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OPT 537 > Exam 1 -- Rheumatology #4 > Flashcards

Exam 1 -- Rheumatology #4 Flashcards

1
Q

What is the full name of lupus?

A

Systemic Lupus Erythematosus (SLE)

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2
Q

Which gender has a higher prevalence for lupus?

A

Female (9:1)

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3
Q

What is a typical age of onset for lupus?

A

20-40 years

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4
Q

Which ethnicities have a higher prevalence of lupus?

A

African and Caribbean (1 in 250)

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5
Q

Lupus can be caused by some medications. Which medication most commonly causes lupus?

A

Procainamide (anti-arrhythmia drug; sodium channel blocker)

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6
Q

True or false: some DMARDs can cause lupus

A

True.

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7
Q

What are some of the common symptoms of lupus?

A

Arthralgia, malar rash, fatigue, fever, weight loss, alopecia

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8
Q

What percentage of lupus patients experience arthralgia?

A

More than 90%

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9
Q

True or false: the arthralgia experienced in lupus is unilateral and deforming

A

False; it is bilateral and non-deforming

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10
Q

What percentage of lupus patients experience myalgia?

A

About 50%

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11
Q

What percentage of lupus patients experience malar rash?

A

More than 75%

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12
Q

True or false: symptoms of lupus can be exacerbated by UV light and also by stress

A

True.

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13
Q

What are some of the common skin-related symptoms of lupus (apart from the malar rash)?

A

Lesions on nails, urticaria (hives) and purpura, livedo reticularis (net-like appearance of BVs), palmar and plantar erythema, mouth ulcers, Raynaud’s phenomenon

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14
Q

Up to ___________% of lupus patients will have lung involvement.

A

50

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15
Q

What sort of lung involvement can a person with lupus experience?

A

Pleural effusion, chest pain, dyspnea

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16
Q

Up to ___________% of lupus patients will have heart issues.

A

25

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17
Q

What sort of heart issues can a person with lupus experience?

A

Heart attack, stroke, vasculitis, anemia

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18
Q

What percentage of lupus patients have kidney involvement?

A

50%

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19
Q

Kidney involvement with lupus is sometimes called what?

A

Lupus nephritis

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20
Q

How are lupus patients with kidney involvement monitored?

A

Urinalysis

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21
Q

What percentage of lupus patients have nervous system involvement?

A

20-80%

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22
Q

What sort of CNS symptoms could a patient with lupus experience?

A

Migraines, epilepsy, cerebellar ataxia, cognitive and mood disorders, memory loss

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23
Q

What might a brain MRI show in a patient with lupus, if they have nervous system involvement?

A

Increased white matter

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24
Q

Up to ___________% of lupus patients will have ocular involvement

A

30

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25
What sort of ocular issues can a person with lupus experience?
Dry eye, optic neuritis, cranial neuropathies, episcleritis, scleritis, conjunctivitis, retinopathy
26
What testing can be performed to try and differentiate lupus?
CBC, ESR, CRP, urea/creatinine (from urinalysis, if renal involvement), ANA**, anti-dsDNA Ig*, anti-SM Ig*
27
What percentage of lupus patients are ANA (+)?
95%
28
What percentage of normal patients are ANA (+)?
15%
29
How would you treat a patient with lupus?
NSAIDs, topical and/or oral corticosteroids, hydroxychloroquine*, cyclophosphamide/cyclosporine in severe cases
30
What is the 10-year survival rate for lupus?
80-90%
31
True or false: patients with lupus have an increased risk of developing lymphoma
True.
32
What are the most common symptoms of Sjogren's Syndrome?
Dry mouth, dry eyes, dry skin and/or vaginal dryness
33
What percentage of Sjogren's patients have xerostomia?
90%
34
True or false: patients with Sjogren's have less dental cavities than the rest of the population
False; they have more
35
What are two of the most common causes of secondary Sjogren's?
RA and lupus; 7% of RA patients and 17% of lupus patients have Sjogren's
36
What sort of systemic findings might a patient with Sjogren's have?
Arthralgia*, RA*, lupus*, thyroid disease, MG, hepatitis, pulmonary fibrosis, vasculitis, Raynaud's phenomenon
37
What percentage of patients with Sjogren's experience arthralgia?
50%
38
Which gender has a higher prevalence for Sjogren's?
Female (12:1)
39
What is the age of onset for Sjogren's?
About 40 years
40
What are some of the common symptoms of Sjogren's?
Dyspnea, COPD, pulmonary fibrosis, Raynaud's phenomenon, liver and kidney damage, hearing loss, dental cavities
41
What sort of testing can be done for Sjogren's?
Salivary gland or lip biopsy, anti-Ro or anti-La, RF, ANA, ESR, CRP
42
What percentage of Sjogren's patients are RF (+)?
Up to 90%
43
What percentage of Sjogren's patients are ANA (+)?
70-80%
44
What are some treatment options for Sjogren's?
Artificial tears, Restasis, punctal plugs, ointment, saliva replacement, pilocarpine (NSAIDs, DMARDs, corticosteroids for arthralgia)
45
What classes of drugs can cause dry mouth or dry eye?
Antihistamines, antipsychotics, anticonvulsants
46
Systemic sclerosis is characterized by ____________.
Thickened, hardened skin
47
Systemic sclerosis is also known as?
Scleroderma
48
True or false: systemic sclerosis affects only the skin
False; it can affect the internal organs as well
49
True or false: systemic sclerosis has the highest mortality of any autoimmune rheumatic disease
True.
50
Which gender has the highest prevalence for systemic sclerosis?
Female (3-:1)
51
What is the age of onset for systemic sclerosis?
30-50 years
52
What is a potential environmental risk factor for systemic sclerosis?
Silica dust
53
What are some clinical features of systemic sclerosis?
Small mouth, beak-like nose, digital ulcers*, arthralgia*, fatigue*, telangiectasia, dry eyes, ED, vaginal dryness
54
What is a mnemonic for the symptoms of systemic sclerosis?
CREST: Calcinosis, Raynaud's*, Esophageal dysfunction, Sclerodactyly, Telangiectasia
55
True or false: virtually all of patients with systemic sclerosis experience Raynaud's phenomenon
True.
56
Fibrosis of which internal organs is most worrisome in a patient with systemic sclerosis?
Lungs, heart, GI tract
57
How many patients with systemic sclerosis experience a renal crisis?
10%
58
True or false: patients with systemic sclerosis can get nail pitting and dactylitis
True.
59
What sort of testing can be done for systemic sclerosis?
CBC, urea and creatinine (urinalysis), ANA, RF
60
What percentage of systemic sclerosis patients are RF (+)?
30%
61
What percentage of systemic sclerosis patients are ANA (+)?
95%
62
What is the 10-year survival rate for systemic sclerosis?
60-80%
63
True or false: there is a cure for systemic sclerosis
False; there is no cure. All you can do is treat the lung and heart issues and use creams for the skin
64
Raynaud's phenomenon can occur in response to what factors?
Stress, cold temperature, smoking
65
Which gender has a higher prevalence for Raynaud's phenomenon?
Female (4:1)
66
What is the age of onset for Raynaud's phenomenon?
15-25 years
67
True or false: Raynaud's phenomenon presents symmetrically and bilaterally
True.
68
What percentage of patients with Raynaud's phenomenon have an underlying condition?
40-80%
69
Raynaud's phenomenon is most commonly associated with what condition? Which other conditions can it be associated with?
Systemic sclerosis; lupus and Sjogren;s
70
Raynaud's phenomenon can cause ___________, which may result in having to remove the affected digits.
Gangrene
71
What are some treatment options for Raynaud's?
Decrease vasoconstrictors (smoking), take vasodilators, treat any underlying disease DMARDs

OPT 537 (21 decks)

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