Lupus, Scleroderma, Sjogren's Syndrome, MCTD, and Spondyloarthropathies Flashcards
HIgh risk races in SLE
African Americans, Hispanics, Asians
Susceptibility genes of SLE
HLA-DR2, complement deficiency
11 criteria for SLE
SOAPBRAINMD - Serositis, Oral ulcers, Arthritis, Photosensitivity, Blood disorders (cytopenias), Renal, ANA (FANA+), Immunologic (anti-Smith, anti-dsDNA, anti-phospholipid, anti-cardiolipin, lupus anticoagulant), Neuro (psychosis, seizures), Malar rash, Discoid rash
Significance of ANA in lupus
ANA is really sensitive, BUT NOT SPECIFIC (useful if high suspicion of lupus)
Where else do you see + ANA
Scleroderma
Anti dsDNA and anti-Sm antibodies
High specificity for lupus, anti-dsDNA associated with nephritis
Significance of anti-SSA and anti-SSB
Subcutaneous lupus, neonatal lupus, complete heart block in utero
Complement pathway in SLE
Both classical and alternative activated–consumes C3 and C4
Recurrent fetal loss in SLE is associated with what?
Antiphospholipid antibody
Major cause of mortality in SLE
Atherosclerosis of the coronary arteries
Criteria for antiphospholipid syndrome
Clinical event and persistent presence of antiphospholipid antibody
Antibodies in scleroderma
Topo 1 (diffuse), centromere (limited), PM/Scl, U1-RNP
Raynaud’s phenomenon
Vasospastic attacks in digits (white to blue to red), can cause digital ulcers
Risk factors for sclerodermal renal crisis
Diffuse skin lesion, corticosteroids, anti-RNA polymerase III Ab
Most common organ involved in scleroderma
GI dismotility, upper GI tract dysfunction, lower GI (bad prognosis)
Lung diseases in scleroderma
Interstitial lung disease and pulmonary arterial hypertension
Lab findings in Sjogren’s syndrome
ANA, SS-A/SS-B, rheumatoid factor
Signs and symptoms in Sjogren’s syndrome
Dry eyes, dry mouth, dental caries, mouth ulcers, parotid/submandibular gland enlargement
Cancer risk in Sjogren’s
Non-hodgkin’s lymphoma
Mixed connective tissue disease overlaps with which diseases?
Overlap with lupus, scleroderma, and inflammatory mysoitis
Antibody in MCTD
U1-RNP
Common findings in MCTD
Puffy, swollen fingers (early), Raynaud’s, Renal, and CNS involvment
Most common cause of death in MCTD
Pulmonary hypertension
Labs in spondyloarthropathies
Rheumatoid factor NEGATIVE, association with HLA-B27 (sensitive but not specific)
Common signs of spondyloarthropathies
Enthesitis, dactylitis (sausage digits),
Epidemiology of ankylosing spondylitis
Weird epidemiology - young, males>females
Clinical features of AS
Chronic back pain, symptoms worse in morning and IMPROVE with exercise
Joint involvement in AS
Hips, shoulders, knees, and ankles, dactylitis, enthesitis with heel pain
X-ray findings of AS
Squaring of vertebral bodies
Classic triad of reactive arthritis
Arthritis, conjunctivitis, urethritis
Psoraitic arthritis patterns
Oligoarticular (less than 4 joints, asymmetric), DIP involvement, axial involvement
Enteropathic arthritis
Occurs after GI disease; gut wall is leaky barrier, associated with Crohn’s and ulcerative colitis
