often present in dermatomyositis) Anti-Mi-2 antibodies: dermatomyositis. Anti-nuclear antibodies: dermatomyositis.
54
How is dermatomyositis/polymyositis diagnosed
``` Clinical presentation Elevated creatine kinase Autoantibodies Electromyography (EMG) Muscle biopsy can be used to establish a definitive diagnosis ```
55
What is the management of dermatomyositis/polymyositis
- Guided by rheumatologist - Assess for underlying cancer - Physiotherapy and OT - Corticosteroids first line
56
When steroids are insufficient management for dermatomyositis/polymyositis what else can be considered
Immunosuppressants (such as azathioprine) IV immunoglobulins Biological therapy (such as infliximab or etanercept)
57
What is Antiphospholipid syndrome
- disorder associated with antiphospholipid antibodies where the blood becomes prone to clotting - patient is in a hyper-coagulable state - Can be primary or secondary associated with SLE
58
Antiphospholipid syndrome is associated with which autoantibodies
Lupus anticoagulant Anticardiolipin antibodies Anti-beta-2 glycoprotein I antibodies
59
What is Anti-phospholipid syndrome associated with
- VTE: DVT/PE - Arterial thrombosis: Stroke, MI, Renal thrombosis - Pregnancy complications - Livedo reticularis - Libmann-Sacks endocarditis - Thrombocytopenia (low platelets
60
What pregnancy complications can you get with anti-phospholipid syndrome
Recurrent miscarriage Stillbirth Pre-eclampsia
61
What is Livedo reticularis
purple lace like rash that gives a mottled appearance to the skin.
62
what is Libmann-Sacks endocarditis
- non-bacterial endocarditis where there are growths (vegetations) on the valves of the heart - mitral valve is most commonly affected - associated with SLE and antiphospholipid syndrome
63
How is anti-phospholipid syndrome diagnosed
history of thrombosis or pregnancy complication plus persistent antibodies
64
What is the management of anti-phospholipid syndrome
- Managed by rheumatology, haematology and obstetrics (if pregnant). - Long term warfarin - Pregnant women: low molecular weight heparin (e.g. enoxaparin) plus aspirin
65
What is the INR range in patients with antiphospholipid syndrome
2-3
66
What is Felty's syndrome
- RA - Splenomegaly - Neutropaenia
67
What is ankylosing spondylitis
- arthritis mainly affecting the back caused by inflammation - the body produces extra calcium around the bones of the spine. - This can make extra bits of bone grow and cause your back and neck to be more stiff.
68
Symptoms of Ankylosing Spondylitis
- Back pain and stiffness (neck, shoulder, hip) - Can wake in night - Morning stiffness - Eases with exercise
69
Typical epidemiology of ankylosing Spondylitis
- males (sex ratio 3:1) | - 20-30 years old.
70
Signs of progressive disease on x ray in ankylosing spondylitis
- sacroiliitis: subchondral erosions, sclerosis - squaring of lumbar vertebrae - 'bamboo spine' (late & uncommon) - syndesmophytes: due to ossification of outer fibers of annulus fibrosus
71
What impact does ankylosing spondylitis have on the lung
- Apical fibrosis | - restrictive spirometry: pulmonary fibrosis, kyphosis and ankylosis of the costovertebral joints
72
Management of ankylosing spondylitis
1. NSAIDs + paracetamol 2. Encourage exercise and swimming 3. DMARDs: sulfasalazine if peripheral joint involvement (Anti-TNF)

Rheumatology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions