immuno tests

Question 1

causes of increased ESR

Answer 1

infection
malignancy
inflammatory dz
trauma
ischemia

Question 2

causes of falsely elevated ESR

Answer 2

abnl RBC- PV, spherocytosis, sickle cell

increased WBC

HF

tech errors- clotting oof blood, delay, room temp

Question 3

CRP characterstics compared to ESR

Answer 3

produced by liver

increases and decreases faster than ESR

Question 4

RA tests and their level of sensitivity/specificty

Answer 4

RF - sensitive

CCP/ACPA: specific, bag prognosis

Question 5

RF positive also for

Answer 5

other autoimmune dz

inflamm (hep B, C, TB)

nl in age>60, 5-25%

Question 6

ANA tested in symptomatic or asx patient?

Answer 6

symptomtic

Question 7

ANA reported how

Answer 7

titer

greater the denominator, the stronger the dx

be suspicious with ANA> 1/160

Question 8

positive ANA if

Answer 8

family member with AI disease

female

drugs (hydralazine, monocycline, TNF in)

recent virus

Question 9

dsDNA

Answer 9

lupus

glomerulonephritis

Question 10

anti-smith

Answer 10

specific

lupus

Question 11

anti-RNP

Answer 11

mixed connective tissue disease

lupus

Question 12

anti-SSA (Ro) and SSB (la)

Answer 12

sjogren
lupus
photosensitive
neonatal lupus- heart block

Question 13

antiphospholipid antibodies types

Answer 13

anti- cardiolipin: nonspecific

anti beta GP1: specific

lupus anticoagulant- inc APTT

Question 14

elevated or decreased C3 causes

Answer 14

decreased: used up in active disease or cirrhosis (made in liver)
elevated: infection

Question 15

scleroderma antibodies

Answer 15

anti-centromere- CREST
–> pulm HTN

anti topo I- severe
–> ILD

anti-RNA pol III
–> renal crisis

Question 16

myositis antibodies

Answer 16

HMG coA reducatase

p155/140 - paraneoplastic

Question 17

anti-tRNA synthetase (anti jo1 ) anitobodies for which dz’s

Answer 17

muscle disease

ILD

Question 18

what % of PMN’s in synovial fluid analysis is indicative of increased risk of septic arthritis?

Answer 18

> 75%

Question 19

rheum joint diseases that can affect 1 joint

Answer 19

trauma
hemarthrosis
spondyloarthropathy
septic arthritis
crystal

Question 20

rheum joint diseases that are oligoarticular

Answer 20

spondyloarthropathy
crystal
infection related

Question 21

rheum joint diseases that are polyarticular

Answer 21

RLA
SLE
crystal
infectious

Question 22

OA most commonly affects which joints

Answer 22

hands- PIP, DIP
feet- big toe
hips 
AC joint
facet joints of cervical and lumbosacral

Question 23

RA affects which joints

Answer 23

wrist, MCP PIP

swan neck, boutonniere

Question 24

RA vs OA which ulnar vs radial deviated

Answer 24

RA- ulnar

OA- radial

Question 25

extra- RA manifestation

Answer 25

ILD vaculitis scleritis risk of CAD

Question 26

is there kidney involvement in RA?

Answer 26

no! think lupus if there is

Question 27

short term vs long term treatment of RA

Answer 27

short: prednisone long: NSAIDS, DMARDs (methotrexate), biologics, hydroxychloroquine

Question 28

treatment for seroneg spondyloarthropathy

Answer 28

similar to RA except no hydroxychloroquine!! humera good TNF alpha inhibitors are mainstay

Question 29

short term vs long term treatment for gout

Answer 29

short: NSAIDs, colchicine, steroids long: allopurinol, feboxustat, probenicid

Question 30

pseudogout treatment

Answer 30

acute: NSAIDs, colchicine, steroids long term: methotrexate in refractory cases

Question 31

how should you alter long term allopurinol during gout attack

Answer 31

DONT CHANGE DOSE

Question 32

what does malar rash spare

Answer 32

nasolabial fold

Question 33

SLE sxs

Answer 33

SOAP BRAIN MD serositis Oral ulcers Arthritis Photosensitive ``` Blood disorder Renal disorder ANA Immune abnl Neuro sxs (HA, seizure, MDD, psychosis) ``` Malar rash Discoid rash

Question 34

what can improve survival in SLE mild dz?

Answer 34

hydroxychloroquine

Question 35

mod-severe dz treatment of SLE

Answer 35

azathioprine mycophenolate mofetil rituximab cyclophosphamide

Question 36

short term treatment of SLE

Answer 36

prednisone

Question 37

CREST syn

Answer 37

``` calicnosis raynauds Esophageal dysmotility Scelrodactyly Telengiecasias ```

Question 38

raynauds is painful in which phase

Answer 38

red

Question 39

lung involvement in scleroderma

Answer 39

limited: pulm HTN diffuse: ILD

Question 40

what to treat scleroderma renal crisis

Answer 40

ACEI NOT PREDNISONE!!

Question 41

how to best treat scleorderma

Answer 41

treat each symptom ( eg. CCB for raynauds)

Question 42

is temporal pulse dec or inc in giant cell arteritis

Answer 42

decreased

Question 43

treatment for large vessel vasculitis

Answer 43

high dose steroids

Question 44

shawl sign, heliotrope rash, mechanic's hands seen in which disease

Answer 44

dermatomyositis

Question 45

diagnosis of myositis

Answer 45

biopsy be suspicious in elevated muscle enzymes and proximal muscle weakness

Question 46

extra-muscle involvement in myositis

Answer 46

ILD malignancy: breast, ovarian, adeno