Rheumatology Flashcards
ds DNA
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 )
ANA
useful to exclude SLE or uveitis associated JIA if negative
sjogrens syndrome
parotid swelling
Anti- Ro /anti La positive
SLE nephritis associted with which antibodies
ds DNA
anti-smith
ribonuclease protein antibody
MCTD
histone antibody
drug induced lupus
cANCA associated with
granulmatosis with polyangiitis
pANCA associated with
microscopic polyangitis
PSC
Churg Strauss syndrome
dystrophic calcinosis occurs in
JDM
JDM
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
psoriatic arthritis affects which joints
DIP
sausage finger dactylitis (ddx sickle cell disease)
rheumatoid arthritis
PIP
deficiency c2 leads to infection with which organism
strep pneumoniae and other encapsulated bacteria
CAPS
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
TRAPS
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
FMF
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
Hyper IgD syndrome
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
Periodic fever with aphthous stomatitis, pharyngitis, and adenitis (PFAPA
Last 3-6 days; respond dramatically to single dose pred
Occur regularly ~ monthly, cease around 10 years of age
what percentage of people with ankylosing spondyloarthtitis are postive for HLAb27
90%
positive in 10% of normal population
what is HLA B27 associated with
ank spond
psoriatic arthritis
IBD associated arthritis
antibody in mied connective tissue disease
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
Fibromyalgia
F>M
>14 years
pain in tendon insertion points
Pathergy
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
Sjogren syndrome
Raynaud phenomenon
Dry mouth
Dental caries
Dry eyes
diffuse hair loss and vitiligo
cutaneous vasulitis
eyelid dermatitis
anemia, fatigue, weight loss, fever, joint pain
