Multi system autoimmune disease

Question 1

Who is systemic lupus erythematous seen in?

Answer 1

Females > males

Onset 15-50

Question 2

What are the classical signs and symptoms of lupus?

Answer 2

Fatigue, fever
Myalgia and arthralgia
Raynaud's
Butterfly rash
Photosensitivity

Question 3

What are the classification criteria of lupus?

Answer 3

Any 4 of-
Butterfly rash
Discoid rash
Photosensitivity
Oral ulcers
Arthritis
Serositis
Proteinuria
Cellular casts in urine
Unexplained seizures/psychosis
Anaemia
Low WCC
Antinuclear antibodies

Question 4

What investigations are done for lupus?

Answer 4

Antibody tests- ANA, anti-dsDNA, Ro, Smith

Question 5

What is the treatment of lupus?

Answer 5

Immune suppressants

Question 6

What are the types of scleroderma?

Answer 6

Limited

Diffuse

Question 7

Who is scleroderma seen in?

Answer 7

Females > males

Onset 30-50

Question 8

What are the signs and symptoms of scleroderma?

Answer 8

CREST
Calcinosis
Raynaud's
Eosophageal dysmotility
Sclerodactyly- swelling of fingers
Telangiectasia- visible small blood vessels

Question 9

What are the investigations for scleroderma?

Answer 9

Antibodies-
ANA,
Diffuse= Scl-70,
Limited= centromere

Question 10

What are the possible complications of scleroderma?

Answer 10

Limited- pulmonary hypertension
Diffuse- pulmonary fibrosis, renal crisis
Small bowel bacterial overgrowth

Question 11

What is Sjogren’s syndrome?

Answer 11

Mildest an host common connective tissue autoimmune disease

Question 12

Who is Sjogren’s syndrome seen in?

Answer 12

Female > male

Onset 40-50

Question 13

What are the signs and symptoms of Sjogren’s syndrome?

Answer 13

Dry eyes and mouth
Parotid gland enlargement
Systemic- fatigue, fever, myalgia and arthralgia

Question 14

What investigations are done for Sjogren’s syndrome?

Answer 14

Anibodies- Ro, La

Question 15

What are the possible complications of Sjogren’s syndrome?

Answer 15

Lymphoma
Neuropathy
Purpura
Interstitial lung disease
Renal tubular acidosis

Question 16

What are the types of Autoimmune myositis?

Answer 16

Polymyosisits

Dermatomyositis

Question 17

What antibodies are present in autoimmune myositis?

Answer 17

Anti Jo-1 antibodies

Question 18

Who does dermatomyositis affect and what is it often a sign of?

Answer 18

Affects older people

Often presentation of cancer as paraneoplastic syndrome

Question 19

What are the manifestations of dermatomyositis?

Answer 19

Gottron’s papules- scaly rash on knuckles

Heliotrope rash- violet discolouration around eyes

Question 20

What are the signs and symptoms of autoimmune myositis?

Answer 20

Muscle weakness- diffuse, symmetrical and proximal

Question 21

What are the possible complications of autoimmune myositis?

Answer 21

Cancer

Interstitial lung disease

Question 22

What are the types of systemic vasculitis?

Answer 22

Giant cell arteritis

ANCA associated vasculitis

Question 23

What is the classification of giant cell arteritis?

Answer 23

3 of-
Age >50
New headache
Temporal artery renderness
ESR > 50
Abnormal temporal biopsy

Question 24

What are the types of ANCA associated vasculitis?

Answer 24

Granulomatosis with polyangitis
Microscopic polyangitis
Eosinophilic granulomatosis with polyangitis

Question 25

What is granulotomatosis with polyangitis

Answer 25

Necrotising granulomatous inflammation
Usually involving upper and lower respiratory tract
Affects small to medium vessels
Necrotising glomerulonephritis common

Question 26

What is microscopic polyangitis?

Answer 26

Necrotising vasculitis with few or no immune deposits and no granulomatous inflammation
Mainly affects small vessels
Necrotising glomerulonephritis very common

Question 27

What is eosinophilic gramulomatosis with polyangitis?

Answer 27

Eosinophil rich and necrotising granulomatous inflammation
Often involves res tract
Mainly affects small to medium vessels
Associated with asthma and eosinophilia