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Year2 MSK exam2 > CTD part I > Flashcards

CTD part I Flashcards

1
Q

autoimmune MHC I more common in

A

men

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2
Q

autoimmune MHC II more common in

A

women

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3
Q

AutoAb in SLE

A

+ ANA HLA B8 HLA DR2 and DR3 W>M black>white

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4
Q

what deficiencies are assoc with SLE

A

C1 C2 and C4

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5
Q

28 F arthralgias, chest pain dyspnea, malar rash on face, 2/6 systolic murmur scartchin sound L lower lung pedal edema elevated ESR troponin inc, moderate proteinuria

A

SLE

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6
Q

11 Criteria for SLE!!!!!

A

-hematologic disorder: pancytopenia -immunologic disorder: dsDNA or SmAg, APA or FPSTS -ANA -Oral ulcers -Renal disorder: protein or casts -Neurologic disorder: seizure or psychosis -malar rash -discoid rash -photosensitivty -arthritis -serostitis :pleuritis or pericarditis

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7
Q

ST elevations in every lead

A

pericarditis

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8
Q

ANA subtpes

A

Ro SS-A La SS-B Sm U1-RNP Scl70/topoisomerase 1 Jo-1

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9
Q

peripheral rim pattern cytology

A

SLE

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10
Q

speckled pattern cytology

A

SLE and sjogrens polymyositis and dermatomyositis PSS

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11
Q

anti centromere pattern cytology

A

PSS (CREST) progessive systemic sclerosis

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12
Q

nucleolar pattern cytology

A

SLE and PSS

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13
Q

telescoping urinary sediment

A

casts, WBC or RBC or protein etc.

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14
Q

urinary findings in SLE

A

casts proteinuria >500 mg in 24 hrs 3+ protein on dipstick

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15
Q

SLE CNS involvement

A

seizures psychoses

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16
Q

what makes SLE rashes worse

A

smoking

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17
Q

reversible swan neck deformtiies

A

SLE arthritis

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18
Q

cardiopulm involvement with sLE

A

alveolar hemorrhage (cough up blood) libman sacks endocarditis (not infectious)

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19
Q

Tx for SLE

A

hydroxychloroquine

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20
Q

what does hydroxychloroquine do in SLE Tx

A

reverse platelet activaiton by IgG antiphospholipid prevents flares reduces congenital heart block reduce DM risk

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21
Q

causes of splinter hemorrhages

A

nail truama SBE sntiphospholipid Ab syndrome hyper-eos syndrome

22
Q

risk factors for libman sacks vegetations

A

lupus nephritis anticardiolipin Ab

23
Q

what cause atypical verrucous vegetations with marantic non bacterial thrombotic endocarditis

A

aka: libman sack mitral regurg SLE causes this

24
Q

What drugs can trigger autoimmunogenicity

A

hydralazine isoniazid procainamide methimazole propylthiouracil etanercept slow acetylators

25
Q

inhibit DNA methylation in T helper cells

A

become autoreactive

26
Q

what is an important screening test for pregnant woman with lupus

A

lupus anticoagulant because pregnancy is a prothrombotic state also La and antiphospholipid Ab, apolipoprotein H to exclude APS

27
Q

pregnancy is most hazardous in what SLE patients

A

those with concurrent HTN and renal disease, APS and RO Ab

28
Q

what drugs are safe in pregnancy for SLE

A

HCQ

29
Q

what drugs are not safe for pregnancy in SLE

A

mycophenolate, cyclophosphamide, MTX azathrioprine

30
Q

what indicates lupus flare and not preeclampsia

A

low C3 C4 uric acid levels normal in SLE flare

31
Q

indications of preeclampsia

A

uric acid high abn LFTs

32
Q

Hx deficiency Cā€™2 most likely Ab

A

Ro/SS-A

33
Q

photosensitivty with Cā€™ deficiency may have daughter with what

A

heart block

34
Q

SCSLE rash

A

spares knuckles and face nonindurated non scaring erythematous plaques papulosquamous or annular lesions with cental hypopigmentation or telangiectasia sun exposed areas

35
Q

SCLE rash also seen in

A

RA and SS

36
Q

What drug can cause SCLE rash

A

HCTZ

37
Q

screen for what when see the SCLE rash

A

anti Ro anti La Ab

38
Q

neonatal lupus affect children born to mothers with what Ab

A

Anti-Ro SS-A or La SS-B

39
Q

what is transient in neonatal lupus

A

rashes- SCSLE thrombocytopenia hemolytic anemia arthritis

40
Q

what is permanent in neonatal lupus

A

complete heart block

41
Q

Tx of neonatal lupus

A

HCQ

42
Q

50 y.o with PMH + 2 spontaneous abortions and TIA fater + stroke DVT in L arm, abdominal ecchymosis from LMWH injections hemosiderin deposits visible in LE prolonged INR and PTT low platelet count Check what Ab?

A

lupus anticoagulnt

43
Q

What is APS

A

antiphospholipid Ab syndrome

44
Q

causes of secondary APS

A

CTDs malignancy infections (HIV) drugs: phenytoin, chlorpromazine

45
Q

Dx of APS

A

1 clinical + 1 lab 3 mo apart

46
Q

clinical criteria APS

A

spontaneous abortion vascular thrombosis

47
Q

lab criteria APS

A

anticardiolipin Ab lupus anticoagulant Anti B2 glycoprotein 1 (ApoH) false + serologic test for syphilis

48
Q

type of rash

A

discoid lupus erythema

49
Q

what are these

A

splinter hemorrhages

assoc with SLE

50
Q

identify rash

A

subacute cutaneous lupus erythematosus

RA SS and SLE

watch out for heartblock in daughter

Year2 MSK exam2 (17 decks)

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