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Exit Viva > investigations/diagnostic criteria > Flashcards

investigations/diagnostic criteria Flashcards

1
Q

DMS initial Invx

A

-admission, histo-(LE interface mucin ), DIF(-ve vs LE),

CK aldolase, EMG/muscle bx

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2
Q

DMS diagnostic criteria

amyopathic

A

clinical+histo+/- myositis(proximal weakness, CK/aldolase

6 mo provisional, 2 y definitive, monitor, anti P155/MDA5

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3
Q

DMS full Invx - overlap, Cx, malignancy

A

a)CTD:ANA, ENA, dsDNA(overlap) U1RNP
b)Cx: pulm: CXR, anti Jo1(50-70% ILD), PFT(Werth 2010 routine PFT-abn-HRCT)
cardiac: ECG ,antiSRP-cardiac, fulminant
c)malignancy: FBC(Fe def), LFT, UECR/UFEME, CXR,
paraneoplastic screen

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4
Q

paraneoplastic screen

A

1.Refer ENT(PNS exam/Bx)
2.breast testicular exam/
mammogram/PAP/ US; ca125(ovarian)/PSA,
3. SOBx 3(>45y) AFP(hepatoma), CEA, ca 19-9,

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5
Q

SSc invx

A

1.Bx- histo
2. gen: FBC, ESR(activity), UEC/UFEME, LFT,
3. spec: SSc: ANA(50%morphea-chronic; 90% scleroderma-nucleolar*speckled homogenous), anti scl70(20%,DNA topoisomerase1) anti centromere(CREST)
4.Cx: CK, aldolase(myositis) CXR, PFT, MDTreferral
Overlap MCTD- +U1 RNP, antifibrillin, antiPMScl

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6
Q

Special site linear facial Invx i.e. en coup de sabre, parry romberg-

A

eye screen 3m: uveitis, episcleritis,pseudopapilledema/MRI( headache seizures NL-neuropathy malformation vasculitis infarct atrophy); salivary gland/tongue hemiatrophy

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7
Q

scleromyxedema Invx:

A

Bx, serum protein electrophoresis;TFT
Cx: ILD, myositis, dysphagia/cardiac(HT,AMI),polyarthritis,
renal crisis, dermatoneural syndrome(dysarthria,seizures/flu like illness)

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8
Q

LP invx

A

Drugs(HCTZ,Antimalarial,NSAID,Gold,Pencillamine,Captopril)/contact(color developer/amalgam);
Infx-HepC(+)/B(weak);
Histo,DIF-cytoid bodies IgM/c3/shaggy fibrinogen @BMZ

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9
Q

PRP Invx

A

Biopsy( vs psoriasis),
FBC, UECR, LFT,
HIV testing-malignancy screen(age-appropriate/symptom directed),
hepatosplenomegaly, LN

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10
Q

PPK Acquired work up

A

workup: scrape-scabies/fungal; bx(PRP); drug hx, urine PCR CT; FBC(nutritional, hematinic)+PBF(MF), UEC/LFT CXR; TFT; paraneoplastic- DMS, bazex

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11
Q

photoderm

A

FBC, ANA, CK/aldolase,porphyrins(plasma stool urine) HIV test ; skin bx(CTD)
phototesting(MED; buttock univolved topicals/sytemics, AH 1w), photoprovocation testing(if phototest inconclusive, CPC)

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12
Q

invx immunoderm

A

biopsy- histo
DIF(perilesional)salt split skin
IIF
ELISA:BP180/230/COL7/p200/antidsg1/3Ab-PF/mucosal/mucocutaneous(1+3)/antiendomysial IgA+antiTTG IgA/desmoplakin/plakophilin/plakoglobin immunoblot EBA,p200;IgA pemphigus,PNP

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13
Q

which Drug? induced- immunobullous

A

penicillamine, ACE i, thiol group-dsg1/3 interaction; BP+frusemide

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14
Q

dz associations DH

A

hashimoto/IDDM, Addison, MG)

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15
Q

Recurrent Oral/genital ulcerations/desquamative gingvitis invx

A

Inx FBC(Differential-cyclic neutropenia-AD,fever infx,LN, anemia), hematinic workup- Fe ferritin, TIBC B12, folate, zinc, HIV, HSV IF c/s, dsg1/3/G6PD, SLE
clinical suspicion: biopsy+DIF( EM,LP, immunobullous, malignancy,oral+skin(behcet’s EN)
GI(IBD)/eye referral(Behcet’s)

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16
Q

EM

A

Invx: FBC(TW, ESR,) Bx, DIF - TSST, HSV PCR; ASOT, CMV, EBV coxsackie, HCV

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17
Q

FDE drugs

A

Tetracyclines, penicillins, sulfamethoxazole, trimethoprim, macrolides, fluoroquinolones, metronidazole, griseofulvin, anticonvulsants ,NSAID

18
Q

FDE invx

A

temporal relationship,+-Bx/Systemic provocation(>4w gold standard (single sub/therapeutic dose increased q12-24h/PT(generalized bFDE) old FDE(+)&normal back skin(-ve)

19
Q

LV invx

A

1.prothrombotic- APS/proteinC/S,factor V leiden/MTHFR;antithrombin111def/PT gene mutation; ↑homocysteminemia/plasminogen activator inhibitor 2. CTD

20
Q

vasculitis gen screen

A

gen FBC(?CTD, infective,eosinophilia-drug/Churg strauss), UEC/UFEME/BP( systemic) LFT; ESR

21
Q

vasculitis Infective-

A

hep B/C, TB spot, SVV ASOT bacteremia blood c/s 2decho

22
Q

vasculitis malignancy-

A

serum urine electrophoresis/myeloma/B2 microglobulin;

23
Q

vasculitis ANCA

A

cANCA/PR3(wegener), pANCA(MPA), churg strauss(pANCA) , CXR, sinusitis

24
Q

CTD screen-,

A

ANA,ENA, anti dsDNA, C3/4/c1q(SLE, HUVS), RF, scleroderma, MCTD

25
Q

Thrombophilic(LV, thrombosis, APS)-

A

PT/PTT antithrombin 111, LAC, anticardiolipin, antib2glycoprotein, cryoglobulin, factor V leiden, - protein C/S, homocysteine(↑CKD, hypothyroidism, b6/12folate def)

26
Q

cut mets bx stains

A

Bx: stains: ck7/20/s100, thyroglobulin+/TTF1(thyroid); prognosis(ER/PR/Her2neu)

27
Q

invx anetoderma

A

Inx-Bx-normal collagen, focal complete loss elastin dermis/reticular dermis
APS, DLE/SLE, HIV(occasional)
systemic: ocular cardiac pulmonary Git endocrine, skeletal

28
Q

invx degos

A

1) epidermal atrophy wedge sclerosis, dermal edema, basal vac,
2) GIT- bowel perf/peritonitis(endoscopy), CNS infarct, ocular, respi/cvs/GU;
3) LE/APS/CTD

29
Q

NXG

A

Invx: serum urine electrophoresis, serum Ig, ESR

30
Q

xanthoma

A

workup histiocytic:Bx(S100, CD1a,langerin, CD68,) FBC(cytopenia), UEC/LFT,
fasting lipids, serum protein electrophoresis/myeloma screen, CXR

31
Q

Disseminated GA

A

Workup- Hx-meds TNF-a inhibitor, LN, DM, TFT, lipids, HIV hepB/C, Malignancy screen- CXR CTAP

32
Q

OFG

A

Invx:Bx, dental Xray, CXR(sarcoid/TB), FBC, ESR, CRP, ACE, TB T Spot, refer GE/patch test/dental

33
Q

granulomatous nasal nodule

A

histo/pyogenic/fungal/mycobacterial c/s, stains

parasitized macrophages:GI,histoplasmosis, leishmaniasis, peniciliosis-??distinguish! rhinoscleroma-

34
Q

Breslow:

A

depth mm from granular layer to deepest tumor

35
Q

Clark

A

:I epidermis II/III papillary dermis IV reticular dermis V subcutaneous tissue.

36
Q

melanoma staging

A

staging:distant mets st4;nodal mets st3; >1mm+ulcer st 2( 10, 50, 70% survival)

37
Q

melamoma dermoscopy

A

Dermoscopy atypical network, irregular streaks/blotch; dots/globules, blue white
ALM parallel ridge ( big RICH is bad guy)

38
Q

PATHO NMSC

A

Patho- thickness, Clark’s IV, perineural; TNM AJCC

39
Q

Dermoscopy pBCCs

A

1-blue-gray ovoid nests multiple blue-gray globules;

2-Arborizing vessels

40
Q

empd

A

Invx: Bx, LN , CLR, urothelial, ovary/prostate ca screen

Exit Viva (8 decks)

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