Systemic Sclerosis Flashcards

1
Q

what are characteristics

A

vasomotor disturbances (raynauds), fibrosis and subsequent atrophy of the skin and subcutaneous tissue

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2
Q

what causes the skin and internal organ changes

A

excessive collagen deposition

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3
Q

what causes death in these patients

A

renal and lung changes

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4
Q

what percentage of deaths does pulmonary hypertension lead to

A

12%

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5
Q

what is the presentation (cutaneous)

A

Raynauds (early, uncommon to not be present)

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6
Q

what three phases does cutaneous involvement have

A
  1. oedematous
  2. indurative
  3. atrophic (skin becomes thickened and tight)
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7
Q

what two groups are the features divided into

A

major and minor

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8
Q

what is included in major

A

centrally located skin sclerosis affecting arms, face and neck

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9
Q

what is included in minor

A

sclerodacyly and atrophy of fingertips and bilateral lung fibrosis

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10
Q

how is a diagnosis made

A

patient has 1 major and 2 minor features

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11
Q

when the skin of the face is affected what is seen

A

pinching of nose (beaking)
tightening of skin around the mouth
telangiectasia

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12
Q

what is calcinosis

A

subcutaneous deposits of calcium seen in digits

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13
Q

what organ involvement can be seen

A

pulmonary hypertension, pulmonary fibrosis, accelerated hypertension leading to renal crisis,
gut involvement can lead to dysphagia, malabsorption and bacterial overgrowth of small bowel
inflammatory arthritis and myositis

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14
Q

what is the classification

A

limited and diffuse form

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15
Q

what is involved in limited

A

skin involved is confined to face, hands, forearm and feet

organ involvement occurs later

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16
Q

what antibody is associated with limited

A

anti-centromere

17
Q

what is involved in diffuse

A

skin changes develop more rapidly and involve whole trunk

early significant organ involvement

18
Q

what antibody is associated with diffuse

A

anti-Scl-70

19
Q

what are investigations

A

anti-centromere and anti-Scl-70 auto-antibodies, organ screening including pulmonary function tests, echo and renal function

20
Q

what is the management dependent on

A

specific issues

21
Q

how is Raynauds/digital ulcers managed

A

calcium channel blockers, iloprost, bosentan

22
Q

how is renal involvement managed

A

ACE inhibitors

23
Q

how is GI involvement managed

A

PPI for reflux

24
Q

how is interstitial lung disease managed

A

immunosuppression (usually cyclophosphamide)