MLC - LUPUS Flashcards
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Inflammatory : prolonged morning sickness . high level of fatigue, respond to steroids
Non Inflamm– morning stiffness wears off quickly. Non steroid responsive.
Mono vs Poly vs Oligo
1 joint, >5, In between (2-4)
Mono: eg Gout, Septic
Oligo- rt knee, left toe.
Sero Neg
Poly - Rheumatoid Arthritis
Acute vs chronic
Acute: <6 wks
Sym or not? is it the same gen distribution?
Symmetrical: Rheumatoid
Assymetrical : Osteo, psoriatic Arthitis
How would you tease apart similar conditions on the DDX.
Review of systems will tease apart similar diagnoses.
A: Alopecia; Lupus - “Hair on pillow in the morning”?
D: Dry mouth, eyes, : SJOGRENS!! primary cms by itself, secondary assoc w/ lupus
R: Raynaud’s: Lupus, secndary Raynauds in rheumatc diseases
O:Oral Ulcers and Genital Ulcers(Lupus, Behcets).. **writer’s syndrome*
P: Photosensitivity, eg psoriasis(may dev arthritis) and other rashes!
Palpable purpura (Lupus, Wegener, HSP)
Regular ROS:
Headache, jaw claudication(pain and faigue of jaw w/ chewing– like an angina w/ low blood to chewing muscles).
Temporary loss in vision: Giant cell
Stroke, Miscarriages: Anti phospolipid syndrome–> thromobocytopenia
Foot drop, testicular pain: PAN
HEENT:
recurrent sinuses: Wegener’s
hearing loss and vertigo: HSP 70, autoimmune disease of the middle ear.
GI:
Dysphagia and frequent heart burn: Scleroderma: difficulty swallowing
Hematochezia: IBS, cholitis
Frequent miscarriages: 1st trimester??
When would the pt have Rheumatoid factor?
notes on tests in general.
CH- Chronic disease in general
R- Rheumatoid A
O- Other rheumatic diseases
N- Neoplasia
I- Hep C and Endocarditis
C- Cyroglobulinemia
note:
1. ANA isnt specific but is a gd Lupus flag
2. ABs against dsDNA –> Lupus, and Chagas**
3. SSa , SSb –> In sjogrens and Lupus sometimes, also in kids w/ congenital Heart block from SSa+ mum. and in scleroderma**
4. ESR : least specific. highest rate in Infection, vasculitis and Malignancy in the 80’s and 90’s.
Anemia will cause high ESR too!
