Autoimmune diseases ( Scleroderma and dermatomyositis )

Question 1

What is the typical sign for dermatomyositis?

Answer 1

Gottron’s sign

Question 2

What is the hallmark antibodies for MCTD ?

Answer 2

• anti–U1-RNP antibodies.

#_Symptoms:
• Raynaud phenomenon, swollen hands.

Question 3

TTT of raynaud’s syndrome ?

Answer 3

• CCB.
• Nitoglycerin.
• Sildenfil (viagra)
• parental vasodilators.

Question 4

Scleroderma?

Answer 4

• An autoimmune systemic disease occurring with the fibrosis of the skin and internal organs.
• more common in women 9 : 1 - onset: 20-40 years

Question 5

Diagnostic Criteria for dermatomyositis ?

Answer 5

_Bohan and Peter Criteria:

1• Symmetric proximal muscle weakness “ most common symptom “
2• typical rash
3• elevated serum muscle enzymes
4•myopathic changes on EMG
5• characteristic muscle biopsy abnormalities and
absence of histopathologic signs of other
myopathies

Question 6

dermatomyositis complications ?

Answer 6

• Interstitial lung diseases.
• Esophageal diseases.
• Myocarditis.
• Malignancy.

Question 7

Which immunological marker in systemic sclerosis is an indicator of severe course (dSSc) ?

Answer 7

Anti-DNA Topoisomerase I antibodies (Scl 70)

• Anti-centremere is associated with less severe course. (ISSc)

Question 8

Dermatomyositis TTT?

Answer 8

GCS are the cornerstone of initial therapy.

Question 9

what basic laboratory studies can be performed to confirm the diagnosis of systemic sclerosis?

Answer 9

• ANA ( ACA for limited and Scl-70 for diffuse )
• lung vital capacity and diffusing capacity for carbon monoxide.
• HRCT.
• Intrarenal duplex doppler sonography.
• ECHO.

Question 10

What are the potential complications of this morphea ?

Answer 10

• Joint immobility.
• difficulty breathing.
• hemiatrophia faciei.

Question 11

Which ANA is characteristic for systemic sclerosis ?

Answer 11

Scl-70 ANA.

*the question is not specific enough.

Question 12

Which immunological marker in systemic sclerosis is most commonly in dSSc with renal involvement ?

Answer 12

Anti-RNA polymerase-III antibodies

Question 13

Which syndromes are overlapping when u have “ Anti-U1RNP antibodies “ ?

Answer 13

The marker of MCTD

Question 14

Criteria for the Classification of Systemic Sclerosis?

Answer 14

• Skin hardening on the hands (9 points)
• Sclerodactyly (2-4)
• Erosive lesions/ulceration of fingers (2-3)
• Telangiectasia (2)
• Abnormal capillaroscopy (2)
• Pulmonary fibrosis / PAH (2)
• Raynaud’s phenomenon (3)
• SSc immunological markers (3)

≥9

Question 15

Indicate specific autoantibodies that can occur in dermatomyositis ?

Answer 15

• Jo-1

Question 16

What is the most specific rash for DM ?

Answer 16

• Heliotrope rash.
  • A reddish-purple eruption on the upper eyelid
  • accompanied by swelling of the eyelid

Question 17

Which syndromes are overlapping when u have “Anti-PM-Scl “ antibodies ?

Answer 17

• systemic sclerosis overlap syndromes with scleromyositis.