I hate myself - autoimmune

Question 1

Autoimmune dosorders

Answer 1

RA
systemic lupus erythematous 
Sjogren's syndrome
Polymyositis/dermatomyositis 
Scleroderma
CREST syndrome

Question 2

Autoimmune lab test

Answer 2

Erythrocyte Sedimentation Rate
C-Reactive Protein
Antinuclear Antibody
Rheumatoid Factor

Question 3

ESR - or Sed rate

Answer 3

Non-specific test used as a marker for inflammation, infection, neoplasm and tissue necrosis or infarction
No one specific disease indicator, but frequently used in the diagnosis of suspected rheumatologic disease or inflammatory conditions
ESR is not diagnostic and can be elevated in many illnesses
Can have frequent false elevation
Often used to aid in diagnosis of vague symptomatology and some physicians do not use due to lack of specificity

Question 4

C-reactive protein - normal value

Answer 4

0-10mg/dL

Question 5

C-reactive protein funtion

Answer 5

Function of C-reactive protein is to recognize and respond to inflammatory mediators and target damaged tissue for clearance

not specific for much

Question 6

*CRP-HS vs. CRP

Answer 6

Note: CRP-HS test detects small enough amounts of CRP to stratify risk fro cardiac disease and future cardiovascular events. In inflammatory or autoimmune disease, we only measure normal CRP, not CRP-HS

Question 7

Butterfly rash

Answer 7

LUPUS until proven otherwise!!! You also see flaring of the nares.

Question 8

Antinuclear Antibody (ANA)

Answer 8

The ANA test measures the presence of autoantibodies towards proteins that are specific to the nucleic acids (DNA or RNA) or complexes involved with the DNA or RNA
The mechanism of development of the nucleic acid autoantibodies in unclear.
ANA is important in the diagnosis of systemic lupus erythematosus (SLE) and is also an indicator of several other autoimmune diseases

Question 9

Lupus (SLE)

Answer 9

SLE is a chronic inflammatory disease that affects multiple joints and organs and is caused by an autoimmune process

Question 10

Thyroid stimulating hormone (normal level)

Answer 10

0.5-5.0uIU/mL

Question 11

Thyroid gland

Answer 11

The thyroid is a gland that is located anteriorly in the neck from the fifth cervical vertebrae to the first thoracic vertebrae.
The gland has a butterfly-like shape due to its two lateral lobes connected by a medial isthmus.
Control of the thyroid gland is regulated by the hypothalamus and pituitary gland.

Question 12

Thyroid hormone functions

Answer 12

Affects nearly all tissues and involved in growth, metabolism and heart rate

myocardial contractility and heart rate
mental alertness
ventilator drive
bone turnover
GI motility

Question 13

TSH Levels

Answer 13

tests are sensitive and used to assess the function of the thyroid gland

Question 14

primary hypothyroidism

Answer 14

“epic fail, thyroid gland” problem w/ the thyroid gland

Question 15

secondary hypothyroidism

Answer 15

decreased secretion of TSH from pituitary or decreased TRH from hypothalamus

Question 16

Primary hypothyroidism causes

Answer 16

Disorder results from impairment of thyroid
Autoimmune thyroiditis (Hashimoto’s thyroiditis)
Most common cause of hypothyroidism
Caused by autoimmune destruction and apoptosis of thyroid cells by TSH stimulation blocking antibody (or TSBAb)
Also can be caused by: iodine deficiency, thyroidectomy, radiation to neck, radioiodine therapy after hyperthyroidism

Question 17

Causes of Secondary hypothyroidism

Answer 17

Represents less than 1% of hypothyroid patients
Causes:
Pituitary tumor
Other infiltrating tumors
Post-partum pituitary necrosis
Can also have tertiary hypothyroidism results from trauma, tumors of hypothalamus