Connective Tissue Disorders CIS - McGowan Flashcards
35 y/o AA female, bipolar disease, joint pain and episodic chest pain. ANA positive w/ speckled pattern. Rash on cheeks.
Why chest pain?
Why bipolar disease?
SLE
Psychiatric disorder common in SLE
Peri-oral furrowing
Scleroderma
Heliotrope rash
Dermatomyositis
?
?
45 white female, seizures, fatigue, headache, myalgias, arthralgias, LAD. Rash on face worse after being in sun. ANA positive.
Additional serology?
SLE
Anti-dsDNA
Mood/seizure disorder, Photosensitivity
Anti-centromere
Means what?
CREST - limited scleroderma
Calcinosis, Raynauds, Esophageal Dismotility, Sclerodactyly, Telangiectasias
Anti-topoisomerase I
Diffuse scleroderma
Anti-Scl-70
Diffuse scleroderma
Anti-Jo-1
Dermatomyositis (check Polymyositis too)
43 Hispanic woman, hematuria, myalgias, arthralgias. Cr = 2.2 on lab work. Anti-dsDNA and Anti-Sm positive.
SLE
50, AA female, fatigue and perioral lesions, has had intermittent symptoms for years. PMH of CAD, chronic intermittent abdominal pain, Hashimoto’s, seizures. Positive ANA and dsDNA.
Most likely mortality? Or?
What is the abdominal pain?
SLE
Atherosclerosis; CKD/ESRD
Intestinal angina
Look up Behcet’s
a
45 W female, chest pain, history of SLE. Positive phospholipid antibodies. 2D echo shows valve thickening and verrucous valvular lesions. Called what?
Nodules are ___, meaning w/o bacteria
Libman Sacks endocarditis
Sterile
Signs of sjogrens
Anti-SSA, Anti-SSB
Enlarged parotid gland
Dry eyes, dry mouth
B-cell lymphoma (MALT)
Mood disorder, splenomegaly, diffuse LAD, ARF and chest pain that does not improve w/ position. DVT. Proliferative glomerulonephritis. Cotton wool spots.
Antibody? (3)
What is the chest pain?
IF it was affected w/ position?
SLE + Anti-phospholipid antibody syndrome
Beta2GPI, Anti-Cardiolipin, Antiphospholipid
Pleuritis - position doesn’t affect it
Pericarditis
Anti-histone antibodies
Drug-induced lupus
45 white, joint pains, recently had pyelonephritis. Discharged on hydralazine for BP and Cipro for infection. Developed malar rash on discharge and diffuse joint pains.
Serology?
Drug-induced lupus
Anti-Histone Ab
25 Hispanic female, SLE, 16 weeks pregnant. Swelling in legs and elevated BP. Fetal echo shows complete heart block in fetus. Serology in mother?
Swelling and high BP?
What is with this?
These antibodies usually show up in what?
Anti-Ro(SSA) Ab
Preeclampsia
Anti-Ro antibody means high risk of fetal issues
Sjogren’s
45 white female, finger stiffness. Hard white nodules on fingers. Fingers will go blue sometimes. Perioral furrowing w/ red spots on lips and tongue
What else could go with this?
CREST syndrome
Esophageal dysmotility
43 female, dyspnea, gets SOA quickly. Hx of GERD, Raynauds, and carpal tunnel. CXR shows mediastinal LAD and honeycombing. Dry crackles on lung exam. Topoisomerase I Ab positive.
Cause of SOB?
Diffuse scleroderma
Interstitial lung disease
Pulmonary artery hypertension…think what disease?
Limited scleroderma - CREST
Wet crackles
CHF
30 AA female, dry itchy skin. Coal miner. Fingers and mouth feel tight. Having difficulty eating. White patches on skin and is self conscious. Ends of fingers have sores. Frequent heartburn.
Most likely etiology?
Other possible etiologies? (4)
Scleroderma
Silica - Silicosis
Cocaine, HRT, Appetite suppressants, Bleomycin
30 AA male, fatigue, stiffness, malaise. Muscle weakness, arthralgia. Hx of Raynauds and carpal tunnel. Confusion and HTN. Protein, blood, and granular casts in urine. Anti-centromere Ab negative. RNA pol’s 1 and 3 Ab positive.
What is the confusion?
Treatment?
Scleroderma Renal Crisis
Hypertension encephalopathy
ACEI, steroids
7 yo female w/ spot on face. Has been there for weeks. Heathy otherwise.
Called what?
Localized scleroderma
Morphea
60, female, facial swelling. Dry eyes, dry mouth, face swollen. Enlarged cheeks.
At risk of developing what?
Sjogren’s
Thrush
