Rheumatology

Question 1

Diagnosis of antiphospholipid syndrome

Answer 1

Solid state immunoassay (ELISA)

• anticardiolipin
• anti-B2-glycoprotein I antibody

Functional assay
- APTT for lupus anticoagulant

Question 2

Anti-Scl-70 (disease classification; associations; specificity)

Answer 2

aka anti-topoisomerase I Diffuse cutaneous SSc (dcSSc)
Increased risk of ILD
99% specificity for SSc

Question 3

Anti-centromere (disease classification; associations; specificity)

Answer 3

Limited cutaneous SSc (lcSSc)
Associated with PAH but protective for ILD and SRC
99% specificity for SSc

Question 4

Anti-RNA polymerase III (disease classification; associations; specificity)

Answer 4

Diffuse cutaneous SSc (dcSSc)
Markedly increased risk SRC (pts should take BP daily), rapid progressive skin involvement
99% specificity for SSc

Question 5

What is secukinumab?

Answer 5

IL-17 inhibitor
IL-17 is critical in pathogenesis of psoriasis
Produced by Th17 cells

Question 6

What is the role of CD40L?

Answer 6

This is a costimulatory molecule on T cells. Its role is to interact with B cell CD40 to mediate B cell class switching. CD40L is mutated or deficient in hyper IgM syndrome