Lupus and other CT disorders Flashcards
How many diagnostic criteria do you have meet to classify SLE?
4/11 criteria needs to be met
how do you distinguish the butterfly (malar) rash from rosacea?
butterfly rash has a nasolabial food
what are some symptoms of lupus?
- butterfly rash
- alopecia
- painless mucosal ulceration
- Jaccoud’s arthropathy
- CNS involvement
what is the most devastating manifestation of lupus?
renal disease- lupus nephritis
what is ANA testing useful for?
ANA has high sensitivity (100%) but low specificity
what does (-) ANA tell you?
you do not have SLE
what does (+) ANA tell you?
many causes for (+)ANA
- malignancies
- infections
- other autoimmune dz
which test is SPECIFIC for SLE?
anti ds-DNA
what is significant about (+)anti ds-DNA?
often associated with renal involvement (so it has poor prognosis)
-and it waxes and wanes with disease activity
what other marker is quite specific for SLE?
anti-Smith
which factors increase risk for avascular necrosis?
- steroid use
- antiphospholipid antibody positvity
- hyperlipidemia
- Raynaud’s phenomenon
what is the hallmark of inflammatory myopathies?
painless proximal muscle weakness
do children mostly have dermatomyositis or polymyositis?
children- dermatomyositis
in adults, which inflammatory myopathy is more common?
polymyositis- most common
dermatomyositis may indicate paraneoiplastic syndrome
what is Gottron’s papules?
rash around knucles indicative of dermatomyositis
how many criteria do you need to fill for polymyositis?
4 out of 5 criteria
how many criteria do yo uneed to fill for dermatoymyositis?
3 out of 4 criteria
Name the 5 criteria for inflammatory myopathies.
- symmetric proximal muscle weakness
- elevated muscle enzymes
- myopathic EMG abnormalities
- typical changes on muscle biopsy
- typical rash of dermatomyositis
which autoantibody is commonly seen in inflammatory myopathies?
anti-Jo1
describe the involved skin in limited scleroderma.
distal extremities & face are involved (but trunk is spared)
what does CREST stand for? CREST is a limited cutaneous system sclerosis.
Calcinosis Raynaud's Esopheal dysmotility Sclerodactyly Telangiectasias
describe the color changes seen in Raynaud’s.
1st white- vasospasm
2nd blue- cyanosis
3rd red- reperfusion hyperemia
which antibody is seen in limited scleroderma?
anti-centromere
which antibody is seen in diffuse scleroderma?
anti-Scl-70
describe treatment for scleroderma.
treatment is very frustrating-steroid use is limited; only symptomatic treatment
what disease must be present for scleroderma?
Raynaud’s
