Rheumatology Flashcards
Investigations in SLE that specific
AntiCCP
Anti SM
Clinical signs of SLE
MD SOAP BRAIN
Malar Rash Discoid Rash Serositis Oral ulcer ANA +ve Photosensitivity Blood (haemolytic anaemia, thrombocytopenia) Renal (red cell casts, proteinuria) Arthritis Immune deficient (leukopenia) Neurological (headache, seizure, neuropathy)
Treatment of SLE
Goals
- early treatment
- avoid steroids long term
- monitor follow up
Derm
Sunscreen , ravoid UV light, estrogen
MSK
Vitamin D
Antiinflammatories
hydroxychloroquine to control long term control and prevent flares
Severe disease
- High dose Pred IV
- steroid sparing azathioprine, mtx
- IV cyclophosphamide
Diagnosis of SLE
7 clinical features
4 investigations
What is scleroderma?
Small vessel vasculopathy
Syndrome associated with scleroderma?
CREST
Calcinosis Raynaud Esophageal dysmotility Sclerodactyly Telangectasia
Investigations to diagnose scleroderma
Anti centromere
Anti topiramase
Anti Scl-70
Management of scleroderma
Derm - steroids topical Vascular - vasodilators (CCB) GI - GERD PPI Renal - ACE Lungs - interstitial disease cyclophosphamide Heart - csc Arthritis - , NSAIDS
What is antiphospholipid Ab?
Ab interfere with normal coagulation
Investigations to diagnose Antiphospholipid Ab?
Anti cardiolipin
ANA positive
Anti beta glycoproteins
Symptoms of antiphospholipid ab syndrome ?
Vascular thrombosis
- TIA, multi infarct dementia,
Recurrent spontaneous abortions
Management of antiphospholipid ab syndrome?
Lifelong anticoagulant
Investigations to diagnose Sjogrens disease?
Anti-SSA/Ro
Anti SSB/La
ANA
Name of the complex involved in Sjogrens?
Sicca complex
What is sicca complex?
Dry eyes
Dry mouth
What sort of vasculitis is GCA?
Large vessel vasculitis
Treatment
- CSC 4 weeks
- then tapering regimen
- Methylpred if vision loss
Prognosis of GCA?
Increased risk thoracic aneurysm and aortic dissection
Medications that precipitate Gout?
FACT
Frusemide
Aspirin low dose / alcohol
Cytotoxic
Thiazide
Acute treatment of gout?
NSAID
CSC
Colchicine if within 12 hours of onset of sx
What is the treatment of pseudo gout?
NSAIDS
Treatment of pulmonary HTN in scleroderma?
Bosetan
Epoprostenol
PE5 inhibitors
Difference between diffuse and limited systemic Scleroderma?
Limited: skin face hand neck, pulmonary HTN, CREST
Diffuse: widespread, more organ involvement
What is pseudo gout associated with?
Haemochromatosis Hyopthyroidism Hypophosphataemia DM Hypomagnesaemia HyperPTH
