Autoimmune Disease

Question 1

Sarcoidosis

• Lip biopsy shows what..?
• Age
• Involved organs
• Describe skin lesions
• Treatment

Answer 1

• Minor salivary glands have non-casseating granulomas
• Middle age
• Lung, eyes, joints, lymph nodes, skin, salivary glands
• Purple papules
• Systemic steroid

Question 2

Heerfordt’s syndrome

• Clinical presentation
• Associated with what disease

Answer 2

Heerfordt’s syndrome: parotid enlargement, uveitis, facial paralysis, fever.

Associated with Sarcoidosis

Question 3

RA

• Common lab findings
• Duration of morning symptoms
• What type of joints are normally involved

Answer 3

RA

• Elevated ESR, Elevated C-reactive protein, RA+, ACPA+
• Morning stiffness that lasts several hours
• Small joints, symetric

Question 4

SLE

• Histo findings
• Clinical findings
• Affected organs
• What immune cell is hyperactive?
• What type of hypersensitivity reaction?
• Treatment

Answer 4

• Anti-Double Stranded-DNA, Antinuclear Antibody
• Arthralgia, malar rash, oral ulcers, pancytopenia
• Any organ, kidney, liver, heart are common
• B-cell
• Type III Hypersensitivity
• Steoids, Chemo

Question 5

MG

• Which receptor is targeted
• Clinical symptoms
• Status of deep tendon reflexes
• Anesthesia management

Answer 5

• Acetylcholine receptor
• Weakness in proximal muscles and extraoccular muscles, eyelid ptosis
• Deep tendon reflexes preserved (big muscles stretched when tendon is percussed). Test
• Continue anti-cholinergic and use less non-depolorizing paralytic. Avoid succhinyle choline.

Question 6

Fibromyalgia

• Diagnostic criteria

Answer 6

• >11 trigger points, pain for >3 months

Question 7

Types of Hypersensitivity

• Mechanism
• Example

Answer 7

Question 8

Vasculitides

• List all 7

Answer 8

Question 9

c-ANCA

• Disease
• Symptoms
• Targeted tissue
• Tx

Answer 9

c-ANCA

• Wegners Granulomatosis
• congestion, epistaxis, muscle aches, fatigue, nodules on CXR
• Targeted tissue: small/medium vessels
• Tx: chemo

Question 10

p-ANCA

• Disease
• Symptoms
• Targeted tissue
• Tx

Answer 10

• Churg-Strauss Angitis
• Myalgia, Asthma, cough, neuropathy, angina
• Respiratory tract, small/large vessels with eosinophilic granulomas, necrotizing vasculitis
• Steroid

Question 11

p-ANCA + ESR

• Non-granulomatous vasculitis
• Organs effected
• Tx

Answer 11

Microscopic polyangitis

Lung, Kidney, nerves vasculitis

Skin lesions

Steroid

Question 12

Giant Cell arteritis

• affected vessels
• symptoms
• histo
• tx

Answer 12

• Branches of carotid a with granulomas
• Severe headache, tender and pulseless temporal artery
• Jaw claudication
• High-dose steroids