Rheum #2

Question 1

multifacotrial etiology of systemic lupus erythematosus

Answer 1

genetics (HLA-B8/DR3)
environment
estrogen
infection
drug-induced (resolves after stop taking meds)

Question 2

key symptoms in SLE (4)

Answer 2

malar rash
Discoid rash
Reynauds Phenom
Livedo reticularis (mottled discoloration of skin due to narrowing of blood vessels)

Question 3

Key features of Nephritic syndrome

Answer 3

-Proteinuria (<3.5g/day)
-Hematuria (blood in urine)
-Azotemia (increased blood and creatinine levels)
-RBC casys
-Oliguria
HTN

Question 4

Nephrotic syndrome features

Answer 4

Proeniuria >3.5

• hypoalbuminemia
• Edema
• Lipid abnormalities

Question 5

nephritis vs nephrotic syndorme defs

Answer 5

nephritis is inflammation in the kidney while nephrotic is leaky protein blood vessels indicative of kidney damage

Question 6

If a patient has 2 or more serious involved organ systems, with no explanation, what condition should you worry about?

Answer 6

Systemic Lupus Erythmatosus

Question 7

If a patient has 2 or more serious involved organ systems, with no explanation, what condition should you worry about?

Answer 7

Systemic Lupus Erythmatosus

Question 8

Diagnostic Crtieria of SLE (4,7 11 rule)

Answer 8

4 or more out of 11 criteria (4 lab, 7 clinical) must be present

Question 9

7 clinical signs of Systemic Lupus

Answer 9

Malar rash (classic butterfly rash)
discoid rash
photosensitivtiy (skin rash rxn to sunlight)
oral/nasal ulcers
arthritis 
serositic
neurologic disorder

Question 10

4 lab tests for SLE (related to 4,7, 11 rule)

Answer 10

renal disorder (proteinuria)
hematologic disorder
immunologic disorder
ANA (test, 98% senstivity, if neg, probably not SLE)

Question 11

types of anemia in SLE

Answer 11

normocytic normochromic

microcytic hypochromic

Question 12

lupus treatments

Answer 12

immunosppresive + corticosteroid

Question 13

What are the 2 main forms of Scleroderma

Answer 13

Limite (CREST syndrome)

Diffuse (systemic)

Question 14

What are the conditions associated with CREST syndrome

Answer 14

C- calcinosis curtis
R- Raynauds 
E- Esophageal dysmotility
S- Sclerodactyly
T- Telangiectasia

Question 15

Major diagnostic criteria for Scleroderma

Answer 15

Tight skin + heartburn (dysphagia) + raynaud

Question 16

what does CREST syndrome not present with (limited scleroderma)

Answer 16

joint pain, heart or lung or kidney involvement

it DOES have pulmonary hypertension though***

Question 17

Test that is 85-90% accurate in scleroderma

Answer 17

ANA

Question 18

Investigations for diffuse scleroderma

Answer 18

anti-topoisomerase 1 + can also use anti-centromere (which is test for limited scleroderma)

Question 19

investigation for CREST only (limited scleroderma/systemic sclerosis)

Answer 19

anti-centromere test

Question 20

What is idiopathic myopathy

Answer 20

autoimmune diseases characterized by prox mm weakness + pain

polymyositis/dermatomyositis

Question 21

what is a major thing idiopatjic myopathy is associated w

Answer 21

malignancy

Question 22

Diagnostic criteria for polymyositis (4)

Answer 22

weakness + increased creatine phosphokinase + increased aldolase + biopsy

Question 23

Diagnostic Criteria for Dermatomyositis

Answer 23

Weakness + increased creatine phosphokinase + increased aldolase + biopsy + SKIN RASH

Question 24

very common dermatologyical signs in dermatomyositis

Answer 24

gottron’s popules (pink-violaceous papules on dorsal IP joints)

Gottron’s signs (erythematous, smooth or scaly patches over dorsal IPs, MCPS, elbows, knees, medial malleoli

Heliotrope rash: (Violaceous rash over eyeless usually with edema)

Question 25

Investigations for idiopathic inflammatory myopathy (polymyositis or dermamyositis)

Answer 25

anti-jo-1 (DMM), anti-mi-2

elevated CPK and aldolase

Biopsy is the best test

Question 26

What has a greater risk for malignancy- DMM or PM

Answer 26

DMM (lung,colon,ovarian etc)

Question 27

What is sjorens syndrome characterized by

Answer 27

Dry eyes, dry mouth