Poly/Monoarthritis Flashcards
What is the ANA blood test for?
AKA anti-nuclear antibodies (ANA)
- Raised in autoimmune disease
Done for arthritis, unexplained rashes, fevers, or chest pain to help diagnose
What is Sjogren’s disease?
Autoimmune disease causing dry mouth and eyes
What is mixed connective tissue disease (MCTD)?
An autoimmune disease
Diagnosis: presence of anti-U1-ribonuceloprotein in blood and features of more than 2 connective tissue diseases like lupus, systemic sclerosis, dermatomyositis
What are the clinical manifestations of SLE?
Systemic:
- Fatigue, reduced exercise tolerance, episodic fever, weight loss
Musculoskeletal:
- Migratory arthralgia that is not erosive
Skin:
- Alopecia, photosensitivity, butterfly face rash, Raynaud’s, Urticaria, mouth ulcers
What exacerbates SLE?
- Exposure to UV light exacerbates systemic disease and rash
- Infection
- Mental stress
- Not taking medication
What is Raynaud’s phenomenon?
- Periodic, vasospastic disorder of
extremities provoked by cold exposure - Triphasic colour change of pallor,
cyanosis and hyperaemia
(peripheries white, blue, red) - Attacks last minutes to hours
- Affects fingers, toes, tip of nose, ear
lobes
What is the difference between primary and secondary Raynaid’s?
Primary: often familial, onset in teens
Secondary: autoimmune, occupational (vibrating instruments), meds like beta-blockers, or chemicals like polyvinyl chloride
Which other organs are Involved with SLE?
- Pulmonary (pneumonitis, fibrosis, hypertension)
- Cardiovascular (artery disease, hypertension, pericarditis, endocarditis)
- Renal (proliferative glomerulonephritis, nephritis)
- Neuropsychiatric (depression, headache, seizures, anxiety, psychosis, stroke)
What is antiphospholipid syndrome?
- Causes venous, arterial thrombosis and recurrent miscarriage
- Can be primary or secondary to SLE
How is SLE diagnosed?
Using the American College of Rheumatology classification of SLE (needs 4+ to diagnose)
- Malar rash
- Discoid rash
- Photosensitivity
- Oral ulcers
- Non-erosive arthritis
- Pleuritis or Pericarditis: chest pain/ rub/ effusion/ ECG evidence
- Renal disorder: persistent proteinuria > 0.5g/ day or > 3+ protein on dip or
- Neurologic disorder: seizures or psychosis
- Haematological disorder
- Immunological disorder’
- Positive antinuclear antibody
What are the different therapies available for autoimmune rheumatic diseases?
- Corticosteroids (prednisolone)
- Steroid sparing drugs (chloroquine, azathioprine, mycophenolate, mycophenolate, methotrexate)
- Biologics (Rituximab, immunoglobulins)
- Cyclophosphamide
How is ankylosing spondylitis scored?
Using Basdai scoring
- Patient scores their symptoms from 1-10 to work out severity of disease
What is the DAS score?
The disease activity score to measure rheumatoid arthritis
1-29: low
30-44: moderate
45-100: high
How is psoriasis scored?
Using PASI (psoriasis area and severity index) scoring
Investigates body percentage affected, erythema, thickness, and scaling
What does ANCA show?
For diagnosis of autoimmune diseases especially vasculitis
