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AC1 > Autoimmune Rheumatic Diseases > Flashcards

Autoimmune Rheumatic Diseases Flashcards

1
Q

Most rheumatic diseases are multi-system, how may the following systems be affected?

Joints
Lungs
Veins
Skin
Nervous system
Eyes
Kidneys
Muscles

A

Joints: synovitis

Lungs: alveolitis/pulmonary fibrosis

Veins/arteries: vasculitis, thrombosis

Nervous system: neuropathies, cerebral damage

Eyes: inflammation

Kidneys: nephritis

Muscles: myositis

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2
Q

Name 4 indicators that a disease is autoimmune

A

Auto-reactive T cells

Auto-reactive B/plasma cells - autoantibodies

Antibodies detectable at sites of damage

Immunosuppression treats the disease

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3
Q

Which organ specific autoimmune diseases affect the:

Brain
Thyroid
Muscle
Stomach
Adrenal
Pancreas

A

Brain: MS

Thyroid:

  • Hashimoto’s thyroiditis
  • Primary myxoedema
  • Thyrotoxicosis

Muscle: Myasthenia gravis

Stomach: pernicious anaemia

Adrenal: addison’s disease

Pancreas: insulin dependent DM

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4
Q

Which non-organ specific autoimmune diseases affect the:

Muscle
Kidney
Skin
Joints

A

Muscle: dermatomyositis

Kidney: SLE

Skin:

  • Scleroderma
  • SLE

Joints: RA

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5
Q

Which extractable nuclear antigens (ENAs) can be found in Sjogren’s syndrome?

A

Anti-Ro

Anti-La

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6
Q

Which extractable nuclear antigens can be found in systemic sclerosis?

A

Anti-Scl70

Anti-centromere

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7
Q

Which extractable nuclear antigens can be found in SLE?

A

Anti-Sm

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8
Q

Which extractable nuclear antigen can be found in Anti-Jo-1 sydrome?

A

Anti-Jo-1

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9
Q

What is the limitation of finding a positive ANA?

A

Positive ANAs occur in healthy people, particularly with increasing age

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10
Q

Name some common symptoms in patients with autoimmune rheumatic diseases

A

Secondary Reynaud’s phenomenon

Joint pains

Rashes

Fatigue

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11
Q

Name the 2 phases of reynaud’s phenomenon

A
  1. White
  2. Blue
  3. Red
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12
Q

Name some multi-system rheumatic diseases

A

Rheumatoid arthritis

SLE

Primary Sjogren’ syndrome

Systemic sclerosis

Ankylosing spondylitis

Primary vasculitis e.g. granulomatous polyangitis

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13
Q

Describe the rash typical of SLE

A

‘Butterfly rash’ across nose and cheeks sparing naso-labial folds

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14
Q

What are the 2 types of Sjogren’s syndrome?

A

Primary: standalone disease

Secondary: in association with other diseases e.g. SLE, RA

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15
Q

What is Sjogren’s syndrome?

A

Autoimmune damage to secretory glands

Takes years to develop

More common in females than males

Most common in 50-60 age groups

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16
Q

What are the symptoms of Sjogren’s syndrome?

A

Sicca symptoms:

  • Dry eyes
  • Dry mouth (xerostomia)
  • Vaginal dryness
  • Cough (dryness of airways)

Increased dental decay

Inflammatory arthritis

Rashes- can look similar to SLE, vasculitic rashes

Pulmonary and renal involvement (rare)

17
Q

What examination findings may be indicative of Sjogren’s syndrome?

A

Reduced tear flow

Dry oral mucosa/ dental decay

Oral candidiasis (thrush)

Salivary gland swelling

Skin rashes:

  • Vasculitic: palpable purpura
  • Annular: similar to SLE (due to Anti-Ro and Anti-La antibodies), appears in sun exposed areas
18
Q

What investigation findings may be present in Sjogren’s syndrome?

A

Anaemia of chronic disease- low Hb

Raised immunoglobulins (IgG)

High ESR

ANA positive

Anti-Ro/Anti-La positive

19
Q

What treatments are available for Sjogren’s syndrome?

A

To treat sicca symptoms:

  • Humidifired environment
  • Punctal plugs
  • Tear/saliva substitutes
  • Saliva stimulants

Oral candidiasis: topical antifungal (nystatin)

Dental care: avoid sweet foods, regular check ups, flouride toothpaste

Inflammatory arthritis: immunosuppressives (methotrexate)

Rashes: hydroxychloroquine

20
Q

What other autoimmune diseases often exist alongside Sjogren’s syndrome?

A

Autoimmune thyroid disease

Coeliac disease

Primary biliary cirrhosis

21
Q

Name some complications of Sjogren’s syndrome

A

40 fold increase in risk of lymphoma

Inflammatory lung disease

Vasculitis/peripheral neuropathies

AC1 (32 decks)

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