Week 8 Quiz Highlights

Question 1

SLE is what type hypersensitivity

Answer 1

Type III w/ a potential type II involvement

Question 2

Who has an eightfold to ninefold increased risk of having SLE

Answer 2

First degree relative of people with SLE

Question 3

What drug increases SLE risk 50%

Answer 3

estrogen containing contraception

Question 4

What 3 general symptoms almost always present at some point in SLE

Answer 4

fatigue, fever, and weight loss

Question 5

Name a couple mucocutaneous symptoms of SLE

Answer 5

non-painful oral ulcers, raynauds, alopecia, malar butterfly rash

Question 6

describe the arthritis in SLE

Answer 6

symmetric, non-deforming arthritis of digits, wrists, knees, and MTP

Question 7

major renal cause of death in SLE

Answer 7

active glomerulonephritis

Question 8

most common CVS problem in SLE

Answer 8

pericarditis (mimics MI)

Question 9

most common respiratory problem in SLE

Answer 9

pleurisy

Question 10

2 CNS disorders in SLE

Answer 10

psychosis and seizures (there are more too)

Question 11

common ophthalmologic problem in SLE

Answer 11

keratoconjunctivitis sicca

Question 12

major lab for SLE

Answer 12

ANA (antinuclear antibodies)

Question 13

autoantibodies in SLE

Answer 13

Anti-dsDNA, Anti-histone, Anti-ENA, Anti-SSA, Anti-SSB

Question 14

11 diagnostic criteria for SLE (need 4)

Answer 14

malar rash, discoid lupus, photosensitivity, oral/nasopharyngeal ulcers, non-erosive arthritis, renal disorder, neurologic disorder, serositis, hemat. disorder, positive ANA, immunologic disorder

Question 15

What is Scleroderma

Answer 15

immune activation, vascular damage, and excessive synthesis of extracellular matrix with deposition of increased amounts of structurally normal collagen

Question 16

3 types of Scleroderma and 1 syndrome

Answer 16

localized scleroderma, systemic sclerosis, systemic diffuse sclerosis, and CREST Syndrome

Question 17

Scleroderma w/ no internal organ involvement

Answer 17

localized scleroderma

Question 18

scleroderma w/ skin thickening distal to elbow or knee

Answer 18

systemic sclerosis

Question 19

Define CREST Syndrome

Answer 19

Calcinosis, Raynauds, Esophageal dysfunction, Sclerodactyly, Telangiectasia

Question 20

Onset of scleroderma

Answer 20

fatigue, swollen digits, stiff joints, loss of strength, pain, insomnia, skin discoloration

Question 21

Leading cause of death in scleroderma

Answer 21

respiratory

Question 22

Major and minor (3) criteria for Dx of scleroderma

Answer 22

Major is skin thickening just proximal to MCPs. Minor are sclerodactyly, permanent ischemia changes of fingertips, bibasilar pulmonary fibrosis

Question 23

Patients with scleroderma or ANA

Answer 23

positive usually

Question 24

Polymyositis is

Answer 24

direct T cell mediated muscle injury

Question 25

Dermatomyositis is

Answer 25

immune complex deposition in vessels (B cell)

Question 26

Dermatomyositis is associated with increased risk of

Answer 26

malignancy

Question 27

Both dermatomyositis and polymyositis present with

Answer 27

symmetric proximal muscle weakness

Question 28

characteristics of dermatomyositis

Answer 28

Gottron's papules, shawl sign, heliotrope periorbital rash, and erythroderma

Question 29

PE for dermatomyositis and polymyositis

Answer 29

Gower's Test +

Question 30

Define polymyalgia rheumatica

Answer 30

clinical syndrome characterized by severe aching and stiffness in the neck, shoulder girdle, and pelvic girdle

Question 31

Pain of polymyalgia rheumatica

Answer 31

severe pain and stiffness in proximal muscle groups without permanent weakness or atrophy

Question 32

How are the mornings for people with polymyalgia rheumatica

Answer 32

marked morning stiffness, difficult to get out of bed

Question 33

Dx criteria for polymyalgia rheumatica

Answer 33

aged 50 + years on onset, bilateral aching and morning stiffness of 30+ mins for at least one month, stiffness involves 2/3 areas, EST >/= 40

Question 34

concomitant to polymyalgia rheumatica

Answer 34

tendency to Temporal Arteritis (Giant Cell Arteritis)

Question 35

What is polyarteritis nodosa

Answer 35

systemic vasculitis characterized by necrotizing inflammatory lesions that affect medium and small muscular arteries, preferentially at vessel bifurcations, resulting in microaneurysm formation, aneurysmal rupture with hemorrhage, thrombosis, and organ ischemia or infarction

Question 36

define mixed connective tissue disease (MCTD)

Answer 36

An overlap syndrome that incorporates selected clinical features of systemic lupus erythematosus, scleroderma and polymyositis with the presence of the distinctive antibody U1-ribonucleoprotein (RNP).

Question 37

early Sxs of MCTD

Answer 37

general malaise, arthralgias, myalgias, and low grade fever. Raynauds too.

Question 38

most important lab for MCTD

Answer 38

Anti-U1-RNP

Question 39

RF and CCP status in MCTD?

Answer 39

Mostly +

Question 40

Dx criteria for MCTD

Answer 40

Anti-U1-RNP w/ 3/5 of: swollen hands, synovitis, myositis/myalgia, raynauds, acrosclerosis

Question 41

disorders of spondyloarthropathies

Answer 41

AS, ReA, PsA, and Enteropathic Spondyloarthritis

Question 42

Spondyloarthropathies generally are linked by

Answer 42

HLA-B27 and enthesitis

Question 43

define AS

Answer 43

chronic painful and progressive inflammatory arthritis primarily affecting spine and SI joints w/ pain and progressive stiffness

Question 44

IL that causes enthesitis in AS

Answer 44

IL-23

Question 45

How's the morning for AS people?

Answer 45

stiffness, it often wakes them up

Question 46

symptoms improve in AS w/

Answer 46

moderate physical activity

Question 47

What segment of the spine can be subluxed with AS?

Answer 47

antlantoaxial subluxation

Question 48

most common extra-articular manifestation of AS

Answer 48

uveitis

Question 49

syndrome that can occur in AS when disease is long standing

Answer 49

cauda equina syndrome

Question 50

PE findings in AS

Answer 50

reduced spinal ROM, loss of lumbar lordosis, accentuation of thoracic spine, stooped posture, decreased expansion of chest, shuffling gait

Question 51

interesting x ray findings in AS

Answer 51

T spine "shiny corners", "bamboo spine"

Question 52

Dx criteria for AS

Answer 52

low back pain/stiffness for more than 3 months that improves with exercise but is not relieved b rest, limitation of lumbar spine motion, limitation of chest expansion

Question 53

4 types of psoriatic arthritis

Answer 53

symmetric polyarthropathy, asymmetric oligoarthropathy, arthritis mutilans, spondylitis

Question 54

How're the hands in Arthritis mutilans?

Answer 54

osteolysis w/ opera glass hands deformity

Question 55

Which psoriatic arthritis is associated w/ HLA-B27

Answer 55

spondylitis

Question 56

Dx criteria for psoriatic arthritis

Answer 56

current psoriasis, history of psoriasis, family history of psoriasis, nail changes/dactylitis, inflammatory musculoskeletal disease

Question 57

define reactive arthritis

Answer 57

arthritis that follows an infection

Question 58

typical pattern of reactive arthritis

Answer 58

mono- or oligoarticular pattern of arthritis, often involving lower extremities

Question 59

classic reiter's

Answer 59

conjunctivitis, urethritis, arthritis--"cant see, cant pee, cant dance"

Question 60

define enteropathic spondyloarthritis

Answer 60

arthritis that accompanies inflammatory bowel disease such as Crohn's or UC, not associated w/ HLA-B27

Question 61

symptoms of enteropathic spondyloarthritis

Answer 61

pauciarticular, asymmetric, non-erosive

Question 62

In enteropathic spondyloarthritis severity correlates w/

Answer 62

IBD activity but axial symptoms do NOT correlate w/ IBD activity