Systemic Lupus Erythematous

Question 1

Systemic Lupus Erythematous

Answer 1

inflammatory autoimmune disorder characterized by autoantibodies to nuclear antigens, affect multiple organs, can be drug induced, mainly women

Question 2

SLE symptoms

Answer 2

rash in ares exposed to sun, joint 90% pts, anemia, leukopenia, thrombocytopenia, glomerulonephritis, CNS, fever, anorexia, malaise, wt loss, pericardium effected

Question 3

Drug induced lupus four features

Answer 3

sex ratio equal, nephritis and CNS not present, hypocomplementemia and ab to dsDNA are absent, clin features are most lab abnormalities usually revert toward normal when offending drug removed

Question 4

SLE lab findings

Answer 4

ANA (sensitive but not specific), anti-dsDNA (specific but not sensitive), low serum complement

Question 5

Treatment of SLE

Answer 5

education and support, antimalarials (hydroxychloroquine), DHEA

Question 6

Prognosis of SLE

Answer 6

accelerated atherosclerosis, chronic inflam, MI higher

Question 7

Prevention in SLE

Answer 7

flu vaccine, pneumococcal vaccine, cancer screenings, stop smoking, control CVD

Question 8

Reynaud Phenomenon

Answer 8

paroxysmal bilateral digital pallor and cyanosis, precipitated by cold or stress, affects young women, usually benign

Question 9

Pathophysiology of RP

Answer 9

initial phase: mediated by excessive vasoconstriction, well-demarcated digital pallor or cyanosis; recovery phase: vasodilation, leads to intense hyperemia

Question 10

Secondary RP

Answer 10

less common, associated with rheumatic diseases, severe cases can lead to digital ulceration and gangrene

Question 11

Reynaud non-pharm treatment

Answer 11

wear gloves or mittens when outside, keep body warm, stop smoking, avoid sympathomimetic drugs

Question 12

Reynaud pharm treatment

Answer 12

CCBs first line

Question 13

Scleroderma

Answer 13

a rare chronic disorder characterized by diffuse fibrosis of skin and internal organs, symptoms 30-50 yo, women 2x more affected, limited and diffuse forms

Question 14

Clinical presentation of scleroderma

Answer 14

initial: hand arthralgia, inflammatory art of hand, reynaud’s phen, skin-thickening, positive ANA

Question 15

CREST syndrome

Answer 15

found with limited scleroderma, calcinosis of digits, Raynaud, esophageal motility disorder, sclerodactyly, telangiectasia

Question 16

Limited scleroderma

Answer 16

CREST, hardening of skin in face and hands, anticentromere abs in 50%, scleroderma ab in 20%

Question 17

Diffuse scleroderma

Answer 17

skin changes over trunk and proximal extremities, tendon friction over forearm and skins, anticentromere ab in 1%, scleroderma ab in 30%

Question 18

Treatment of scleroderma

Answer 18

symptomatic and supportive, no effective therapy for underlying

Question 19

Sjogren Syndrome

Answer 19

dryness of eyes and dry mouth are most common features, 90% women, over 50 yo, RF and other autoab common, inc lymphoma

Question 20

Rhabdomyolysis

Answer 20

associated w/ crush injuries to muscle, prolonged immobility, drug toxicities (statins), hypothermia, massive acute elevation of muscle enzymes

Question 21

Lab tests of rhabdomyolysis

Answer 21

serum creatine kinase, CPK, marked elevation

Question 22

Treatment of rhabdomyolysis

Answer 22

determine cause, correct cause, discontinue drug, should improve in several weeks

Question 23

Granulomatosis with polyangiitis classic triad

Answer 23

URT disease, LRT disease, glomerulonephritis

Question 24

Granulomatosis with polyangiitis pathologic triad

Answer 24

small vessel vasculitis, granulomatous inflammation, necrosis

Question 25

Clinical presentation of Gw/P

Answer 25

sinusitis, congestion, mucous, sinus pressure, lung disease, bronchitis, pneumonia, hematuria, proteinuria

Question 26

Progression of Gw/P

Answer 26

chronic kidney disease, rapidly over several weeks, no treatment

Question 27

Diagnosis of Gw/P

Answer 27

Clinical presentation, ANCA, positive in 90%

Question 28

Lyme disease

Answer 28

borrelia burgdorferi, moves through bloodstream and between tissue, vector is deer tick, must be attached for 24+ hours

Question 29

Clinical presentation of Lyme disease

Answer 29

3-30 days after bite, rash, fever, chills, HA, muscle/joint pain, fatigue, weeks after: multiple rashes, facial hemiparalysis, fever, stiff neck, HA, weakness, pain, irregular HR, then arthrits, CNS probs

Question 30

Diagnosis of lyme disease

Answer 30

anyone bitten by tick should be tested, ELISA, prevue B, C6 lyme peptide ELISA, confirmation w/ western blot

Question 31

Treatment of lyme disease

Answer 31

sooner the better, antibiotics, doxycycline, cefuroxime axetil, amoxicillin, orally for few weeks

Question 32

Treatment of lyme disease in

Answer 32

amoxiciliin, cefuroxime, or penicillin, doxycycline can stain permanent teeth developing in young children or unborn babies, erythromycin if allergic to penicillin