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MSK > MSK Autoimmune Diseases > Flashcards

MSK Autoimmune Diseases Flashcards

1
Q

What can mimic MSK autoimmune disease presentation?

A 
Drugs- cocaine, mocycline, PTU
Infection- HIV, endocarditis, hepatitis, TB
Malignancy- lymphoma
Cardiac myxoma,
Cholesterol emboli, 
Scurvy
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2
Q

Risk factors for systemic lupus erythematous

A

Female,
15-50,
Afro-caribbean

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3
Q

Systems affected by SLE?

A 
Face, 
Nervous system, 
General,
Skin, 
Heart, 
Chest, 
Muscles, 
Blood, 
Joints
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4
Q

What are the classification criteria for SLE?

A

Any 4 of:
Malar rash,
Discoid rash,
Photosensitivity,
Oral ulcers,
Arthritis,
Serositis,
Renal (signif proteinuria or cellular casts in urine),
Neurological (unexplained seizures or psychosis),
Haematological (low WCC, platelets, lymphocytes, haemolytic anaemia),
Immunological (anti ds-DNA, cardiolupin, lupus anticoagulant),
ANA

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5
Q

Skin manifestations of SLE

A 
Butterfly rash on face,
Photosensitivity, 
Vasculitis, 
Purpura,
Urticaria,
Alopecia
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6
Q

Nervous system manifestations of SLE?

A 
Fits, 
Hemiplegia, 
Ataxia, 
Peripheral neuropathy, 
Cranial Nerve lesions
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7
Q

Chest and heart manifestations of SLE?

A 
Pericarditis, 
Endocarditis, 
Aortic valve lesions,
Pleurisy, 
Pleural effusion, 
Fibrosis
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8
Q

Joint and muscle presentation of SLE?

A

Myopathy,
Aseptic necrosis of hip,
Arthritis in small joints

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9
Q

Blood presentation of SLE?

A

Anaemia,
Leukopenia,
Thrombocytopenia,
Raynaund’s phenomeno

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10
Q

What is Scleroderma?

A

Immune system attacking connective tissue under the skin and around internal organs and blood vessels

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11
Q

What are the 2 classes of scleroderma?

A

Localised or systemic

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12
Q

What is the presentation of localised scleroderma?

A

Morphea

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13
Q

What are the 2 classes of systemic scleroderma?

A

Limited and diffuse

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14
Q

Presentation of limited scleroderma (CREST)

A 
Calcinosis,
Raynaund’s phenomenon,
Esophageal dysmotility, 
Sclerodactomy, 
Talangectasia
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15
Q

Presentation of diffuse scleroderma?

A

Fixed flexion

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16
Q

Complications of limited scleroderma?

A

Pulmonary hypertension

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17
Q

Complications of diffuse scleroderma?

A

Pulmonary fibrosis,
Renal crisis,
Small bowel bacterial overgrowth

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18
Q

What is Sjogren’s syndrome?

A

Autoimmune against exocrine glands

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19
Q

Main 2 symptoms of Sjogren’s syndrome?

A

Dry mouth,

Dry eyes

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20
Q

GI presentation of Sjogren’s syndrome?

A

Dry mouth,
Parotid gland enlargement,
Dysphagia,
Abnormal oesophageal motility

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21
Q

CNS and PNS presentation of Sjögren’s syndrome?

A

Fits,
Hemiplegia,
Ataxia,
Cranial nerve lesions

Sensory neuropathy,
Mononeuritis multiplex

22
Q

Respiratory presentation of Sjögren’s syndrome?

A

Interstitial lung disease

23
Q

Kidney presentation of Sjögren’s syndrome?

A

Renal ubular acidosis

24
Q

Skin and joint presentation of Sjögren’s syndrome?

A

Palpable purpura,
Raynauds Syndrome,

Arthralgia

25
Q

Complications of Sjögren’s syndrome?

A 
Lymphoma, 
Neuropathy, 
Purpura, 
Interstitial lung disease, 
Renal tubular acidosis
26
Q

Systemic presentation of Sjögren’s syndrome?

A

Fatigue,
Fever,
Myalgia,
Arthralgia

27
Q

What is auto-immune myositis?

A

Autoimmune condition causing inflammation and weakness in muscles

28
Q

Incidence of auto-immune myositis?

A

6/million

29
Q

Presentation of auto-immune myositis?

A

Polymyositis,
Dermatomyositis,
Gottrons papules (on hands),
Heliotrope rash (ocular, purple oedema)

30
Q

Complications of auto-immune myositis?

A

Cancer,
Interstitial lung disease,
Respiratory muscle weakness

31
Q

Giant cell arthritis classification criteria?

A 
3 of the following.... 
age of onset >50,
New headache, 
Temporal artery tenderness/ reduced pulsation, 
ESR >49,
Abnormal temporal biopsy
32
Q

ANCA associated vasculitis types?

A

Granulomatosis with polyangiitis,
Microscopic polyangiitis,
Eosiniphilic granulomatosis with polyangiitis

33
Q

What is granulomatosis with polyangiitis?

A

Necrotising granulomatous inflammation

34
Q

Which ANCA associated vasculitis involves the upper and lower respiratory tracts?

A

Granulomatosis with polyangiitis,

Eosinophilic granulomatosis with polyangiitis

35
Q

Describe microscopic polyangiitis

A

Necrotising vasculitis,
Few/ no immune deposits,
Affects small vessels

36
Q

In what ANCA associated vasculitis does pulmonary capillaritis occur?

A

Microscopic polyangiitis

37
Q

Describe Eosinophilic granulomatosis with polyangiitis

A

Eosinophil rich and necrotising granulomatous inflammation often involving the respiratory tract

38
Q

Which ANCA associated vasculitis is associated with asthma and eosinophilia?

A

Eosinophilic granulomatosis with polyangiitis

39
Q

Specific ANA profiles for SLE?

A

DsDNA,
Ro,
Sm

40
Q

Specific ANA profiles for scleroderma?

A

Scl-70,

Centromere

41
Q

Specific ANA profiles for polymyositis?

A

Jo-1

42
Q

Specific ANA profiles for Sjögren’s syndrome?

A

Ro,

La

43
Q

Lupus nephritis class 1

A

Minimal mesangial

44
Q

Lupus nephritis class 2

A

Mesangial proliferative

45
Q

Lupus nephritis class 3

A

Focal

46
Q

Lupus nephritis class 4

A

Diffuse

47
Q

Lupus nephritis class 5

A

Membranous

48
Q

Lupus nephritis class 6

A

Advanced sclerosing

49
Q

Multi-system autoimmune diseases mild organ threat treatment?

A

Hydroxychloroquine

50
Q

Multi-system autoimmune diseases moderate organ threat treatment?

A

Azathioprine,
Methotrexate,
Mycophenolate

51
Q

Multi-system autoimmune diseases severe organ threat treatment?

A

Cyclophosphamide,

Rituximab

MSK (40 decks)

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