Connective Tissue Disease

Question 1

what are the 4 key features of connective tissue disease?

Answer 1

Inlammation
fibrosis
vasoconstriction (inc. Reynauds)
Vascular thombosis

Question 2

What is the most significant risk factor for getting a connective tissue disease?

Answer 2

having a family member with a CTD

Question 3

What are the categories of symptoms displayed in SLE?

Answer 3

Photosensitive rash
'Nonspecific symptioms'
Vascular change
Arthritis
Systemic involvement
Nervous system

Question 4

Where is the photosensitive rash of SLE most likely to occur?

Answer 4

on the face as this is the most exposed to the sun

Question 5

What nonspecific symtoms can a patient with SLE dispaly?

Answer 5

Fatigue
lethary
low fever
weight loss
alopecia
mucosal ulceration

Question 6

What vascular symptoms may be present in a patient with SLE?

Answer 6

Nail edge infarcts

Splinter Haemorrhages

Question 7

Describe the features of arthritis caused by SLE

Answer 7

Symettrical
Small joints
Polyarthritis
non-erosive
deformaties are reducible and so the patient should still be able to make a fist

Question 8

How does SLE affect the kidney?

Answer 8

anti-DNA antibodies ae nephrotoxic and so doing a dipstick on an SLE atient will show excess protein (and may show blood

Question 9

What are the 11 criteria in the diagnosis of SLE and how many must be met to confrim SLE?

Answer 9

11 criteria - 4 must be met.

• Malar rash
• oral ulceration
• discoid rash (in sun exposed areas)
• arthritis
• Photosensitivity
• Serositis
• Neurologivcal disorders (Seizures, psychosis)
• Renal Disorders (Proteinuria, ed cell casts in urine)
• Haematological Disorder(leucopenia, lymphopenia, haemolytic anaemia, thrombocytopenia)
• Immunological Disorder (antiDNAAB, AntiSm Ab)
• ANA positive

Question 10

What is serositis and where would you commononly find the inflamation

Answer 10

Inflammation of serous tissue including Lung Pleura, pericardium and peritoneum

Question 11

What investigations can be carried out to diagnose SLE? (3)

Answer 11

Urine dipstick (proteinuria and red cell casts)

FBC - looking for pancytopaenia, anaemia, thrombocytopaenia, leukopenia, lymphpenia and raised CRP (ESR)

AntiDNA and/or ANA antibody testing

Question 12

What are the three biggest complications arising from SLE?

Answer 12

Increased incidence of artherosclerotic disease
Increased risk of thrombus
Increased risk of infection.

Question 13

How should moderate to severe SLE?

Answer 13

Sulphasalisate, methotrexate, hydroxychloroquine, steroid injections in flare ups and symptomatic treatment in specific organ involovement