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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
Q

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

A

Dry eye, optic neuritis, cranial neuropathies, episcleritis, scleritis, conjunctivitis, retinopathy

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26
Q

What testing can be performed to try and differentiate lupus?

A

CBC, ESR, CRP, urea/creatinine (from urinalysis, if renal involvement), ANA, anti-dsDNA Ig, anti-SM Ig

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27
Q

What percentage of lupus patients are ANA (+)?

A

95%

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28
Q

What percentage of normal patients are ANA (+)?

A

15%

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29
Q

How would you treat a patient with lupus?

A

NSAIDs, topical and/or oral corticosteroids, hydroxychloroquine*, cyclophosphamide/cyclosporine in severe cases

30
Q

What is the 10-year survival rate for lupus?

31
Q

True or false: patients with lupus have an increased risk of developing lymphoma

32
Q

What are the most common symptoms of Sjogren’s Syndrome?

A

Dry mouth, dry eyes, dry skin and/or vaginal dryness

33
Q

What percentage of Sjogren’s patients have xerostomia?

34
Q

True or false: patients with Sjogren’s have less dental cavities than the rest of the population

A

False; they have more

35
Q

What are two of the most common causes of secondary Sjogren’s?

A

RA and lupus; 7% of RA patients and 17% of lupus patients have Sjogren’s

36
Q

What sort of systemic findings might a patient with Sjogren’s have?

A

Arthralgia, RA, lupus*, thyroid disease, MG, hepatitis, pulmonary fibrosis, vasculitis, Raynaud’s phenomenon

37
Q

What percentage of patients with Sjogren’s experience arthralgia?

38
Q

Which gender has a higher prevalence for Sjogren’s?

A

Female (12:1)

39
Q

What is the age of onset for Sjogren’s?

A

About 40 years

40
Q

What are some of the common symptoms of Sjogren’s?

A

Dyspnea, COPD, pulmonary fibrosis, Raynaud’s phenomenon, liver and kidney damage, hearing loss, dental cavities

41
Q

What sort of testing can be done for Sjogren’s?

A

Salivary gland or lip biopsy, anti-Ro or anti-La, RF, ANA, ESR, CRP

42
Q

What percentage of Sjogren’s patients are RF (+)?

43
Q

What percentage of Sjogren’s patients are ANA (+)?

44
Q

What are some treatment options for Sjogren’s?

A

Artificial tears, Restasis, punctal plugs, ointment, saliva replacement, pilocarpine (NSAIDs, DMARDs, corticosteroids for arthralgia)

45
Q

What classes of drugs can cause dry mouth or dry eye?

A

Antihistamines, antipsychotics, anticonvulsants

46
Q

Systemic sclerosis is characterized by ____________.

A

Thickened, hardened skin

47
Q

Systemic sclerosis is also known as?

A

Scleroderma

48
Q

True or false: systemic sclerosis affects only the skin

A

False; it can affect the internal organs as well

49
Q

True or false: systemic sclerosis has the highest mortality of any autoimmune rheumatic disease

50
Q

Which gender has the highest prevalence for systemic sclerosis?

A

Female (3-:1)

51
Q

What is the age of onset for systemic sclerosis?

A

30-50 years

52
Q

What is a potential environmental risk factor for systemic sclerosis?

A

Silica dust

53
Q

What are some clinical features of systemic sclerosis?

A

Small mouth, beak-like nose, digital ulcers, arthralgia, fatigue*, telangiectasia, dry eyes, ED, vaginal dryness

54
Q

What is a mnemonic for the symptoms of systemic sclerosis?

A

CREST: Calcinosis, Raynaud’s*, Esophageal dysfunction, Sclerodactyly, Telangiectasia

55
Q

True or false: virtually all of patients with systemic sclerosis experience Raynaud’s phenomenon

56
Q

Fibrosis of which internal organs is most worrisome in a patient with systemic sclerosis?

A

Lungs, heart, GI tract

57
Q

How many patients with systemic sclerosis experience a renal crisis?

58
Q

True or false: patients with systemic sclerosis can get nail pitting and dactylitis

59
Q

What sort of testing can be done for systemic sclerosis?

A

CBC, urea and creatinine (urinalysis), ANA, RF

60
Q

What percentage of systemic sclerosis patients are RF (+)?

61
Q

What percentage of systemic sclerosis patients are ANA (+)?

62
Q

What is the 10-year survival rate for systemic sclerosis?

63
Q

True or false: there is a cure for systemic sclerosis

A

False; there is no cure. All you can do is treat the lung and heart issues and use creams for the skin

64
Q

Raynaud’s phenomenon can occur in response to what factors?

A

Stress, cold temperature, smoking

65
Q

Which gender has a higher prevalence for Raynaud’s phenomenon?

A

Female (4:1)

66
Q

What is the age of onset for Raynaud’s phenomenon?

A

15-25 years

67
Q

True or false: Raynaud’s phenomenon presents symmetrically and bilaterally

68
Q

What percentage of patients with Raynaud’s phenomenon have an underlying condition?

69
Q

Raynaud’s phenomenon is most commonly associated with what condition? Which other conditions can it be associated with?

A

Systemic sclerosis; lupus and Sjogren;s

70
Q

Raynaud’s phenomenon can cause ___________, which may result in having to remove the affected digits.

71
Q

What are some treatment options for Raynaud’s?

A

Decrease vasoconstrictors (smoking), take vasodilators, treat any underlying disease DMARDs

OPT 537 (21 decks)

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