Connective Tissue Diseases (4)

Question 1

Types of Arthritis (deign, seropos, seroneg, crystal, vasculides)

Answer 1

Degen- OA
Seropos- RA, SLE, shortens
Seroneg- PA, AS, reactive
crystal- gout/pseudo gout`

Question 2

General tests for inflammation

Answer 2

ESR

CRP (increases faster, better for monitoring)

Question 3

RA tests

Answer 3

-IgM (IgG)- antibodies against the Fc frag of IgG

RF- not very specific (don’t use for screening)

Question 4

Anti phospholipid antibodies (causes what and what is it pos in)

Answer 4

causes thrombosis, excessive coagulation

pos in 20-40% of SLE

Question 5

What is anti neutrophil cytoplasmic antibodies (ANCA) seen in

Answer 5

seen in vasculitis

Question 6

What are cryoglobulins and what are they seen in

Answer 6

immunoglobulins which forms precipitates or gels in the cold tat become soluble when warmed (reynauds phenom)

Seen in RA, SLE, polyarteritis nodosa

Question 7

HLAs associated w

1. RA
2. AS
3. reactive, RA, graves, celiac, goodpastures

Answer 7

1. HLA DR4
2. HLA B27
3. HLA B27

Question 8

What is the classical and alternate pathway of complement

Answer 8

classical- activated by antigen antibody complex

alternate- activated by microbes

Question 9

steps when complement is activated

Answer 9

c3 converted to c3a and c3b
c5 converted to c5a and c5b

c3a and c5a stim neutrophils and mast cells to increase phase activity
c3b coat pathogens (opsonization follows)

c5b for membrane attack complex with c6-9

Question 10

RA features + what may be pos b4 symptoms

Answer 10

systemic
bimodal (15-35, 55-65)
women>men
Anticitrullinated pro antibody may be positive 9 years before symptoms

Question 11

SLE features, pop

Answer 11

young women

fever, rash, artritis

Question 12

Antibodies in RA, SLE, Scleroderma, dermatomyotisis, MCD

Answer 12

RA- RF
SLE- Anti-sm, anti-DNA, C3, C4, CH50
Scleroderma- Anti-Scl-70, anti centromere
Dermatomyositis- CK increased anti jo-1
MCD- Anti RNP

Question 13

tx of RA

Answer 13

treat with high dose methotrexate

Question 14

AS age, gender, lab tests

Answer 14

men 15-40
m>w
HLA B27

Question 15

Tests for Gout and pseudogout

Answer 15

gout- Urate, Kidney function tests, synovial fluid tests

psuedogout- synovial fluid microscopy

Question 16

Key cause of gout

Answer 16

high concentration of urate may lead to kidney stones and/or deposition of uric acid crystals in synovial fluid of jts.

definitive test–> need to sample the fluid in swollen jt
needle shaped crystals

Question 17

Polymyalgia rheumatica- age, gender, associated disease, lab tests

Answer 17

over 70 w
can lead to temporal arteritis
lab tests- none, dx by response to prednisone

Question 18

What is infectious arthritis seen in

Answer 18

hep b/c
rheumatic fever
lyme disease
septic arthritis
STDs
Rubella

Question 19

rheumatic fever- s/s and cause

Answer 19

jts painful at first and heart perm damaged

group A haemolytic streptococci

Question 20

Neisseria gonorrhoea arthritis and s/s

Answer 20

mono or polyarticular arthritis
tenosynovitis or wrist or dorsum of hand
conjunctivitis

lab- cucture organism in the jt

Question 21

Reuters syndrome s/s

Answer 21

asymmetrical oligo arthritis
sacroilitis
extra articular inflammations

lab tests- culture, HLA B27