Pages 434-438 Flashcards
A 40 yo female comes in with a Hx of dyspnea especially after climbing stairs. HR and pulse are normal. After doing pulmonary function test, results show an elevated FEV1/FVC ratio. She also has a slight facial droop that has been worsening over the months. What pathology is associated with these symptoms, and what findings are prominent on imaging?
The pt has Sarcoidosis and hilar nodes are prominent on CXR known as potato sac lymph adenopathy bilaterally. The facial droop is due to Bell’s palsy.
A physician orders a biopsy for an African descent patient with positive HX for Sarcoidosis. What will be found int he biopsy (appearance and inclusions)?
Epithelioid granulomas containing Asteroid and Schuamann bodies
A physican orders lab test for a 40 yo female with interstitial fibrosis suspected of Sarcoidosis. What metabolites will be elevated and the mechanism behind the pathology
Hypercalcemia. Sarcoidosis causes increased activation 1 alpha hydroxylase int eh kidney. This mediates Vitamin D activation and leads to increased Ca reabsorption
A 60 yo female comes into the ER complaining of severe pain in her hips. She previously stated that she has been having intermittent pain in her forehead. What disease is she affected by at the moment? Which lab results will be found?
Polymyalgia Rheumatica –> Assoc with GCA. Lab reults will show elevated ESR, CRP
A 40 yo female comes to her family physician complaining of pain and stiffness in her muscles. She also feels lethargic during the day, and is having trouble sleeping at night. What Dx do the physician make and what does he prescribe?
Fibromyalgia
TX with SNRI/TCA and regular exercise
A patients come in a malar rash and redness on her hands. The physician also notices that the patient’s hands look roughed up as if she has been working outside with her hands. What is the Dx and TX?
Dermatomyositis with perimysial inflammation from CD4 Th cells. Tx with corticosteroids + MTX
Immunopathologically how does Polymyositis differ from dermatomyositis?
Polymyositis- Cd8 +CTL induced endomysial inflammation
Dermatomyositis - CD4+ Th cells induced permysial inflammation
A 40 yo female comes in with a Hx of dyspnea especially after climbing stairs, and has lost 10 lbs of weight in the last 3 months. HR and pulse are normal. She also feels tired easily and feels weakness in washing dishes in the morning and prefers to do them at night time. What pathology is associated with these symptoms, and what underlying mechanism is associated with it?
Patient has Lambert Eaton syndrome where the Abs are destroying her presynaptic Ca Ch and decrease ACh release in the NMJ. LE syndrome is associated with Small CC of the lung which explains the dyspnea and cachexia b/c
How does Myasthenia Gravis differ from LE with regards to muscle movement? Why?
Muscle weakness worsens as the day progresses b/c Abs are against the AcH receptor. As the day ends the ACh receptors decrease which causes increased weakness later.
A 45 yo female comes into her physician and complains of increased tightness and puffiness in her skin. She also shows that fingertips around her nails feel rougher than usual. What is the physician worried about after confirming his DX with these lab results to be positive?
The patient is positive for anti topisomerase I Ab (SCl-70) as and has Diffuse systemic Scleroderma. These patients have a high mortality rate with renal and pulmonary sclerosis.
Name the findings in Limited Scleroderma (5 S/S) and the Ab associated with the path?
Limited Scleroderma is associated with anti centromere AB
CREST syndrome
1) Calcinosis
2) Raynaud’s phenomenon
3) Esophageal dysmotility
4) Sclerodactyly
5) Telengectasia
Name the pathology associated with this dermal morphology: honey crusts
Impetgio caused by GAS
Name the pathology associated with this dermal morphology: transient smooth plaque/papule known as wheal
Urticaria
Name the pathology associated with this dermal morphology: bulla
Bullous pemphigoid,
Name the pathology associated with this dermal morphology: flaking off skin, scales
Psoriasis Eczema
