Rheumatology

Question 1

What are the presenting symptoms of Sjogren’s syndrome?

Answer 1

Sjogren’s syndrome is an autoimmune condition affecting secretions from exocrine glands - therefore presents with dry eyes, dry mouth, vaginal dryness as well as arthralgia and Raynauds. It can be primary or secondary to rheumatoid arthritis or other connective tissue disorders (~ 10 yrs after onset). It carries an increased risk of developing a lymphoid malignancy. Mainly affects females.

Question 2

What are the main autoantibodies associated with primary Sjogren’s syndrome?

Answer 2

Anti-Ro (70%), ANA (70%), Rheumatoid Factor (50%) Anti-La (30%)

Question 3

How quickly would you expect the symptoms of PMR to respond to steroids.

Answer 3

Within 2 weeks. If don’t see dramatic improvement to steroids within this time then need to consider an alternative diagnosis

Question 4

What are the 4 As associated with ankylosing spondylitis?

Answer 4

Anterior uveitis
Achilles tendonitis
Aortic regurgitation
Apical fibrosis

Question 5

Which antigen is seen in almost all cases of ankylosing spondylitis?

Answer 5

HLA-B27 presents in upto 95% of AS cases