Clinical Approach To Autoimminuty

Question 1

What are ards and why do they occur

Answer 1

Autoimmune rheumatic diseases, • Heterogeneous group of diseases
• Immune tolerance breakdown
• Production of pathogenic antibodies • Multisystemic features

Question 2

Describe the importance of autoantibodies

Answer 2

• Aid to diagnosis
• Associated with specific clinical features • Disease prognosis
• To stratify therapy

Question 3

Describe the epidemiology of lupus

Answer 3

• Femaletomaleratio:9:1
• Prevalence:24/100,000
• Race: Afro-Caribbean > South Asians > Caucasians
• Genetic factors are important
• Environmental factors

Question 4

How is a history taken for ards

Answer 4

Current symptoms
• Pain
• Stiffness
• Swelling
• Patternofjointinvolvement

Evolution
• Acuteorchronic?
• Associatedevents
• Responsetotreatment/Familyhistory

Involvement of other systems
• Skin,eye,lung
• Malaise, weightloss, fevers, nightsweats?
Impact on patient’s lifestyle

• Constitutional symptoms (Fever, fatigue, weight loss, night sweats,
Poor appetite)
• “Glove and sweater” approach

Question 5

What is the glove and sweater approach

Answer 5

Raynauds
Joint pains and swelling Hand rash
 
Proximal muscle weakness > Myalgia Hair loss
Eye and mouth dryness
Nose bleeds
Mouth ulcers
Pleuritic chest pain Pericardial pain
Truncal Rash/Photosensitivity Limb weakness

Question 6

Describe the examination for ards

Answer 6

S

Question 7

Ecsirbe the investigators of ards

Answer 7

S

Question 8

What is the treatment approac for ards

Answer 8

• Patient education RE: lifestyle modification, use of sunscreen
• Start DMARDs : Hydroxychloroquine, Azathioprine, Mycophenolate
• Use of steroids: Prednisolone, methylprednislone
• In Severe cases: IV Cyclophosphamide

Question 9

What are the diagnostic criteria for lupus

Answer 9

-

Question 10

Describe the epidemiology of rheumatoid

Answer 10

• Female to male ratio: 3:1
• Prevalence: 1%
• No race predilection
• Genetic factors/environmental factors
Any age

Question 11

Describe history for rA

Answer 11

Current symptoms
• Pain
• Stiffness
• Swelling
• Patternofjointinvolvement
Evolution
• Acuteorchronic?
• Associatedevents
• Responsetotreatment/Familyhistory
Involvement of other systems
• Skin,eye,lung
• Malaise,weightloss,fevers,nightsweats?

Question 12

Describe the investigations for rna

Answer 12

-

Question 13

Describ ethe examinations for ra

Answer 13

-

Question 14

Descrbe the treatment of ra

Answer 14

• Start DMARDs early!! : Methotrexate Hydroxychloroquine, Sulfasalazine, Leflunomide
• Use of steroids: Prednisolone, methylprednisolone
• Combination therapy is usual.