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Rheumatology > SLE, SS, SSc > Flashcards

SLE, SS, SSc Flashcards

1
Q

What are the GI manifestations of systemic sclerosis?

A

esophageal dysmotility with markedly diminished peristalsis

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2
Q

No wrinkles is associated with what condition?

A

systemic sclerosis

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3
Q

What is unique in the arthritis seen in SLE?

A

they are nonerosive to bone

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4
Q

What 2 medications will help with dry mouth (xerostomia) seen in Sjogren syndrome

A
  • Cevimeline

- Pilocarpine

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5
Q

90% of SLE cases are in what gender?

A

women

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6
Q

What are the pulmonary manifestations of systemic sclerosis? (3)

A
  • interstitial lung disease (pulmonary fibrosis)
  • pulmonary hypertension
  • lung cancer
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7
Q

If a patient is having a severe or life threatening SLE flair what is the acute treatment?

A
  • hospital admission for high dose IV steroids
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8
Q

Baby born to a mother with SLE may develop what 2 manifestations?

A
  • self limited cutaneous rash that will get better in time
  • heart blocks (any degree)
  • if 3rd degree HB need a pacemaker for life*
  • are at higher rate for autoimmune diseases later in life*
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9
Q

What 3 non-pharmacological treatment options are recommended for SLE?

A
  • exercise
  • smoking cessation
  • sunscreen
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10
Q

Which organ systems does lupus NOT involve?

A

trick question - it can involve any organ

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11
Q

Patients with Sjogren Syndrome are at high risk for what 5 complications?

A
  • dental caries
  • oral candidiasis
  • bacterial sialadenitis
  • corneal damage
  • vaginal dryness and dyspareunia
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12
Q

What is the number 1 symptom in SLE?

A

profound fatigue

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13
Q

How is drug-induced SLE diagnosis made?

A
  • positive anti-histone antibody
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14
Q

What is necessary to make the diagnosis of Sjogren Syndrome?

A
  • Positive Schirmer test OR imaging with glandular abnormalities
  • salivary gland biopsy OR Anti-Ro (SSA) AND/OR Anti-La (SSB) antibodies
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15
Q

What other antibodies, besides ANA, are associated with SLE? (3)

A
  • Anti-DS DNA
  • Anti-Sm (Smith)
  • Antiphospholipid antibodies
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16
Q

What are the 5 signs of CREST syndrome associated with limited cutaneous SSc?

A
  • calcinosis
  • Raynaud phenomenon
  • esophageal dysmotility
  • sclerodactyly
  • telangiectasias
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17
Q

The production of a high number of _________ antibodies are associated with SLE

A

antinuclear antibodies (ANA)

18
Q

ANA is a very _______ antibody. It is good to rule OUT SLE.

A

sensitive

19
Q

This is a chronic inflammatory autoimmune disease that can affect essentially any organ of the body.

A

Systemic Lupus Erythematosus (SLE)

20
Q

What test do we do to measure tear production when working-up Sjogren Syndrome?

A

Schirmer Test

  • normal = 15-25mm
  • SS = <10mm
21
Q

What life saving medication should be administered in a patient with scleroderma renal crisis in systemic sclerosis?

A

ACE inhibitors

22
Q

This is a chronic systemic autoimmune disorder associated with collagen deposition in the dermis, blood, and internal organs.

A

systemic sclerosis

23
Q

What are the renal manifestations of systemic sclerosis?

A

scleroderma renal crisis = a deadly hypertensive crisis with BP >200/100

24
Q

What are the 11 criteria for SLE?

A
  • malar rash
  • discoid rash
  • oral ulcers
  • photosensitivity
  • arthritis
  • serositis (e.g. pleuritis/pericarditis)
  • renal disorder (lupus nephritis)
  • neurologic disorder (e.g. seizures, psychosis)
  • hematologic disorder (e.g. anemia or any -penias)
  • ANA positive
  • immunologic disorder
25
Q

Who primarily gets Sjogren Syndrome?

A

women in 4th to 6th decade of life

26
Q

Patients with SLE have mortality rates ranging from __ to __ times higher than that of the general population

A

2-5 times higher

27
Q

What is the treatment for Sjogren Syndrome? (3 part)

A
  • routine dental care d/t xerostomia
  • routine eye exams d/t xerophthalmia
  • if systemic disease: steroids, DMARDs, biologics
28
Q

What DMARD is the first line treatment for SLE?

A

hydroxychloroquine

29
Q

What is the classic sequence of color changes in Raynaud’s phenomenon?

A

white, blue, red

30
Q

Anti-Sm (Smith) antibodies are predictor of what organ disease secondary to SLE? (2)

A
  • CNS

- renal

31
Q

The 1997 ACR Criteria requires ___ / 11 criteria serially or simultaneously to diagnose SLE

A

4/11

32
Q

What ethnicity tend to have earlier-onset disease and more severe disease phenotypes for systemic sclerosis?

A

african americans

33
Q

A patient presents with joint pain, rash, pleuritic chest pain, and positive ANA at a low dilution (weak positive). On review of medications, she has been taking minocycline for the past year for acne. Which antibody is most likely to be positive?

A

anti-histone

34
Q

What antibody is associated with limited cutaneous systemic sclerosis (aka CREST syndrome)?

A

anti-centromere antibody

35
Q

What is the natural history of the skin manifestations associated with systemic sclerosis?

A
  • starts off as a “puffy” phase that progresses to a “tight” phase
  • starting in the hands/feet and progressing centrally
36
Q

Neonatal lupus is due to 2 antibodies in the mother crossing the placenta.

A
  • anti-Ro (Anti-SSA)

- Anti-La (Anti-SSB)

37
Q

What is unique in the oral ulcers seen in SLE?

A

they are painless ulcers

38
Q

What antibody is associated with diffuse cutaneous systemic sclerosis?

A

anti-ScL 70 (anti-topoisomerase I antibody)

39
Q

What medication can help with dry eyes (xerophthalmia) seen in Sjogren syndrome?

A

cyclosporin drops (restasis)

40
Q

What are the 3 hallmark symptoms of Sjogren Syndrome?

A
  • xerophthalmia
  • xerostomia
  • enlarged salivary glands

Rheumatology (7 decks)

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