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39 Cards in this Set
- Front
- Back
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What drugs can induce SLE?
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Procainamide
Hydralazine Isoniazid Chlorpromazine Methyldopa Quinidine |
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What are the features of SLE?
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Fever, anorexia, malaise, weight loss
Butterfly rash Nail fold infarcts Splinter hemorrhages Raynaud's Phenomenon |
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What is the diagnostic criteria for SLE?
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Requires 4 of 11 criteria:
Malar rash Discoid rash Photosensitivity Oral ulcers Arthritis Serositis Renal disorder Seizures, psychosis Hematologic Immunologic Positive ANA |
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How do you treat SLE?
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Refer to rheumatologist
NSAIDS Antimalarial drugs Steroids Immunosuppressive drugs Anticoagulation |
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What is antiphospholipid antibody syndrome?
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Recurrent venous or arterial occlusions
Recurrent fetal loss Thrombocytopenia Antiphospholipid antibodies No other features of SLE |
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What is scleroderma?
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diffuse fibrosis of the skin and internal organs
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What are the two forms of scleroderma?
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Limited - CREST
Diffuse - Renal failure, intersitial lung disease, cardiac disease |
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What is CREST syndrome?
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Calcinosis
Raynaud's syndrome Esophageal dysmotility Sclerodactyly Telangiectasia |
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What are the clinical findings of scleroderma?
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Polyarthralgia, Raynaud's phenomenon
Thickened skin, with loss of normal folds telangiectasia, pigmentation, depigmentation Dysphagia Restrictive lung disease Pericarditis, heart block Renal disease |
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What labs do you see with scleroderma?
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mild anemia
normal ESR positive ANA SCL-70 Anticentromere antibody (50% w/ CREST) |
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How do you treat scleroderma?
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Severe Raynaud's phenomenon - nifedipine, losartan
Esophageal reflux - H2 blockers, PPI, antacids Bacterial overgrowth and pseudoobstruction - octreotide Malabsorption d/t bacterial overgrowth - tetracycline |
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True or False: Prednisone is commonly used in the treatment of scleroderma.
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False
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What is Sjogren's Syndrome?
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chronic dysfuction of exocrine glands
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What are the clinical findings of Sjogren's Syndrome?
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keratoconjunctivitis
burning, itching, FB sensation in eye Dry mouth Loss of taste and smell Parotid enlargement Desiccation of nose, throat, larynx, vagina, skin Dysphagia Pancreatitis |
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What labs do you see with Sjogren's syndrome?
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Mild anemia
Leukopenia Eosinophilia Polyclonal hypergammaglobulinemia Positive RF ANA Anti-SS-a and Anti-SS-b Thyroid-associated autoimmunity Schirmer test Lip biopsy Parotid gland biopsy |
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What does a Schirmer test measure?
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quantity of tears secreted
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How do you treat Sjogren's syndrome?
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Supportive and symptomatic
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What drug can relieve xerostomia?
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Pilocarpine
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People with Sjogren's are at risk for developing what?
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lymphoma
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What is polymyalgia rheumatica?
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pain and stiffness in neck, shoulder, and pelvic girdle
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What are the characteristics of polymyalgia rheumatica?
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pain and stiffness in neck, shoulder, and pelvic girdle
symmetrical symptoms more prolonged in the morning low-grade fever, fatigue, weight loss |
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Does PMR have muscle weakness?
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No
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What labs do you see with polymyalgia rheumatica?
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ESR and CRP elevated
Anemia and mild thrombocytosis |
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How do you treat polymyalgia rheumatica?
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Prednisone 10-20 mg/day for 6 months-2 years
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Know about Giant Cell Arteritis.
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Symptoms
Treatment |
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What is polyarteritis nodosa?
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medium-sized necrotizing arteritis
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What can cause polyarteritis nodosa?
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Idiopathic
Hep B or C Drugs |
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What drugs can cause polyarteritis nodosa?
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PTU
Hydralazine Allopurinol Penicillamine Sulfasalazine |
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What are the signs and symptoms of polyarteritis nodosa?
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fever, malaise, weight loss
pain in extremities Foot drop livedo reticularis HTN |
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What labs do you see in polyarteritis nodosa?
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anemia
elevated ESR Leukocytosis Hep B or C |
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How do you confirm a diagnosis of polyarteritis nodosa?
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tissue biopsy
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How do you treat polyarteritis nodosa?
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corticosteroids (up to 60mg/day)
immunosuppressive agents (cyclophosphamide) refer to rheumatologist |
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What is a complication of polyarteritis nodosa?
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mesenteric vasculitis
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What is Reiter's syndrome?
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Reactive arthritis
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What causes Reiter's syndrome?
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dysentery - Shigella, Salmonella, Yersinia, Campylobacter
STD - Chlamydia |
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What are the clinical findings of Reiter's syndrome?
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Urethritis
Conjunctivitis Mucocutaneous lesions Aseptic arthritis Fever, weight loss Aortic regurgitation |
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With Reiter's syndrome, what do you see on x-ray?
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permanent or progressive joint disease (sacroiliac or peripheral joints)
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How do you treat Reiter's syndrome?
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NSAIDS
antibiotics at time of infection tetracycline sulfasalazine methotrexate anti-TNF agents |
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True or False: Once symptoms of Reiter's syndrome develop, antibiotics can reduce the severity of the disease.
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False
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