Autoimmune conditions

Question 1

SLE clinical features

Answer 1

Fever, fatigue, weight loss
•	Malar rash 
•	Photosensitivity
•	Arthritis + arthralgia
•	Renal disorder --> haematuria 
Discoid rash
Non-scarring alopecia

Question 2

Sarcoidosis TCP

Answer 2

<40yo African American woman presents with
• Fever, malaise, weight loss
• LUNG INVOLVEMENT = dyspnoea, dry cough (bilateral hilar lymphadenopathy), crepitations
• Chest pain
• Anterior uveitis + sicca syndrome
• Erythema nodosum

Question 3

GCA TCP

Answer 3

70yo F presents with
•	Constitutional symptoms 
•	Anaemia sx: fatigue + malaise
•	Dull throbbing headache over temples 
•	Intermittent/constant
•	Tender temples
•	Jaw claudication --> severe weight loss
•	Sudden monocular visual loss – amaurosis fugax + diplopia
•	Polymyalgia rheumatic 50% of pts

Question 4

What is the tetrad of findings in Wegeners?

Answer 4

Microscopic polyangiitis characterised by a tetrad:

1. Granulomas with cavity of lung – similar to TB: Cough, dyspnoea, haemoptysis, wheezing, hoarseness, pleuritic pain
2. Granulomatous inflammation around small vessels – vasculitis
3. Glomerulonephritis - rapidly progressive (crescentic)
4. Tissue necrosis of nasal septum and oral cavity –> saddle-nose deformity, chronic rhinitis/sinusitis

Question 5

TCP 5 features of Henoch Schonlein purpura

Answer 5

2-8 year old kid presents with 1) abdominal pain 2) palpable purpura 3) haematuria 4) proteinuria and 5) 50% of pts have had recent URTI

Question 6

What is a good general test to screen for autoimmune condition?

Answer 6

levels of anti-nuclear Ab (ANA) - they are observed in many different autoimmune conditions.

Question 7

What is the rule concerning ANA + ANCAs?

Answer 7

ANAs - generally more increased in CT disease

ANCA- generally more increased in vasculitides

Question 8

Disease-specific Ab for Sjogrens

Answer 8

Anti-Ro/SSA

Anti-La/SSB

Question 9

Disease-specific Ab for SLE

Answer 9

anti-ds DNA

Question 10

Disease-specific Ab for Wegeners

Answer 10

c-ANCA

Question 11

Disease-specific Ab for PSC

Answer 11

atypical p-ANCA

Question 12

3 antibodies we test for in antiphospholipid syndrome

Answer 12

lupus anticoagulant
anti-b2 glycorpotein antibody
anti-cardiolipin