Connective Tissue Disease Flashcards

1
Q

how does sjogren’s syndrome present? (4)

A

dry eyes, mouth + throat
parotid gland enlargement
joint pains
fatigue

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2
Q

who is a typical sjogren’s syndrome patient?

A

middle aged female

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3
Q

what antibodies are seen in sjogren’s syndrome?

A

anti Ro

anti La

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4
Q

besides antibodies, what else can be seen in sjogren’s syndrome?

A

raised IgG

raised inflammatory markers

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5
Q

what are patients at increased risk of in sjogren’s syndrome?

A

lymphoma

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6
Q

what is another name for systemic sclerosis?

A

scleroderma

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7
Q

what characterises systemic sclerosis?

A

vasculopathy
autoimmunity
fibrosis

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8
Q

how does systemic sclerosis present? (5)

A
raynaud's
GORD
telangiectasia 
SOB 
difficulty swallowing
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9
Q

what are four red flags for systemic sclerosis?

A

raynaud’s coming on in mid adulthood
digital ulcers or ischaemia
loss of dexterity in the hands
raynaud’s + SOB

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10
Q

what are the two types of systemic sclerosis?

A

diffuse

limited

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11
Q

what is diffuse systemic sclerosis?

A

when the skin involvement is on extremities above + below the elbows and knees, and the face and trunk

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12
Q

what is limited systemic sclerosis?

A

when the skin involvement is only below the elbows and knees and on the face

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13
Q

what five antibodies can be seen in systemic sclerosis?

A
anti centromere 
anti SCL 70 
anti pm scl 
anti to
anti RNA polymerase
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14
Q

what is another name for anti SCL 70?

A

anti topoisomerase

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15
Q

what facial changes can be seen in systemic sclerosis?

A

small mouth with puckering
beaked nose
thickened and tight skin
telangiectasia

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16
Q

what are three possible GI complications of systemic sclerosis?

A

GORD
malabsorption
small intestinal bacterial overgrowth

17
Q

what are two possible respiratory complications of systemic sclerosis?

A

interstitial lung disease

pulmonary arterial hypertension

18
Q

what renal complication can occur in systemic sclerosis?

A

scleroderma renal crisis

19
Q

how does scleroderma renal crisis present?

A

worsening renal function

sustained high BP

20
Q

what antibody is associated with scleroderma renal crisis?

A

anti RNA polymerase

21
Q

what puts patients at risk of scleroderma renal crisis?

A

high dose steroids

22
Q

how is scleroderma renal crisis managed?

A

ACE inhibitors

23
Q

what are the three phases of raynaud’s phenomenon?

A

blanching - white
acrocyanosis - blue
reactive hyperaemia - red

24
Q

what is the first line treatment for raynaud’s?

A

calcium channel blockers - nifedipine

25
how is skin fibrosis in scleroderma managed?
methotrexate | mycophenolate
26
what is the pathophysiology behind SLE?
immune system attacks cells causing inflammation immune complexes form and precipitate in areas, resulting in further immune response
27
who is most commonly affected by SLE and when does it usually present?
more common in females commonly presents in childbearing years
28
what diagnostic criteria is used to diagnose SLE?
EULAR/ACR 2019 SLE classification citeria
29
what criteria must be met to diagnose SLE?
ANA positive and score >10 in classification criteria
30
name two markers of SLE
low complement levels | anti phospholipid antibodies
31
what score can be used to monitor SLE activity?
SLEDAI score