Rheumatology Flashcards
Specific autoantibody for:
SLE
Anti-dsDNA
Sensitive autoantibody for SLE
ANA (anti-nuclear antibody)
Autoantibody for diffuse scleroderma vs. limited scleroderma (CREST)
Anti-scl70
Anti-centromere
Autoantibody for polymyositis and Sjogren’s syndrome
Polymyositis - anti-Jo1
Sjogren’s sndrome - anti-Ro, anti-La
Autoantibody for primary biliary cirrhosis, autoimmune hepatitis
PBC - anti-mitochondrial
Autoimmune hepatitis - anti-smooth muscle
Autoantibodies for Churg-Strauss vs Wegener’s granulomatosis
Wegener’s granulomatosis - c-ANCA
Churg-Strauss - p-ANCA
Most specific autoantibody for rheumatoid arthritis
Anti-CCP
***IN fact, it is more sensitive and specific for RA compared to RF. (RA Revision Guide)
Autoantibodies for coeliac disease
Anti-tissue transglutaminase
Anti-gliadin
Anti-endomysial
Autoantibody for Graves disease
TSH-receptor antibody
Drugs causing lupus
INH - (INH causes SLE)
Chlorpromazine
Hydralazine
SLE and antinuclear antibody. Clinchers
Initial tests
Most sensitive test
Best screening test
SLE and antidsDNA
Most specific test
Most discriminative
Definitive test for polymyositis
Autoantibody for polymyositis
Muscle biopsy
Anti-Jo1
Treatment for polymyositis
Steroids
Treatment for dermatomyositis
Steroids
Sun-blocking agent
Differentiate polymyositis from dermatomyositis
In polymyositis, you will be given a stem of a patient having difficulty standing from the chair or combing hair while in dermatomyositis, you have a patient with dermatologic manifestations in addition to weakness. They are both managed with steroids, however, in dermatomyositis, you also given sunblocking agent.
Features and associated condition of polymyalgia rheumatica
Bilateral pain (neck, shoulder or pelvic girdle) and morning stiffness Difficulty standing from bed or raising arm to comb hair
Associated with giant cell arteritis
Aged (>50y/o)
Best initial test for giant cell arteritis
Elevated ESR
Definitive test for giant cell arteritis
Tamporal artery biopsy
Why would you not wait for biopsy if you suspect giant cell arteritis?
Give HIGH—DOSE prednisolone as delaying can result in permanent loss of vision
In addition, to high-dose prednisolone, what other medication should be given in a patient with giant cell arteritis?
Low-dose aspirin
GEMS of Behcet’s Disease
Genital ulcer
(Eye) Uveitis
(Mouth) Oral ulcer
Skin injury exaggerated after minor trauma
Treatment of Behcet’s disease
Topical corticosteroids
Seronegative spondyloarthropathies - associated with HLA-B27
PAIR-B
Psoriatic arthritis Ankylosing spondylitis IBD-associated arthritis Reiter’s syndrome Behcet’s disease
Features of ankylosing spondylitis
Morning stiffness, improves with physical activity
Also associated with anterior uveitis (or iritis, or iridocyclitis)
Ankylosing spondylitis : uveitis :: Reiter’s syndrome: ________
Conjunctivitis
Most commonly involved joint in gout
1st metatarsal phalangeal joint
What is HEALS of Lofgren?
Hilar Erythema nodosum Arthritis Lofgren Sarcoidosis
Difference between Mikulicz’s disease and Mikulicz’s syndrome
Mikulicz’s disease - no specific cause
Mikulicz’s syndrome - symptoms are secondary to sarcoidosis or TB
Four steps in managing rheumatoid arthritis
Refer to rheuma
Steroids - to reduce inflammation
NSAIDs - to relieve pain
DMARDs (MTX) - first line
What are the associated eye condition with ankylosing spondylitis?
Uveitis, Iritis, Iridocyclitis
What are the associated eye condition with rheumatoid arthritis?
Scleritis
Episcleritis
JONES criteria’s Major manifestations in the diagnosis of Rheumatic Fever
Joints (arthritis) O-heart (carditis) Nodules (SC nodules) Erythema marginatum Sydenham chorea
Sensitive and specific lab tests in the diagnosis of Rheumatic Fever
Sensitive - ESR
Specific - ASO
