Rheumatology

Question 1

ds DNA

Answer 1

specific for SLE
reliable marker of disease activity

anti smith is also specific for SLE but doesnt associate with disease activity

Low c3/c4 also associate with disease activity (immune complex consumption )

Question 2

ANA

Answer 2

useful to exclude SLE or uveitis associated JIA if negative

Question 3

sjogrens syndrome

Answer 3

parotid swelling
Anti- Ro /anti La positive

Question 4

SLE nephritis associted with which antibodies

Answer 4

ds DNA
anti-smith

Question 5

ribonuclease protein antibody

Answer 5

MCTD

Question 6

histone antibody

Answer 6

drug induced lupus

Question 7

cANCA associated with

Answer 7

granulmatosis with polyangiitis

Question 8

pANCA associated with

Answer 8

microscopic polyangitis
PSC
Churg Strauss syndrome

Question 9

dystrophic calcinosis occurs in

Answer 9

JDM

Question 10

JDM

Answer 10

capillary vasculopathy
Gattron papule (90%), Heiliptropic rash (85%), calcinosis cutis, symmetrical proximal weakness and truncal weakness
nail fold capillary changes

rash often first symptom
photosensitivity and generalised erythema in sun exposed areas “shawl sign”
malar rash on face
esophageal and resp muscles can also be affected- dysphonia, dysphagia, reflux

Question 11

psoriatic arthritis affects which joints

Answer 11

DIP

sausage finger dactylitis (ddx sickle cell disease)

Question 12

rheumatoid arthritis

Answer 12

PIP

Question 13

deficiency c2 leads to infection with which organism

Answer 13

strep pneumoniae and other encapsulated bacteria

Question 14

CAPS

Answer 14

febrile attacks + urticarial rash

a. Group of AD disorders 
b. Mild to severe
	i. Cold autoinflammatory syndrome (FCAS1)
	ii. Muckle-Wells syndrome (MWS) Neonatal-onset multisystem inflammatory disease (NOMID

Rx: anakinra

Question 15

TRAPS

Answer 15

a. Presents in first decade of life
b. Intermittent febrile episodes with abdominal pain, nausea and vomiting
i. May present as acute abdomen
c. Other symptoms
Oligoarthritis
Myalgias
Rash = erythematous macular rash, annular patches or serpiginous
Ocular = conjunctivitis, unilateral periorbital edema
d. Episodes LONGER than FMF, 3 days to 3 weeks

Question 16

FMF

Answer 16

Attacks last 1-3 days
FEVER, SEROSITIS, RASH
Rx: colchicine to reduce risk amyloidosis
Serositis: abdominal pain, pleurisy, and arthralgias/arthritis secondary to serositis and synovitis.
The diagnosis of FMF may be strongly suggested by patient ethnicity since this autoinflammatory disease is most commonly seen in certain ethnic groups including Sephardic Jews, Armenians, North Africans, and Turks

Question 17

Hyper IgD syndrome

Answer 17

Attacks last 3-7 days
Cervical lymphadenopathy, abdominal pain, vomiting, and/or diarrhea. Other symptoms include headache, arthralgias/arthritis, aphthous ulceration, a pleomorphic rash, and, occasionally, splenomegaly.
Elevated levels of immunoglobulin D

often present after first vaccine

Question 18

Periodic fever with aphthous stomatitis, pharyngitis, and adenitis (PFAPA

Answer 18

Last 3-6 days; respond dramatically to single dose pred
Occur regularly ~ monthly, cease around 10 years of age

Question 19

what percentage of people with ankylosing spondyloarthtitis are postive for HLAb27

Answer 19

90%

positive in 10% of normal population

Question 20

what is HLA B27 associated with

Answer 20

ank spond
psoriatic arthritis
IBD associated arthritis

Question 21

antibody in mied connective tissue disease

Answer 21

anti RNP

think of a variant of SLE
presents with fatigue, Raynaud phenomenon, puffy fingers, nail changes
Absence of severe kidney and CNS involvement
more severe arthritis and insidious pulmunary HTN

Question 22

Fibromyalgia

Answer 22

F>M
>14 years
pain in tendon insertion points

Question 23

Pathergy

Answer 23

Pathergy is an exaggerated skin injury occurring after minor trauma such as bump, bruise, needle stick injury. A more severe injury, such as a surgical procedure, can result in persistent ulceration in a patient with pathergy. It typically occurs in patients with Behcet disease.
Red bump (papule)
Pustule
Ulceration

Question 24

Sjogren syndrome

Answer 24

Raynaud phenomenon
Dry mouth
Dental caries
Dry eyes
diffuse hair loss and vitiligo
cutaneous vasulitis
eyelid dermatitis
anemia, fatigue, weight loss, fever, joint pain