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Medicine > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What disease is associated with anti-U1RNP?

A

Mixed connective tissue disease

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2
Q

What is anti-ANA antibody associated with?

A

Generic vasculitides and SLE

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3
Q

What antibody is seen in scleroderma (+types)?

A

Anti-centromere: scleroderma

Anti-DNA Topoisomerase 1: diffuse scleroderma

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4
Q

What antibody is specific for Goodpasture’s disease?

A

Anti-basement membrane antibody

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5
Q

What disease is associated with Anti- glutamate decarboxylase antibody?

A

Type 1 diabetes mellitus

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6
Q

What antibody is specific for polymyositis? And what is sensitive for myositis?

A

Polymyositis: Anti-Jo1 antibody
Dermatomyositis/polymyositis: Anti-Mi2 antibody
Lose your MiJo

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7
Q

What antibody is most specfic for Rheumatoid?

A

ANti-CCP (centrinylated peptide)
80% of RhA have positive Anti-IgG
Rheumatoid factor may be positive.

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8
Q

What antibody is seen in Hashimoto’s thyroiditis?

A

Anti-microsomal antibody

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9
Q

What antibodies are seen in Sjogren’s syndrome?

A

Sjogrens likes to RhoLa skate: anti-Rho and Anti-La (both are RiboNucleoProteins RNPs)

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10
Q

Which vasculitides are ANCA positive?

A

C-ANCA (pr3): Wegener’s vasculitis (GPA)

P-ANCA (mpo): Microscopic polyangiitis (MPA) and Chung-strauss (E-GP) Pancakes for ME!

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11
Q

Which antibody is specific for PBC?

A

Anti-mitochondrial antibody. NB. You can see anti-smooth muscle antibody in PBC and PSC and Type 1 autoimmune hepatitis

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12
Q

What antibody is seen in pemphigis vulgaris?

A

Anti-desmoglue

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13
Q

Specific antibody for SLE?

A

Anti-dsDNA (seen in only 60% but only seen in SLE)

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14
Q

Which antibody is most specific for sjogren’s syndrome?

A

Anti-IgG (although also commonly seen in Rheumatoid arthritis)

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15
Q

Diagnostic criteria for SLE?

A 
MR. ANA PHOIDS has SLE -> need 4/11
Malar rash
Renal disorder (proteinuria or haematuria)
ANA+
Neurological: psychosis or seizures
Arthritis (polyarticular, non-erosive, small joints e.g. Hands)
Photosentivity
Haematology: -paenia of any cell line 
Oral ulcers
Immunological disorders: anti-dsDNA Ab and anti-smiff Ab
Discoid rash
Serositis (pleurisy, pericarditis)
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16
Q

Most sensitive antibody for SLE? Most specific?

A

Most sensitive: Anti- ANA (if negative, they are unlikely to have SLE)
most specific: Anti-dsDNA (only seen in 60%, but only in SLE)

17
Q

How to distinguish drug induced SLE from other SLE?

A

Anti-histone Ab is specific for drug induced SLE. Also take a careful drug history. Renal involvement uncommon in drug-induced SLE. They recover once you remove drug.

18
Q

What is Leidman-Sacks endocarditis?

A

Sterile endocarditis due to SLE

19
Q

How to distinguish SLE and RhAr?

A

SLE: CRP normal, C3/C4 low, RhF- , ANA+ , Anti-DNA+
RhAr: CRP high, C3/C4 normal, RhF+ , ANA- , AntiDNA-

20
Q

What are Anti-IgG antibodies?

A

IgM/IgA to Fc portion of own IgG

21
Q

Do people with Sjogren’s syndrome live as long as general population?

A

No.
Primary disease (sicca) < secondary disease (other autoimmune condition)
Most commonly RhAr (CD4+ Tcells and plasma cells)
x40 increased risk of non-hodgekin’s lymphoma

22
Q

Features of Systemic sclerosis?

A 
Diffuse scleroderma (widespread skin, rapid progress -> viscera) OR
Cutaneous scleroderma AKA CREST
Calcinosis
Raynaud's disease
Esophageal dysmotility
Sclerodactyl
Telangectasia
23
Q

Pt comes in ?SLE and has blood tests showing increased bleeding time and positive syphilis test- explain.

A

Anti-phospholipid antibodies: Main 2 are anti-cardiolipin or lupus anticoagulants
SLE: anti-cardiolipin antibodies cross react with syphilis test.
Also lupus anticoagulant results in decreased clotting in vitro (and increased clotting in vivo)

24
Q

Features of polymyositis?

A

Rash around orbits, proximal muscle weakness and aching.

25
Q

Immune complex deposition vasculitides?

A

SLE: autoimmune antigens
Penicillin- hapten
Secondary to infections e.g. Polyarteriitis nodosa is Hep B+ in 30% -> HBsAg-Ab complexes.

26
Q

Which disease is caused by anti-endothelial cell antibodies?

A

Kawasaki’s disease.

27
Q

What disease is caused by anti-basement membrane antibodies?

A

Goodpasture’s disease

28
Q

Large vessel vasculitides?

A

Takayasu’s arteriitis/aortitis

Giant cell arteriitis

29
Q

Complications of Takasayu’s arteriitis?

A

Transmural scarring and thickening of aorta. Aortic valve insufficiency.

30
Q

Medium vessel vasculitides

A

PolyArteriitis Nodosa

Kawasaki’s arteriitis

31
Q

What vasculitis is not associated with asthma or granulomas?

A

Microscopic polyangiitis

  • asthma -> Chung-strauss
  • granulomas -> Chung-strauss or wegener’s

Medicine (16 decks)

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