Trigger - Rheumatological Diseases Flashcards
What is the sensitivity and specificity of an ANA test
- HIGH sensitivity (because ANA has an “N” in it)
- LOW specificity (because ANA does NOT have a “P” in it)
i know i know, but it might be a question lol
does ANA quantitiy correlate with severity of disease?
NO
what ANA is indicative of autoimmunity?
- > /= 1:160
Is rheumatoid factor sensitive or specific?
no
can be found in healthy patients and is sometimes not positive in pts w rheumatoid diseases
when is CRP not a reliable test
when you have liver failure because CRP is produced by the liver!!
A chronic, systemic, multi organ autoimmune disease of connective tissues secondary to antibody formation and immune complex deposition.
SLE
associated with pericarditis, myocarditis, ILD, and pulm HTN
SLE
if you have a + ANA and you are suspecting a possible CT disorder, what should you order
ENA
procainamide, hydralazine and penicillamine are all associated with what diagnosis
drug induced SLE
Thrombocytopenia suggests a flare up of which disease
SLE
what is the treatment of SLE that only involves the skin, joint and mucosa
- hydroxychloroquine +/- NSAID
- <7.5mg prednisone QD PRN
what is the tx of SLE that is significant but has not yet become organ threatening
- hydroxychloroquine +/- NSAID
- 5-15 mg prednisone QD PRN
- immunosuppressive (MTX or azothioprine)
what is the Tx of SLE with Renal or CNS involvement
- hydroxychloroquine +/- NSAID
- high dose IV prednisone
- immunosuppressive agent (Belimumab, rituximab, cyclosporine)
Bull’s eye retinopathy is a SE of what
chloroquine toxicity!
What type of scleroderma is distal to the elbows (also on face/neck) and may present with the manifestation of CREST
limited cutaneous systemic sclerosis
Which scleroderma presents with proximal and even truncal manifestations
diffuse cutaneous systemic scleroderma
Which scleroderma presents with NO skin manifestations but does have all of the other manifestations
rare
systemic sclerosis sine scleroderma
telangiectasis and sclerodactyly with associated calcium deposits on their hands and neck. Pt reports rayneuds phenomenon and esophageal dysfunction such as acid reflux and decreased esophageal motility
CREST!! (Limited cutaneous systemic sclerosis)
90% of patients with this disorder have GI issues!
Systemic scleroderma
Anti-DNA topoisomerase I is for which diagnosis
diffuse cutaneous systemic scleroderma
In this disease you want to have baseline testing of the lungs to assess for ILD.
PFTs, Echo, CT chest
scleroderma!
Pt presents with dryness of the eyes and decreased salivation/dry mouth
sjogrens
Shirmer test is used with which disease? what is a negative test?
sjogrens
negative = >10mm of tears!
HLA-DR52
sjogrens
seen in 85% of pts
HIV, HCV and Vitamin A deficiency can all mimic which disease?
sjogrens
Omega-3-fatty acids are specifically good for this disease
Sjogrens for dry eye
when do you use pilocarpine as treatment
Sjogrens
sudden symmetrical onset of painless proximal weakness that spares the face and eye muscles
PM and DM
pt has raised, violaceous scaly eruptions on the knucles and a blueish purple eruption of rash on the face.
DM
heliotrope eruption, gottrons papules
may also see hyperkeratotic dirty appearing hands (mechanic hands)!
heliotrope eruption, gottrons papules
DM
you may also see mechanic hands!
these patients should use SPF 55+ and should probs suppplement w vit D!
SLE
mechanic hands are seen in which diagnosis
DM
hyperkeratotic, dirty appearing hands
hyperkeratotic dirty appearing hands
DM
Shawl sign
DM
hyperkeratotic macular rash appearing on pts back!
hyperkeratotic macular rash appearing on pts back!
DM
shawl sign!
CK is 10x the upper normal limit
DM/PM
what is the maxx amount of prednisone that can be taken daily for PM and DM
100mg!!!!
remember its 1mg/kg/day
