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Year 3 Conditions > ID and Immunology > Flashcards

ID and Immunology Flashcards

1
Q

What is sjogrens

A

Autoimmune condition affecting exocrine glands mainly the tear and salivary glands

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2
Q

Risk factors for sjogrens

A

Middle aged women
Rheumatoid and SLE associated
Infections of glands

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3
Q

Aetiology of sjogrens

A

Genetic- HLA associations

Environment- infection of glands

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4
Q

Specific ABs tested for in sjogrens

A

Anti-SS-A (Ro)
Anti-SS-B (La)
these are ribonuclear proetins found in gland cells

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5
Q

Symptoms of sjogrens

A 
Keratoconjunctivits
Xerostomia
Dry skin
Dryness in vagina leading to pain
Difficulty talking as larynx affected
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6
Q

What are symptoms associated with xerostomia

A

Dry mouth
Difficulty tasting and swallowing
Cracks and fissures in mouth

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7
Q

Symptoms of keratoconjunctivitis

A

Dry and itchy eyes
Blurred vision
Burning eye pain

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8
Q

Investigations for sjogrens

A 
Test exocrine function
- saliometry
- schirmers test
Confirmatory
- anti-SS-A
- anti-SS-B
- lip biopsy will show T cell infiltration, macrophages and thickening of inner duct wall
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9
Q

What is most likely diagnosis of someone returning from africa with a fever

A

Malaria

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10
Q

How does malaria present

A 
Cyclical fever
Malaise
Headache
Vomiting
Diarrorhoea
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11
Q

First line treatment of malaria

A

Quinines

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12
Q

What is confirmatory test for malaria

A

Thick and thin blood films

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13
Q

What is main test for infective mononucelosis

A

Paul Bunnell

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14
Q

Other than malaria what else can you get from mosquitos

A

Dengue fever

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15
Q

Presentation of dengue fever

A

Quick onset fever
Facial flushing
Retrobulbar pain
Maculopapular rash

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16
Q

What is primary TB

A

Initial infection post exposure that is normally asymptomatic

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17
Q

What is post primaryTB

A

Happens a few weeks post exposure and presents with pulmonary symptoms

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18
Q

How does reinfection with TB occur

A

Latent TB can lie in granulomas

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19
Q

What infective agent causes pneumocystic pneumonia

A

Pneumocystic jerovecii- fungal

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20
Q

What is common lung complication of HIV

A

PCP

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21
Q

How does PCP present

A

Dry cough
Fevers
Night sweats

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22
Q

How does PCP appear on CXR

A

Widespread infiltrates

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23
Q

How does mycoplasma atypical pneumonia present

A

Dry cough
Myalgia
Arthralgia

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24
Q

Most common cause of infective exacerbated COPD

A

Haemophillus influenzae

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25
Q

Who does klebsiella penemoniae present in

A

Elderly
Immunocompromised
Alcoholics

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26
Q

How does klebsiella pneumoniae present

A

Cavitating lesion causing haemoptysis and prurulent sputum

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27
Q

When does staph aureus infection most commonly happen

A

After influenza infection

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28
Q

What is problem of staph aureus infection

A

Life threatening as causes cavitating lesion

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29
Q

How does cholera present

A

Normally mild diarrorhoea but sometimes can be profuse “rice water stools”

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30
Q

What organism causes typhoid

A

Salmonella typhi

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31
Q

Early presentation of typhoid

A 
Fever
Headache
Malaise
Diarrorhoea or constipation
Maculopapular rash on trunks-> rose spots
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32
Q

What infection presents with rose spots

A

Salmonella typhi

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33
Q

Most common cause of travellers diarrorhoea

A

Enterotoxigenic E.Coli

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34
Q

Which infection is common in transplant patients

A

CMV

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35
Q

Who does CMV occur in

A

Immunocompromised transplant patients- opportunistic virus

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36
Q

How does varicella zoster virus present

A

Prodromal illness of malaise, headache, fever then vesicular rash all over face and scalp- sometimes the trunk

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37
Q

Most common outbreak of diarrorhoea in children

A

Rotavirus

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38
Q

How are vasculitis’ split up

A

Small vessel
Medium
Large

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39
Q

How does mechanism for small vessel vasculitis differ from that for large and medium

A

In lage and medium immune system attacks endothelium directly due to molecular mimicry whereas in small is indirect

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40
Q

What happens physiologically in vasculitis

A

Damage to vessel walls leading to weaker walls within which aneurysms develop, fibrin deposited and clots form thus making the vessels narrower leading to ischaemia

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41
Q

Generalised sx of vasculitidies

A

Fever
Weight loss
Lethargy

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42
Q

2 large vessel vasculitidies

A

GCA

Takayasu

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43
Q

What is affected in takayasu

A

Aortic arch

Sx depend on branch- carotid ->neuro sx. Subclavian->reduced pulses

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44
Q

Who does Takayasu normally occur in

A

Asian women under the age of 40

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45
Q

Investigations and findings of Takayasu

A

ESR raised

Biopsy showing granulomas

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46
Q

1 medium sized vasculitidies need to know and 1 dont

A

Polyarteritis nodosa

Kawasaki

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47
Q

What vessels are affected in kawasakis

A

Coronary arteries

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48
Q

What condition is associated with polyarteritis nodosa

A

Hep B

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49
Q

Organs affected in polyarteritis nodosa and their effect

A 
Kidney- HTN
Brain- TIA
Coronary arteries
Gut- mesenteric ischaemia
Skin- lesions
Nerves
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50
Q

What are particularly common to polyarteritis nodosa

A

Aneurysms- see beaded appearance on angio

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51
Q

What do you see on angio of polyarteritis nodosa

A

Beaded appearance due to aneurysms

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52
Q

Pathophysiology of Wegners

A

Ig CANCA produced against protein of neutrophils

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53
Q

What is proper name of Wegners

A

Granulomatosis with polyangiitis

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54
Q

Who does Wegners normally occur in

A

Middle aged men

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55
Q

Which organs are affected in Wegners and their affects

A

Nasopharynx- chronic pain from sinusitis, bloody mucus, saddle nose deformity
Lung- SOB, haemoptysis
Kidney- oligouria, HTN

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56
Q

Are relapses common in Wegners

A

Yes

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57
Q

Small vessel vasculitides need to know

A

Microscopic polyangiitis
Henoch schonlein purpura
Eosinophillic granulomatosis with polyangiitis

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58
Q

Antibody in Wegners

A

C-ANCA IgG

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59
Q

Antibody in microscopic polyangiitis

A

P-ANCA

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60
Q

Differences between Wegners and microscopic polyangiitis

A

Wegners affects nose
Granulomas in wegners
Wegners C-ANCA vs P-ANCA in MP

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61
Q

What is name given to shape of nose in Wegners

A

Saddle nose deformity

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62
Q

What is the other name for Eosinophillic granulomatosis with polyangiitis

A

Churg strauss syndrome

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63
Q

What organs does churg strauss syndrome affect

A 
Wegners one
GI
Skin
Nerve
Heart
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64
Q

What is churg strauss often confused with

A

Asthma and allergies

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65
Q

Antibody for churg strauss

A

P-ANCA

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66
Q

Blood finding for churg strauss

A

Increased eospinophils

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67
Q

Biopsy finding for Churg strauss syndrome

A

Granulomas

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68
Q

What are risk factors for churg strauss syndrome

A

Asthma
Allergies
Which already have eosinophilia

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69
Q

What are checklists for tonsilitis

A

Centor

Feverpain

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70
Q

Investigations for EBV

A

FBC
Blood film
Monospots to look for heterophile antibodies
Be more specific can do EBV specific ABs

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71
Q

What happens when give amoxicillin to EBV patient

A

Maculopapular rash

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72
Q

Treatment for tonsilitis

A

Penicillin

If allergic give erithomycin

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73
Q

Blood findings of EBV

A

Lymphocytosis
Anaemia
Thrmobocytopenia

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74
Q

Examination findings of EBV

A

Hepatosplenomegaly
Posterior cervical ymphadenopathy
Tonsillar exudates

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75
Q

Management of EBV after treatment of cause

A

Let sexual partners know
Avoid contact
Avoid contact sports within 6 weeks

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76
Q

How does EBV present on blood film

A

Atypical activated lymphocytes

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77
Q

How does SLE normally present

A 
Malar rash
Athritis
Glomerulonephritis
Alopecia
Pericarditis
Pleurisy
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78
Q

What is shared with myositis, SLE, sjogrens and systemic sclerosis

A

ANA

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79
Q

What is problem with ANA use

A

Common in titres up to 1/80 in older women

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80
Q

How do titre results work

A

Denominator is the number of titres done until the ABs arent present

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81
Q

What is elevated in SLE

A 
ESR not CRP niche
ANA
Anti DsDNA
Anti Ro
Anti smith
RF pos
C3 (complement)
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82
Q

What does it mean if C3 elevated in SLE

A

Disease well progressed

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83
Q

Examination findings sjogrens

A

Red eyes
Fissures in mouth
Dry skin
Swollen parotid glands

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84
Q

What does sjogrens increase risk of

A

Lymphoma

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85
Q

What are associated symptoms of myositis’

A

ILD
Calcinosis
Raynauds

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86
Q

Derm changes seen in dermatomyositis

A

Helioptrope
Gattrons papules
Shawl sign
Mechanics hand

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87
Q

What is a heliotrope rash

A

Red/purple rash under eyes or on eyelids

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88
Q

Where are gottrons nodules found

A

On the knuckles

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89
Q

What is shawl sign

A

Extreme reddening of chest area or on back

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90
Q

What are mecahnics hands

A

Blisters of the hands that make look like have lived a mechanics life

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91
Q

Difference in skin presentation of limited vs diffuse scleroderma

A

Limited affects distal limbs and face

Diffuse all over

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92
Q

What is a halo on US indicative of

A

GCA

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93
Q

Antibodies found in systemic sclerosis

A

Anti- centromere

Anti-Scl70

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94
Q

Antibody in diffuse vs limited scleroderma

A

Limited-anti centromere

Diffuse- anti Scl70

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95
Q

Complications of diffuse scelorderma

A

ILD

Kidney problems

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96
Q

Complication of limited scleroderma

A

Pulmonary HTN

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97
Q

CREST symptoms

A 
Calcinosis
Raynauds
Eosophageal dysmobility
Sclerodactyly
Telengiectasia
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98
Q

Limb symptoms of Takayasu

A

Limb claudication

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99
Q

What is presentation of PMR

A

Shoulder and hip pain, tenderness and stiffness

Reduced mobility

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100
Q

What is danger of PMR

A

Can develop to GCA with artery involvement

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101
Q

What inflammation do you get with PMR

A

Bursitis and synovitis

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102
Q

Where is bursitis in PMR

A

Subacromial

Trochanteric

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103
Q

Where is synovitis in PMR

A

Shoulder
Hip
Other joints

104
Q

What triggers HSP

105
Q

Who does HSP occur in

106
Q

What happens in HSP physiological

A

IgA deposits

107
Q

How is HSV 1 transmitted

A

Resp

Saliva

108
Q

How is HSV 2 transmitted

A

Sex

Perinatal

109
Q

How is Varicella transmitted

110
Q

How is HHV-8 transmitted

111
Q

How is EBV transmitted

112
Q

What are the 5 human herpes viruses we need to know

A 
HSV 1 
HSV2
EBV
Varicella
HHV 8
113
Q

What does HHV 8 cause

A

Kaposi sarcoma in immunocompromised patients

114
Q

What can HSV 1 cause as complications

A

Temporal enchephalitis
Keratoconjunctivits
Menigitis
Systemic infection

115
Q

What is gingivostomatitis

A

Cold sores

116
Q

What are cold sores also known as

A

gingivostomatitis

Herpes labialis

117
Q

What is vesicular lesion on hands called caused by HSV-1

A

Herpetic whitlow

118
Q

How does neonatal herpes present

A

Eczema herpeticum- red spots all over face mainly around mouth

119
Q

Presentation of HSV 2

A

Flu like prodrome

Vesicles and papules around anus and genitals

120
Q

Features of HSV2 skin changes

A

Dysuria
Shallow ulcers
Discharge
Fever

121
Q

Infectious course of HSV

A

Following primary infection the virus will remain dormant in the sacral or trigeminal root ganglia called LATENT phase where asymptomatic. Then a stress or immunocompromised will cause it reactivate and go to skin in LYTIC phase. Will have it for whole life

122
Q

How is herpes investigated

A

Diagnosis made clincally but can do viral culture and HSV PCR

123
Q

How is HSV treated

A

Topical, oral or IV acyclovir

124
Q

What happens when varicella reactivated

A

Causes shingles after being dormant in dorsal root ganglia

125
Q

When does shingles most commonly present

A

After age of 50 post a stress on body or immunocompromised

126
Q

Peak incidence for chicken pox

127
Q

When is a chicken pox patient no longer contagious

A

When vesicles have crusted over

128
Q

Presentation of shingles

A

Occurs due to stress- get tingling in dermatomal distribution then painful skin lesions lasting 10-14 days

129
Q

How is Varicella investigated

A

Purely off clinical diagnosis

130
Q

How is chicken pox managed in children

A

Calamine lotion
Analgesia
Antihistamines

131
Q

How is chicken pox managed in adults

A

Acyclovir if within 24hr of rash onset

132
Q

How is shingles treated

A

1st line valaciclovir or famciclovir
2nd line acyclovir
But only if within 72 hrs of rash

133
Q

What is only time give VZIG

A

Immunosuppressed

Pregnant women exposed to Varicella zoster as likely to get shingles

134
Q

What is complications of varicella

A

Bacterial sepsis
Widespread rash
Pneumonia

135
Q

Main complication of shingles

A

Postherpetic shingles

136
Q

What cells does EBV infect

A

B lymphocytes

137
Q

Presentation of EBV

A

Fever
Pharyngitis
Swollen lymph nodes
Jaundice

138
Q

Which lymph nodes does EBV affect

A

Posterior cervical

139
Q

Management of EBV

A

Paracetamol

Corticosteroids in severe cases where obstructive pharyngitis, haemolytic anaemia, or really swollen glands

140
Q

What are 3 components to EBV specific antibodies

A

EBV VCA (viral capsular antigen) IgM
EBV VCA IgG
EBNA( epstein barr nuclear antigen) IgG

141
Q

When is only time get EBNA IgG

A

6-12 weeks post infection

Will also have VCA IgG

142
Q

What ABS do you have at these stages of EBV infection
Early primary infection
Acute primary infection
Past infection

A

Early primary infection- VCA IgM
Acute primary infection- VCA IgG, VCA IgM
Past infection- VCA IgG, EBNA IgG

143
Q

What is vesicular whitlow

A

HSV 1 blister on hand

144
Q

What lymphadenopathy is seen in strep pyogenes

145
Q

How is HIV transmitted

A 
Sex
Vertical
IV injections
Trnasfusion or organ donation
Occupational
146
Q

4 stages of untreated HIV

A

Flu like
Feeling fine
Falling count
Final crisis

147
Q

What is hairy leukoplakia

A

Irregular white painless plaques that cant be scraped off the tongue

148
Q

Which organism causes hairy leukoplakia directly

149
Q

Who does hairy leukoplakia occur in

A

HIV
Immunocompromised
Organ transplant

150
Q

What is candidiasis

A

Fungal infection caused by candida albicans causing thrush

151
Q

Conditions caused by candidiasis

A 
Oral and oesophageal candidiasis
Vulvovaginits
Diaper rash
Infective endocarditis
Disseminated candidiasis
152
Q

Who does disseminated candidiasis occur in

A

Neutropenic

153
Q

What causes vulvovaginitis

A

Diabetes

Abx

154
Q

Symptoms of oral candidiasis

A

Dysphagia

White exudate can scrape off

155
Q

Symptoms of vulvovaginitis

A

Thick discharge
Itching
Sore
Red

156
Q

Symptoms of disseminated candidiasis

A

Lymphocytosis
Fever
Hypotension

157
Q

Investigations for candidiasis

A 
Swabs 
Invesitgations mainly rule out others
Urinalysis for UTI
Vaginal pH to exclude other STIs
HIV test
Diabetes
158
Q

What does kaposi sarcoma look like

A

Pink or purple patch on skin or mouth

159
Q

If have kaposi sarcoma what does this suggest

A

Have AIDS- is defining

160
Q

What are cancers associated with HIV

A

Kaposi sarcoma
Squamous cell carcinoma of cervix or anus due to HPV
Lymphoma

161
Q

Confirm HIV

A

Elisa

Then confirm with WESTERN BLOT

162
Q

Other disease tests needed for HIV

A

Hep B, Hep C
Syphilis test
Tuberculin

163
Q

Most common viral causes of tonsilitis

A

Rhinovirus
Coronaviruses
Adenovirus

164
Q

Most common bacterial causes of tonsilitis

A

Group A strep
Mycoplasma pneumonia
Neisseria gonorrhoea

165
Q

Investigations for tonsilitis

A

Rapid strep antigen test

Throat culture

166
Q

Symptoms of tonsilitis

A

Pain on swallowing
Fever
Sore throat sudden onset

167
Q

Signs on examination of tonsilitis

A

Tonsillar exudate
Tonsillar erythema and enlargement
Anterior cervical enlargement

168
Q

What is under centor criteria

A

Tonsilar exudates
Fever
Anterior lymphadenopathy
No cough

169
Q

How does centor criteria work in terms of investigations

A

If 2 or less probably viral so do nothing

If 3 or more do rapid strep antigen test

170
Q

Symptoms of cold

A

Viral URTI with nasal stuffiness, discharge, sore throat, headache and cough

171
Q

Investigations for cold

A

Clincal diagnosis

172
Q

Management of cold

A

Anticongestants
Hydration
Analgesia

173
Q

3 most common causes of cold

A

Rhinovirus
Coronavirus
Influenza

174
Q

How to define abscess

A

Collection of pus within tissue or walled off by fibrosis

175
Q

Most common cause of external abscess

176
Q

How do external abscess present

A 
Erythema
Hot
Pain
Oedema
Loss of function
177
Q

Who are perianal abscesses common in

A

IBD

Diabetes

178
Q

How do internal abscess present

A

Vety unwell
Pain
Fever

179
Q

Management of uncomplicated abscesses

A

Aspiration

Incision and drainage

180
Q

Management of severe abscess and rapid disease progression

A

Antibiotics
Incision and drainage
Excision in some cases

181
Q

Which abscesses do you only give Abx in

182
Q

What causes multiple ring enhancing lesions in HIV pts

A

Toxoplasmosis

183
Q

How to differentiate between viral and bacterial tonsilits

A

Do centor
2 or less viral
3 or more bacterial

184
Q

Cause of meningitis if long pregnancy

A

Group B strep

185
Q

Cause of meningitis if infection in previous pregnancy

A

Group b strep

186
Q

Cause of meningitis if late neonatal infection

187
Q

Cause of meningitis if gram -ve diplococci

A

Neisseria meningitidis

188
Q

Cause of meningitis if unvaccinated teenager

A

Haemophilus influenzae

189
Q

Cause of meningitis if gram +ve cocci

A

Strep pneumoniae

190
Q

Cause of meningitis if elderly

A

Listeria monocytogenes

191
Q

Cause of meningitis if eaten cheese or unpasteurised milk

A

Listeria monocytogenes

192
Q

Cause of meningitis if alcoholic

A

Listeria monocytogenes

193
Q

What does skin rash in meningitis imply

A

Meningococcal septicaemia

194
Q

If has signs of meningococcal septicaemia what is drug give

A

IV benzylpenicillin

195
Q

Management of non meningococcal septicaemia

A

IV ceftriaxone
Consider dexamethasone
Consider IV acyclovir if LOC to cover encephalitis

196
Q

What can be given to close contacts of people with meningitis

A

Rifampicin or ciprofloxacin

197
Q

If listeria indicated what is treatment meningitis

A

Ampicillin

198
Q

What separates protein and glucose in bacterial meningitis from others

A

Protein extremely high

Glucose extremely low

199
Q

What are risk factors for streptococci endocarditis

A

Abnormal valves ie from calcification, degeneration, rheumatic fever. Is quite a weak bacteria so struggles in healthy tissues

200
Q

What are risk factors for staphyloccocus endocarditis

A

IV drug user

Prosthetic valve

201
Q

3 most common causes of endocarditis

A

Streptococci
Staphyloccocus
Enterococci
Other organisms that give negative blood cultures

202
Q

Risk factors for endocarditis in general

A 
Abnormal valves ie from calcification, degeneration, rheumatic fever
IV drug user
Prosthetic valve
Dental work
Turbulent flow
Indwelling catheter
203
Q

Frequency with which endocarditis affects vavles

A

Mitral
Aortic
Tricuspid
Pulmonary

204
Q

Non hand signs on examination of endocarditis

A 
Pyrexia
Clubbing
New murmur
Splenomegaly
Vasculitis lesions
Roth spots
205
Q

Investigations for endocarditis

A

FBC- high neutrophils, anaemia
CRP and ESR up
U&Es
Rheumatoid factor- positve in some cases as can cause endocarditis
3 blood cultures 1 hour apart within 24hrs
Urgent echo
Duke criteria

206
Q

Complications of endocarditis

A 
CHF
Valve incompetence
Aneurysm formatin
Systemic emoli
Renal failure
Glomerulonephritis
207
Q

General management of endocarditis

A

Abx for 6 weeks

208
Q

If have prosthetic valves what antibiotics do you give in endocarditis

A

Flucloxacillin
Rifampicin
Gentamicin

209
Q

If have native valves what antibiotics are given for strep viridans if penicillin sensitive

A

Benzylpenicillin

Gentamicin

210
Q

Treatment for staph aureus endocarditis in native valves

A

Flucloxacillin

211
Q

What would be given if endocarditis bacteria resistant to penicillin or allergic

A

Vancomycin

212
Q

What diarrorhoea comes from leafy vedgetables

A

E.coli and haemorrhagic e coli

213
Q

What diarrorhoea comes from reheated rice

A

Bacillus cereus

214
Q

What diarrorhoea can cause cerebral abscess

A

Bacillus cereus

215
Q

What diarrorhoea comes from eggs and poultry

A

Salmonella

216
Q

What diarrorhoea comes from uncooked poultry

A

Campylobacter

217
Q

Which organism causes diarrorhoea following poor sanitation and tropical places

A

Entamoeba histolytica

218
Q

Management of gastroenteritis dependant upon

A

Depends on systemic signs like prolonged visible blood, fever over 39 and dehydration

219
Q

Treatment for gastroenteritis when no systemic signs

A

Supportive therapy- bed rest, oral hydration, electrolyte replacement
NO stool culture needed

220
Q

Treatment for systemic gastroenteritis

A

Admit and oral fluids
If severe dehydration give IV
Antibiotics if organism identified

221
Q

When is only time give antibiotics in gastroenteritis

A

Infective organism idenitified

222
Q

Acute hepatitis investigations

A 
FBC
LFTS
Clotting
US scan
Viral serology and PCR
Biopsy maybe
223
Q

How is Hep A and E transmitted

A

Faeco oral

224
Q

Where do people normally pick Hep A up

A

Travel history from contaminated water

225
Q

How does Hep A normally present

A

Asymptomatic

226
Q

Who normally presents with Hep E

A

Pregnant
Immunocompromised
Travel history to endemic area

227
Q

Management of Hep A and E

A

Supportive

Avoid alcohol

228
Q

How is Hep B transmitted

A

Sex
Needles
Vertical

229
Q

Managment of Hep B acute

A

Symptom support

230
Q

Management of Hep B chronic

A

Tenofovir

Peginterferon alpha

231
Q

How is Hep D transmitted

A

Must have Hep B infection

232
Q

What is management of Hep C

A

Antiretrovirals are now curative

For example sofosbuvir, Ledipasvir

233
Q

Presentation of cystitis

A

FUD
Haematuria
Foul smelling and cloudy urine
Suprabubic or loin pain

234
Q

Presentation of pyelonephritis

A 
Rigors
Pyrexia
Nausea and vomiting
Confusion in elderly
Flank pain to back
235
Q

Most common causes of UTI

A

Ecoli
Proteus mirabilis
Klebsiella
Enterococcci

236
Q

What are nitrates specific to

237
Q

Investigations UTI

A

Urinalysis
MC and S
USS to rule out obstruction

238
Q

What are 2 rashes seen in SLE

A

Malar

Discoid

239
Q

What is main common and pathogmonic feature of discoid and malar rashes

A

Photosensitive

240
Q

What does malar rash look like and what does it spare

A

Erythematous and photosensitive covering cheek and nasal bridge
Spares the nasolabial fold

241
Q

How does discoid rash appear

A

Erthematous plaques that look like discs

Photosensitive

242
Q

Where are discoid rashes seen

A

Scalp
Face
Ears

243
Q

Diagnosis criteria for SLE

A 
DOPAMINERASH
Discoid rash
Oral ulcers
Photosensitivity
Arthritis
Malar rash
Immunological criteria
Neurological sx
ESR
Renal disease
ANA
Serosities
Haem abnormalities
244
Q

What are serosities seen in lupus

A

Pleural effusion

Pericardial effusion

245
Q

How can SLE renal disease present

A

Nephrotic syndrome
Nephritis syndrome
Rapid glomerulonephritis

246
Q

How does SLE joint disease present

A

Symmetrical polyarthritis affecting hands just like RA with early morning stiffness

247
Q

How does SLE joint disease present on examination and Xray

248
Q

How can neurological SLE present

A

Seizures

Psychosis

249
Q

Haem presentation of SLE

250
Q

Most specific AB for SLE

A

Anti smith

251
Q

Inflammatory markers in SLE

A

CRP normal

ESR elevated

252
Q

What are C3 and C4 in normal SLE disease

253
Q

DDx for nephrotic syndrome

A 
minimal change disease
membranous
focal segmented glomerulosclerosis
diabetic
myeloma
254
Q

What causes membranous change nephrotic syndrome

A

Secondary to cancer, lupus, viral hepatitis B/C

255
Q

What causes focal segmented glomerulosclerosis

A

HIV

Heroine

256
Q

Microscopy finding of membranous change disease

A

Thickened basement membrane

Subepithelial deposits of immune complexes

Year 3 Conditions (33 decks)

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