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00000 IM PLATINUM BOARD CORRELATES > RHEUMA/ ALLERGO > Flashcards

RHEUMA/ ALLERGO Flashcards

1
Q

B cell surface marker and EBV receptor

A

CD21

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2
Q
  • Highly phagocytic APCs [antigen presenting cells) in the body
  • Function as link between innate and adaptive immune systems
A

Dendritic cells

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3
Q

Major receptor for antigen in B cells (2)

A

lgM and lgD

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4
Q

Majority of total serum immunoglobulin

A

IgG

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5
Q

Only immunoglobulin able to cross the placenta

A

IgG

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6
Q

Antibody secreted in mucosal surfaces as dimer, most produced antibody overall

A

IgA

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7
Q

Immunoglobulin Produced in the primary (immediate) response to an antigen

A

IgM

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8
Q

immunoglobulin associated with cold autoimmune hemolytic anemia.

A

IgM

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9
Q

Protein molecules capable of activating up to 20% of T-cell pool resulting in widespread immune response

A

superantigen

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10
Q

Binding of an opsonized target cell to a FC receptor bearing effector cell resulting in lysis of the target by the effector cell

A

ADCC (antibody dependent cellular cytotoxicity)

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11
Q
  • Expressed in all nucleated cells,
  • Present endogenous intracellular antigens to CD8 cytotoxic T-cells

MHC 1a or MHC 2

A

MHC(Major Histocompatibility Complex) la

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12
Q

Expressed only on APCs and present exogenous or extracellularly engulfed antigens to CD4 T-helper cells

MHC 1 or MHC2

A

MHC 2

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13
Q

Secrete IFN-y, which enhances the ability of monocytes and macrophages to kill microbes thet ingest

TH1 or TH2

A

TH1

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14
Q

Secretes IL4, 5, 6, 13 recruiting eosinophils stimulating antibody production

TH1 or TH2

A

TH2

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15
Q

Cells that release cytotoxic granules (perforin, granzyme B) and activates apoptosis

A

cytotoxic T cells

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16
Q

Facilitates phagocytosis by coating antigen

A

Opsonins

(lgG and C3b)

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17
Q

Proteins that are decreased during inflammation (2)

A

albumin
transferrin

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18
Q

Complement proteins involved in anaphylaxis (anaphylatoxins) – 3

A

C3a, 4a, 5a

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19
Q

complement protein which induces neutrophil chemotaxis

A

C5a

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20
Q

The key effector cell in allergic rhinitis, asthma, anaphylaxis and urticaria

A

mast cell

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20
Q

Neutrophil chemotaxis

A

Leukotriene LTB4

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21
Q

Most cost-effective means of managing allergic rhinitis

A

allergen avoidance

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22
Q

autoantibody associated with
myasthenia gravis

A

Anti-Ach Receptor

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23
Q

autoantibody associated with
Goodpasture’s syndrome

A

anti GBM

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24
Q

autoantibody associated with
type 1 DM (2)

A
  • Anti-glutamic acid decarboxylase,
  • islet cell cytoplasmic antibodies
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24
Q

autoantibody associated with
Dermatomyositis and Polymyositis (3)

A
  • Antisynthetase (eg, anti-Jo-1),
  • anti-SRP,
  • anti helicase (anti-Mi-2)
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25
Q

autoantibody associated with
Hashimoto’s thyroiditis (2)

A
  • Anti-Thyroglobulin,
  • Anti-TPO
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26
Q

autoantibody associated with
primary biliary cirrhosis

A

Anti-Mitochondrial

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27
Q

autoantibody associated with
autoimmune hepatitis

A

Anti-smooth muscle, anti-liver /kidney microsomal-1

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28
Q

autoantibody associated with
Grave’s disease (1)

A

Anti-TSH receptor

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29
Q

autoantibody associated with
Mixed Connective Tissue Disease (1)

A

Anti-Ul RNP (Ribonucleoprotein)

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30
Q

autoantibody associated with
Limited scleroderma and CREST syndrome (1)

vs
diffuse scleroderma (1)

A

Anti-Centromere
vs
Anti Scl-70

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31
Q

autoantibody associated with
Sjogren Syndrome (2)

A
  • Anti Ro (SS-A),
  • Anti-LA (SS-B)
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32
Q

Best screening test for SLE (most sensitive)

A

ANA

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33
Q

SLE-specific antibodies that correlate with level of disease activity, nephritis and vasculitis

A

anti dsDNA

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34
Q

SLE-specific antibodies with no clinical correlations

A

anti Sm

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35
Q

Antibodies associated with Sicca syndrome, subacute cutaneous lupus, neonatal lupus with congenital heart block and decreased risk for nephritis

A

anti-Ro (SS-A)

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36
Q

Antibodies in drug-induced lupus

A

anti-histone

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37
Q

Positive test in serum correlates with depression or psychosis due to CNS lupus

A

anti-ribosomal P

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38
Q

Most serious manifestation of SLE

A

nehpritis

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38
Q

Antibodies predisposing to recurrent fetal loss, thrombosis, detected by ELISA for Cardiolipin and B2Gl and DRVVTfor lupus anticoagulant

A

antiphospholipid antibody

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39
Q

Most common pulmonary manifestation of SLE

A

Pleuritis with or without effusion

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40
Q

Most frequent cardiac manifestation of SLE

A

pericarditis

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41
Q

Fibrinous vegetations and endocarditis in SLE

A

Libman-Sacks Endocarditis (LSE)

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42
Q

Most frequent hematologic manifestation of SLE

A

Normo normo anemia

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43
Q

Most common manifestation of diffuse CNSlupus

A

cognitive dysfunction

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44
Q

Most common chronic dermatitis in SLE

A

discoid lupus erythematosus

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45
Q

Most common form of chronic inflammatory arthritis

A

RA

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46
Q

most common cardiac and valvular manifestation in RA

A

pericarditis and mitral regurgitation

47
Q

Syndrome with the Triad of neutropenia, splenomegaly and nodular R

A

Felty’s syndrome

48
Q

Length of time for joint symptoms to be suggestive of RA

A

6 weeks or more

49
Q

Pathologic hallmarks of RA (3)

A
  • Synovial inflammation and proliferation,
  • focal bone erosions,
  • thinning of the articular cartilage
50
Q

lgM against the Fc portion of lgG

A

Rheumatoid factor

51
Q

Serum marker with higher specificity for RA than RF

A

Anti-CCP

52
Q

Initial radiological finding in RA

A

Periarticular osteopenia

53
Q

Test with greatest sensitivity for detecting synovitis, joint effusions and early bone and marrow changes in RA

A

MRI

54
Q

DMARD of choice for RA

A

methotrexate

55
Q

Most common type of arthritis

A

OA

56
Q

2 major factors contributing to the development of OA

A

Joint loading and joint vulnerability

57
Q

Most potent risk factor for OA

A

age

58
Q

Nodes found on the PIP joint in QA

A

Bouchard’s nodes (Mnemonic·B of Bouchard comes first in the alphabet before H of Heberden’s)

59
Q

Nodes found on the DIP joint in OA

A

Heberden’s nodes

60
Q

Fulcrum of the longest lever arm in the body

A

Knee

61
Q

Radiographic hallmark of QA

A

osteophytes

62
Q

Initial analgesic of choice for OA

A

acetaminophen or paracetamol

63
Q

Inflammation of the first MTP joint in gout

A

Podagra

64
Q

Describe crystals in gouty arthritis

A

Needle-shaped crystals that are negatively birefringent (yellow under parallel light and blue under perpendicular light)

65
Q

Describe crystals in pseudogout

A

Rhomboid-shaped crystals that are weakly positively birefringent

66
Q

Mainstay of treatment during acute attack of gout (3)

A

NSAIDs{lndomethacin], colchicine, or glucocorticoids

67
Q

Urate-lowering therapy should be initiated in any patient who already has tophi or chronic goutv arthritis.

True or False

A

True

68
Q

Indication for uricosuric agents

A

Under excretors of uric acid
(<600mg in 24 hour urine sample)

69
Q

Most commonly used hypouricemic and best drug to use in urate overoroducers, urate stone formers and renal disease

A

Allopurinol

70
Q

Target theraoeutic blood uric acid level for gout

A

Less than or equal to 6mg/dl

71
Q

Joint most frequentlv affected in CPPD or pseudogout

A

knee

72
Q

Radiograph findings of punctate or linear radiodense deposits in fibrocartilaginous joint menisci or articular hyaline cartilage suggestive of CPPD

A

chondrocalcinosis

73
Q

Arthritis presenting with predominant involvement, asymmetric or symmetric, involving one or more joints, dactylitis, shortening of digits and nail changes with or without silvery scaly skin lesions

A

psoriatic arthritis

74
Q

Uveitis in psoriatic arthritis

A

Bilateral chronic posterior uveitis

75
Q

5 patterns of psoriatic arthritis (from most to least common)

A
76
Q

Classic “pencil in cup” deformity is seen in what type of arthritis

A

psoriatic arthritis

77
Q

Marginal erosions with adjacent bony proliferation (“whiskering”) is seen in what type of arthritis

A

psoriatic arthritis

78
Q

Ideal treatment for psoriatic arthritis

A

anti TNF alpha agents

79
Q

Acute non purulent arthritis complicating an infection elsewhere in the body

A

reactive arthritis

80
Q

triad of reactive arthritis

A
  • arthritis,
  • urethritis,
  • and conjunctivitis
81
Q

Common organisms implicated in ReA. Give 3

A
  • Chlamydia,
  • Shigella,
  • Salmonella,
  • Yersinia
  • Campylobacter,
  • E coli
82
Q

Initial treatment of choice for ReA

A

NSAIDS

83
Q

Young adult male, insidious onset of dull pain in the lower lumbar or gluteal region, lumbar morning stiffness lasting a few hours that improves with activity and returns after inactivity with nocturnal exacerbation

A

ankylosing spondylitis

84
Q

gene that plays a direct role in AS pathogenesis

A

HLA-B27

85
Q

Earliest changes in AS

A

Synovitis and myxoid marrow

86
Q

lnnammation in the fibrocartilaginous regions where a tendon, ligament or joint capsule attaches to bone characteristic of SpA

A

enthesitis

87
Q

Associated with prominent edema of the adjacent bone marrow and is often characterized by erosive lesions that eventually undergo ossification.

A

enthesitis

88
Q

Most common extra-articular manifestation of AS

A

acute anterior uveitis

89
Q

First line pharmacologic management for AS

A

NSAIDS

90
Q

Most common site of infectious arthritis

A

knee

91
Q

Most common route of infection for infectious arthritis in all age groups

A

hematogenous

92
Q

Most common etiologic agent for infectious arthritis among young aduuts and adolescents (sexually active)

A

Neisseria gonorrhea

93
Q

Most common nongonococcal cause of infectious arthritis in adults of all age groups

A

Staph aureus

94
Q

Most common etiologic agent for infectious arthritis after surgery or penetrating injuries

A

Staph aureus

95
Q

Subset of patients with highest incidence of infectious arthritis

A

RA patients

96
Q

Most common presentation of infectious arthritis is polyarthritis. True or False

A

Monoarthritis

97
Q

Sites of infectious arthritis common among IV drug abusers (3)

A
  • Spine,
  • sacroiliac
  • and sternoclavicular joints
98
Q

Other than antibiotics, essential treatment needed for a favorable outcome on joint function in infectious arthritis

A

Timely drainage of pus and necrotic debris

99
Q

Late manifestation of congenital syphilis manifesting as chronic painless synovitis with effusion of large joints, particularly the knees and elbows

A

Clutton’s joints

100
Q

Reactive symmetric form of polyarthritis that affects persons with visceral or disseminated tuberculosis

A

Poncet’s disease

101
Q

Antibodies directed against proteinase-3 detected as diffuse granular cytoplasmic staining pattern in neutrophils

A

cANCA( cytoplasmic anti-neutropbil antibodies)

102
Q

Antibodies directed against myeloperoxidase with perinuclear or nuclear staining in neutrophils

A

pANCA(perinuclear antineutrophil cytoplasmic antibodies)

103
Q

First step in the workup of a patient with suspected vasculitis

A

Exclude other diseases

104
Q

Granulomatous necrotizing vasculitis of the triad of upper and lower respiratory tract and kidney (sinusitis, lung involvement, glomerulonephritis), [+J cANCA

A

Wegener’s granulomatosis

105
Q

Necroitzing inflammation of small arteries and veins including venules, glomerulonephritis, usually with no upper airway involvement and no pulmonary nodules, (+) pANCA

A

Microscopic polyangiitis

106
Q

cANCA : Wegener’s granulomatosis
pANCA: Microscopic polyangiitis

True or False

A

True

107
Q

WHAT DISEASE:
Asthma, peripheral and tissue eosinophilia, extravascular granuloma and vasculitis of multiple organ systems (predominant pulmonary findings)

A

Churg-Strauss syndrome

108
Q

Necrotizing vasculitis, renal and visceral artery involvement with aneurysmal dilatations, no pulmonary aassociated with Hepatitis B infection

A

Polyarteritis nodosa

109
Q

WHAT DISEASE :
Elderly female presenting with fever, anemia, headaches, temporal tenderness, jaw claudication, high ESR,and accompanying stiffness and muscle pains of the neck, shoulders, hip and thighs

A

Giant cell/temporal arteritis

110
Q

Syndrome characterized by stiffness aching and pain in the muscles of the neck, shoulders, lower back, hips and thighs associated with giant cell arteritis

A

Polymyalgia rheumatica

111
Q

Dreaded complication of giant cell arteritis

A

lschemic optic neuropathy

112
Q

WHAT DISEASE :
Young female, systemic symptoms, arm claudication, diminished pulses on one arm, vasculitis of medium to large arteries involving the aortic arch and branches

A

Takayasu arteritis (also known as Aortic Arch Syndrome or Pulseless Disease)

113
Q

WHAT DISEASE:
Child with glomerulonephritis, palpable purpura over the buttocks and lower extremities, gastrointestinal symptoms, arthralgias, and history of recent respiratory infection

A

Henoch Schonlein Purpura (HSP) (lmmunoglobulin A vasculitis)

114
Q

Most commonly encountered vasculitis in clinical practice

A

cutaneous vasculitis

115
Q

The most effective drug therapy for the systemic vasculitides is

A

cyclophosphamide

116
Q

WHAT DISEASE
Cutaneous vasculitis, arthritis, peripheral neuropathy, membranoproliferative glomerulonephritis, Hepatitis C, coldprecipitated agglutinins or immunoglobulins

A

Cryglobulinemic vasculitis

117
Q

Components of CREST syndrome (limited scleroderma)

A
  • Calcinosis
  • Raynaud’s phenomenon
  • Esophageal dysmotility
  • Sclerodactyly
  • Telangiectasia
118
Q

Chronic, slowly progressing autoimmune disease characterized by lymphocytic infiltration of the exocrine glands resulting in xerostomia and dry eyes (keratoconjunctivitis sicca)

A

Sjogren’s syndrome

119
Q
A

00000 IM PLATINUM BOARD CORRELATES (7 decks)

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