CT dz and vasculitides

Question 1

SLE- Eti

Answer 1

• Autoimmune multi organ CT disorder

- Young women, black

Question 2

SLE- Sx

Answer 2

• Triad: Joint pain, fever & malar rash
• Pericarditis, pleuritis
• Annular rash
• Glomerulonephritis, retinitis, oral ulcers & alopecia

Question 3

SLE- Dx

Answer 3

• ANA best initial test
• Anti- double stranded DNA, anti-smith Abs
• Antiphospholipid Abs

Question 4

SLE- Tx

Answer 4

• Sun protection

- NSAIDs or acetaminophen

Question 5

Polymyalgia rheumatica- Eti

Answer 5

• Idiopathic inflammatory condition
• Related to giant cell arteritis
• > 50 yrs, women

Question 6

Polymyalgia rheumatica- Sx

Answer 6

• Bilateral proximal AM joint stiffness
• Shoulder girdle, pelvis
• No muscle weakness

Question 7

Polymyalgia rheumatica- Dx

Answer 7

Clinical, elevated ESR,

Question 8

Polymyalgia rheumatica- Tx

Answer 8

Low dose corticosteroids

Question 9

Gout- Eti

Answer 9

Hyperuricemia -> deposition of uric acid in joints, soft tissue
- Men, purine rich foods

Question 10

Gout- Sx

Answer 10

• Podagra of 1st MTP joint unilaterally
• Monoarthropathy
• Tophi deposition
• Uric acid nephrolitiasis

Question 11

Gout- Dx

Answer 11

Negatively birefringent crystals

Question 12

Gout- Tx

Answer 12

NSAIDs- indomethacin

- Colchicine

Question 13

Pseudogout

Answer 13

female predominance

• knees, wrists, MCP joints
• Steroid injections

Question 14

Rheumatoid arthritis- Eti

Answer 14

• Chronic inflammation, T cell mediated

Question 15

Rheumatoid arthritis- Sx

Answer 15

• Worse at rest, AM stiffness
• Small joints, symmetric
• Tender, erythematous, boggy joints

Question 16

Rheumatoid arthritis- Dx

Answer 16

• RF & Anti citrullinated peptide Abs

Question 17

Rheumatoid arthritis- Tx

Answer 17

DMARDs- methotrexate

- NSAIDs for pain

Question 18

Reactive arthritis- Eti

Answer 18

Autoimmune response to infection

Chlamydia MC cause

Question 19

Reactive arthritis- Sx

Answer 19

• Monoarticular arthritis
• Conjunctivitis
• Urethritis
• Can’t see, pee, climb a tree
• Ketoderma blennorrhagica (hyperkeratosis of palms, soles)

Question 20

Reactive arthritis- Dx

Answer 20

• HLA-B27

- Aseptic synovial fluid with 1,000-8,000 WBCs

Question 21

Reactive arthritis- Tx

Answer 21

NSAIDs

- Abx to tx underlying infection

Question 22

Sarcoid- Eti

Answer 22

• Disordered immune regulation in genetically predisposed individuals
• Lung MC affected, multiorgan sx dz
• African americans, women

Question 23

Sarcoid- Sx

Answer 23

50% asymptomatic

• Dry, non-productive cough, dyspnea, chest pain
• Erythema nods
• Lupus pernio (resembles frost bite)

Question 24

Sarcoid- Dx

Answer 24

• CXR: bilateral hilar adenopathy, interstitial lung dz

- Bx: Non-caseating granulomas

Question 25

Sarcoid- Tx

Answer 25

- Most resolve spontaneously - Oral corticosteroids - ILD and lupus pernio with worse outcome

Question 26

Hypersensitivity vasculitis- Eti

Answer 26

- Small vessel vasculitis | - idiopathic MC

Question 27

Hypersensitivity vasculitis- Sx

Answer 27

- Palpable purpura | - Urticarial lesions

Question 28

Hypersensitivity vasculitis- Dx

Answer 28

- Biopsy: polymorphonucular leukocytes

Question 29

Hypersensitivity vasculitis- Tx

Answer 29

Corticosteroids