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Internal Medicine > Autoimmune Diseases > Flashcards

Autoimmune Diseases Flashcards

SLE MCTD

1
Q

Systemic Lupus Erythematosus is what type of autoimmune reaction?

A

Antibody-mediated response (Type III hypersensitivity reaction)

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2
Q

What features indicate Drug-Induced SLE?

A
  • Only anti-histone antibodies (No Anti-DsDna antibodies)
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3
Q

What drugs are associated with Drug-Induced SLE?

A
  • Sulfa drugs
  • Hydralazine
  • Isoniazid
  • Procainamide
  • Phenytoin
  • Etanercept
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4
Q

Clinical Manifestations of SLE?

A

“SOAP BRAIN MD”

  • Serositis
  • Oral ulcers
  • Arthritis (>2 joints)
  • Photosensitivity (sun-inducedrashes)
  • Blood disorders (anemia, thrombocytopenia,and leukopenia)
  • Renal disorder (lupus nephritis)
  • ANA positive (sensitive not specific)
  • Immunologic (anti-dsDNA, anti-Smith, lupus anticoagulant)
  • Neurologic disorders (seizures, psychosis)
  • Malar “butterfly” rash
  • Discoid rash
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5
Q

Blood Disorders in SLE are what type of hypersensitivity reaction?

A

Type II Hypersensitivity Reaction

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6
Q

What type of blood disorders are associated with SLE?

A
  • Hemolytic anemia with reticulocytosis
  • Thrombocytopenia
  • Lymphopenia
  • Leukopenia
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7
Q

What are the renal disorders associated with SLE?

A
  • Class IV Lupus Nephritis: Most severe, Diffuse Proliferative Glomerulonephritis, Wire loops lesions
  • Class V Lupus Nephtitis: Membranous Glomerulonephritis
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8
Q

Immunological Abnormalities in SLE? (Hint: Antibodies)

A
  • Anti-dsDNA Antibodies
  • Anti-Sm antibodies
  • Anti-phospholipid antibodies
  • Decreased C3 and C4
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9
Q

SLE patients may receive a false positive for which disease?

A

Syphillis

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10
Q

First line treatment for SLE?

A

Hydrochloroquine

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11
Q

Complications of SLE?

A
  • Libman-Sacks
  • Recurrent Miscarriages
  • Congential complete heart block (d/t Anti-SSA/Ro)
  • Interstitial Fibrosis
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12
Q

Serologic criteria for Mixed Connective Tissue Disease?

A

Anti-U1 RNP titer > 1:1,600

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13
Q

Clinical Criteria for Mixed Connective Tissue Disease?

A
  • Myositis/ Synvositis
  • Hand Edema
  • Raynard’s phenomenon
  • Acrosclerosis
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14
Q

MCTD (Mixed Connective Tissue Disease) Complications in the lung?

A
  • Pulmonary Hypertension

- Interstitial Pulmonary Fibrosis

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15
Q

MCTD Conplications in the Cardio system?

A
  • Heart Failure
  • Stroke
  • Vasculitis
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16
Q

MCTD Complications in the Renal System?

A
  • Membranous or Mesangial Glomerulonephritis
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17
Q

Treatment for MCTD?

A

NSAIDS and Low dose corticosteriods

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18
Q

Immune Cells most prominent in Polymyositis?

A

CD8+ T-Cells

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19
Q

Immune Cells most prominent in Dermatomyositis?

A

CD4+ T-Cells & B- Cells

20
Q

Skin manifestations in Dermatomyositis?

A
  • Heiotrope Rash- Racoon eyes (purple rash across eyes)
  • Gottron’s nodules- Purple patches/scales on knuckles
  • Poilkoderma (photosensitive rash)
21
Q

Diagnostic techniques in dermatomyositis/polymyositis?

A
  • Check Elevated Serum muscle enzyme levels

- MRI

22
Q

Antibodies common in Polymyositis and dermatomyositis?

A
  • Anti- Jo-1 (tRNA synthetase antibodies)
  • Anti- RNP (signal recognition particleantibodies)
  • Anti- Mi-2 (nuclear helicaseantibodies)
23
Q

Clinical Presentation of Myositis?

A

Symmetrical limb weakness in shoulders and anterior neck flexors progressing over weeks to months.

Add skin manifestations for dermatomyositis

24
Q

Results of EMG in both polymyositis and dermatomyositis?

A

Short-duration,low-amplitude,polyphasic motor potentials.

25
Q

Complications of Polymyositis an Dermatomyositis?

A
  • Respiratory failure
  • Myoglobinuric renal failure
  • Cardiomyopathy.
26
Q

Treatment of Polymyositis and Dermatomyositis?

A
  • Systemic Corticosteriods

- Azathioprine

27
Q

Sjorgen Syndrome?

A

Lymphocyte-mediated destruction of salivary and lacrimal glands–> atrophy and fibrosis

28
Q

Clincal Presentation of Sjorgen Syndrome?

A
  • Dry eyes (Keratoconjuntivitis sicca)
  • Dry mouth (Xerostomia)
  • Joint Pain
29
Q

Physical exam findings and antibodies found in Sjorgen Syndrome?

A

Bilateral Parotid gland swelling

Anti- Ro/SSA
Anti- La/ SSB

30
Q

Diagnostic test in Sjorgen Syndrome?

A

Lip biopsy finding lymphocyte sialadenitis (Definitive)

Schrimer’s test (checks tear production) (Suggestive)

31
Q

Complicationsof Sjorgen Syndrome?

A
  • Dental caries from dry mouth
  • MALT lymphomas
  • Congenital Heart Block
32
Q

Treatment for Sjorgen Syndrome?

A
  • Artificial tears and Saliva

- Muscarinic Agonists (Pilocarpine, Cevimeline) (if resistant)

33
Q

Scleroderma?

A

Iodiopathic systemic disease of connective tissue

aka Systemic Sclerosis

34
Q

Clinical Presentation of Scleroderma?

A
  • Thick, tight, shiny skin
  • Raynard Phenomenon
  • Myalgias, myositis, arthralgias, swelling
  • GI upset (Diarrhea, Constipation, Dysphagia)
35
Q

Complications of Scleroderma?

A
  • Renal Crisis
  • Myocardial Fibrosis
  • Interstitial Fibrosis
36
Q

Patients with Scleroderma Limited type present with what collection of symptoms?

A 
CREST Syndrome:
C- Anti- Centromere Antibodies and Skin Calcifications
Raynard's Phenomenon
Esophageal Hypomotility
Sclerodactyly 
Telangietasia
37
Q

Common antibody found in patients with Diffuse Scleroderma?

A

Anti-SCL 70 (Topoisomerase I)

38
Q

Treatment for Scleroderma?

A

Treat each systemic symptoms

39
Q

Clinical Findings of Cryogloblinemia?

A
  • Renal Disease
  • Non-blanching Purple Purpura
  • Peripheral Neuropathies
40
Q

Clinical Presentation of Ankylosis Spondylitis?

A
  • Inflammatory lower back pain
  • Neck and upper thoracic pain
  • Pain down the posterior lower extremity (fromsciatic nerve compression)
  • Shortness of breath from costovertebral joint involvement
  • Enthesitis
41
Q

Diagnostic imaging for Ankylosing Spondylitis?

A

MRI

42
Q

Treatment for Ankylosing Spondylitis?

A
  • Physical Therapy
  • NSAIDS
  • Methotrexate/Sulfasalazine
43
Q

Polymyalgia Rheumatica?

A

Autoimmune that causes several sites of muscle and joint pain. Associated with temporal arteritis

44
Q

Clinical Presentation of Polymyalgia rheumatica?

A
  • Symmetrical morning muscle stiffness in shoulders, hips, neck.
  • Fatigue
45
Q

Physical Exam Findings of Polymyalgia Rheumatica?

A
  • Normal Muscle Strength (vs. Polymyositis)
  • Edema of Extremities
  • Tenderness
  • Limited motion
46
Q

Lab Findings in Polymyalgia Rheumatica?

A
  • Decreased Hematocrit and Increased ESR
47
Q

Treatment for Polymyalgia Rheumatica?

A

Low dose corticosteriods

Internal Medicine (15 decks)

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