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MSK clinical > Autoimmune diseases > Flashcards

Autoimmune diseases Flashcards

1
Q

what is the prevalence of SLE?

A

females: males 9:1
onset 15-15yrs (disease of the young)
afro carribeans>asian>caucasian

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2
Q

what are some of the presentations of SLE?

A 
face:
- butterfly rash
- photosensitivity
- allopecia
nervous:
- seizures
- hemiplegia
- ataxia
- neuropathy 
- cranial nerve palsies
chest:
- pleurisy
- pleural effusion
- fibrosis
skin:
- vasculitis
- purpura
- urticaria
heart:
- pericarditis
- endocarditis
- arctic valve lesions
blood:
- anaemia
- leukopenia
- thrombocytopenia 
myopathy
abdominal pain
reynauld's phenomenon 
fever
depression
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3
Q

what is the classification criteria for SLE?

A

any 4 of the following:

malar rash
discoid rash
photosensitivity
oral ulcers
arthritis
serositis
renal
neurological
haematological
immunological
ANA
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4
Q

what is the classifications of scleroderma?

A

limited (localised)

diffuse (systemic)

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5
Q

what is the prevalence of scleroderma?

A

onset 30-50yrs

female:male 3:1

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6
Q

what are the features of limited scleroderma?

A 
also known as crest syndrome
Calcinosis
Reynaulds
Esophageal dysmotility 
Sclerodactyly
Telangiectasia
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7
Q

what are the complications of diffuse and localised scleroderma?

A

limited:
- pulmonary hypertension
diffuse:
- pulmonary fibrosis
- renal crisis
- small bowel overgrowth

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8
Q

what is the prevalance of sjogren’s syndrome?

A

onset 40-50s

female: male 9:1

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9
Q

what is sjogrens syndrome and how does it present?

A

an autoimmune connective tissue condition

presentation;

  • dry mouth and eyes
  • parotid duct enlargement
  • malaise, fatigue, fever
  • arthralgia, myalgia
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10
Q

what are the complications of sjogrens syndrome?

A 
lymphoma 
neuropathy
purpura 
interstitial lung disease
renal tubular acidosis
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11
Q

what is autoimmune myositis?

A

a group of autoimmune conditions which cause inflammation and weakness in the muscles (polymyositis) or the skin and muscles (dermatomyositis)

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12
Q

what are the main presenting features of autoimmune myositis?

A

muscle weakness
raised CK
(no pain or stiffness)

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13
Q

what are the complications of autoimmune myositis?

A

cancer

interstitial lung disease

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14
Q

what are clinical signs associated with dermatomyositis?

A

gottron’s papules

heliotrope rash

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15
Q

what is the classification criteria for giant cell arteritis?

A 
3 of the following:
age > 50 yrs
new onset headache
temporal artery tenderness/reduced pulsation
ESR > 50
abnormal temporal biopsy
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16
Q

what is the diagnostic investigation for giant cell arteritis?
and how is it treated?

A

temporal artery biopsy

prednisolone

17
Q

what is giant cell arteritis?

A

vasculitis of the large vessels

18
Q

what condition is a saddle shaped nose found in?

A

granulomatosis with polyangitis

ANCA associated vasculitis

19
Q

what are the ANCA associated vasculitis conditions?

A

granulomatosis with polyangitis
microscopic polyangitis
eosinophilic granulomatosis with polyangitis

20
Q

what vessels does granulomatosis with polyangitis (Wegner’s) affect?

A

medium/large vessels of mainly the upper and lower respiratory tract (pulmonary haemorrhage)

21
Q

what type of vessels does microscopic polyangitis affect?

A

small vessels

necrotising arteritis may be found in medium and small vessels

22
Q

what is eosinophilic granulomatosis with polyangitis? (churg strauss)

A

eosinophil rich and necrotising granulomatous inflammation involving the respiratory tract
associated with asthma and eosinophilia

23
Q

what are the specific ANA profiles in SLE?

A

anti - dsDNA antibody
anti- Ro antibody
anti- Smith antibody

24
Q

what are the specific ANA profiles in scleroderma?

A

anti - Sci-70

anti- centromere

25
Q

what are the specific ANA profile in polymyositis?

A

Jo-1

26
Q

what are the specific ANA profiles in sjogren’s disease?

A

anti-60 kd Ro

anti- La

27
Q

would investigations would you carry out if you suspected sjogrens syndrome?

A

anti-60 kd Ro antibody
anti-La antibody
Schirmer’s test

28
Q

what investigations would you carry out if you suspected SLE?

A 
ANA, anti-dsDNA, anti-Ro, anti-Smith antibodies 
FBC 
protein creatinine ratio 
urinalysis 
renal biopsy 
ESR and CRP 
complement c3 and c4
29
Q

what is the treatment for SLE?

A

NSAIDS + immunosuppression (hydrochloroquine)

30
Q

what is the treatment for scleroderma?

A

steroids + immunosuppression (hydrochloroquine)

nifedipine for reynaulds

31
Q

what ANA is associated with diffuse scleroderma?

A

anti-sci 70 antibody

32
Q

what ANA is associated with localised scleroderma?

A

anti-centromere antibody

MSK clinical (25 decks)

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