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F3 E2 Shea > Rheum 2 > Flashcards

Rheum 2 Flashcards

1
Q

What disease is associated with

  • Autoimmune disorder of Multiple organ systems affected
  • Mainly in young black women
  • Spontaneous relapses and remissions
  • Many symptoms are from trapping of antigen-antibody complexes in capillaries or to antibody destruction of host cells (platelets)
A

Systemic Lupus Erythematosus

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2
Q

Popcorn term for what disease?

  • FATIGUE
  • Butterfly rash”
  • Photosensitivity
  • Livedo reticularis
  • Panniculitis
  • Discoid plaques
  • Periungual erythema
  • Nail fold infarcts
  • Alopecia
A

Systemic Lupus Erythematosus

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3
Q

What disease is diagnosed with 4/11 of the following?

Malar rash, Discoid rash, Photosensitivity, Oral ulcers, Arthritis

Serositis (pleuritis or pericarditis)

Kidney disease

Neurologic disease (Seizures, or Psychosis)

+ ANA, antiphospholipid antibodies based on (1) IgG or IgM anticardiolipin antibodies

A

Systemic Lupus Erythematosus

False positive Antiphosepholipid Syphilis

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4
Q

What other immune tests can be used to DIAG SLE besides +ANA?

A

Anti-dsDNA** (high specificity and sensitivity)

Anti-Sm (high specificity)

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5
Q

What disease is treated with

  • Sun protection, exercise
  • hydroxycholorquine
  • Remember eye exams
  • NSAIDS – prn for flares
  • Corticosteroids – prn for flares
  • methotrexate, azathioprine, Resistant to treatment: belimumab
A

Systemic Lupus Erythematosus

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6
Q

30% of patients with SLE are allergic to ________drugs

A

sulfonamide

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7
Q

Discoid lupus are inflammation and ______ Lesions on the _______.

A

Scarring

Face

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8
Q

What are the main drugs that cause a Drug-induced Lupus attack?

Think MD PHI

A
  • Minocycline
  • Diltiazem
  • Procainamide
  • Hydralazine
  • Isoniazid
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9
Q

What antibodies cross the placenta in SLE?

A

Anti SSA and Anti SSB

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10
Q

What disease is associated with

  • Recurrent pregnancy loss in the first trimester
  • DVT
  • Pulmonary emboli
  • CVAs
  • Budd-Chiari syndrome
  • Cerebral vein thrombosis
  • Myocardial or digital infarctions
A

Antiphospholipid Antibody Syndrome

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11
Q

What disease is diagnosed with

1 Clot + A positive antibody test

Anti-cardiolipin antibodies (false-positive test for syphilis)

Antibodies to beta-2-glycoprotein

Lupus anticoagulant antibody

A

Antiphospholipid Antibody Syndrome (APS)

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12
Q

What disease is treated with

  • Anticoagulation for life (warfarin)
  • Teratogenic so give Subcutaneous heparin
  • Low-dose aspirin
  • IV heparin
  • High dose corticosteroids
  • IVIG
  • Plasmapheresis
A

Antiphospholipid Antibody Syndrome

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13
Q

What disease has paroxysmal digital ischemia.

  • Initial phase: excessive vasoconstriction
  • Recovery phase: vasodilation
  • Triggered by emotional stress, cold
A

Raynaud Phenomenon

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14
Q

What does Raynaud’s look like?

Think ischemic digital

A

​

  • well demarcated digital pallor or cyanosis
  • Numbness, stiffness, pain decreased sensation
  • Recovery phase: intense hyperemia and rubor
  • Intense throbbing, paresthesia, pain
  • Primarily affects fingers
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15
Q

What ischemic finger disease is treated with wear gloves, stop smoking, and heat the body?

* Avoid Sympathomimetics (decongestants, diet pills, amphetamines)

A

Raynaud Phenomenon

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16
Q

What disease is treated with

—Calcium channel blockers - first line

—Nifedipine, amlodipine, felodipine

—Other options: PDE-5 inhibitor (sildenafil), topical nitroglycerin, prazosin, losartan, prostaglandin

OR a Sympathectomy?

A

Raynaud Phenomenon

17
Q

What disease has diffused collagen deposits on the SKIN and other organs?

AND

Has the CREST syndrome?

A

Scleroderma

CREST

  • —Calcinosis cutis
  • —Raynaud phenomenon
  • —Esophageal dysfunction
  • —Sclerodactyly
  • —Telangiectasias
18
Q

T/F can you Diagnose Scleroderma with

+ ANA in 90% of patients with diffuse scleroderma

+ anti-centromere antibody in CREST syndrome

+ anti-SCL-70 antibody in diffuse disease; indicates poorer prognosis

A

True

19
Q

Is there a cure for Scleroderma?

A

No cure but you can monitor HTN, PPI (reflux), ACE, CCB, or immunospuressants.

20
Q

What disease has Inflammed Striated Muscle, Muscle weakness, and is associated with Malignancy (>50 Paraneoplastic Syndrome)?

A

Polymyositis & Dermatomyositis

21
Q

What is the Skin Rash in Dermatomyositis?

(HMS Gottron’s)

Her Majesty’s Ship - Gottron’s

A

Polymyositis & Dermatomyositis

22
Q

How can you Diagnose and Treat Polymyositis & Dermatomyositis?

(think Striated muscle disease)

A

Diag: Muscle Biopsy

CK, Aldolase, MRI

Tx: HIGH DOSE STEROID, DMARDS

23
Q

What disease was called SICCA syndrome

Is a Connective tissue disorder where auto antibodies destroy salivary and lacrimal glands?

A

Sjӧgren Syndrome

24
Q

This disease presents with

  • Dry mouth (xerostomia)
  • Dry eyes (xerophthalmia or keratoconjunctivitis sicca)
  • Enlarged parotid glands

And is Diagnosed with the Schirmer Test

A

Sjӧgren Syndrome

25
Q

What disease is Diagnosed with

  • +ANA in 95%
  • +anti-Ro antibodies (anti SSA) in 60%
  • +anti-La antibodies (anti SSB) in 40%
  • Lip biopsy to evaluate for gland fibrosis

TX: Pilocarpine (salivary flow), Cyclosporine (improves eye sxs)

A

Sjӧgren Syndrome

26
Q
A

F3 E2 Shea (14 decks)

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