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18 Cards in this Set
- Front
- Back
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Constitutional symptoms of autoimmunity (5)
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Fatigue, myalgia, arthralgia, fever, weight loss (evidence of inflammation in different organ systems/body regions)
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Systems involved in systemic inflammation
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Dermis, salivary/lacrimal glands, serosa, glomeuli/renal tubules, synovium, muscles, heme
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Systems involved in systemic fibrosis
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Digital arteries, dermis, pulmonary and renal arteries, alveoli
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Taking history for suspected autoimmune disease
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1) Systemic inflammation
2) Immune-mediated pathology 3) Previous history 4) Family history 5) Demographics 6) Other disorders (infection, drug reaction, malignancy, fibromyalgia) |
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SLE Physical Exam
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Skin: malar rash (ACLE), photosensitive
HEENT: non-scarring alopecia, oral ulcers Lungs: Pleuritic chest pain, pleural effusion, alveolar inflammation Cardio: Pericarditis, CHF Abdomen: Peritonitis, splenomegaly MSK: arthritis of small joints (no erosions) Neuro: neuritis, headache, CNS vasculopathy |
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Dermatomyositis physical exam
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Skin: Photosensitive skin (face, upper back, exposed chest)
Light purple (heliotrope) eyelids, Gottron's papules and sign (over hand joints, knees, elbows) MSK: progressive muscle weakness (esp UE, neck, pharynx) Associated with inc lympoma, ovarian cancer |
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Systemic Sclerosis physical exam
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Skin: sclerodactyly (skin thickening), telangiectasiae (superficial small dilated vessels)
Lungs: Interstitial lung disease -> rales, pulm HTN MSK: Raynaud's phenomenon Renal: Glomerular damage -> proteinuria |
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Discoid LE findings
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Red, scaly plagues that heal with atrophy and scarring
Alopecia with follicular atrophy and scarring |
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Serology
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SLE: Anti-dsDNA, anti-Sm
SSc: Anti-Ro, anti-La, anti-centromere, anti-topo WG: cANCA |
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SLE pattern
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Malar rash, ANA, anti-dsDNA/Sm, inflammatory arthritis, serositis, glomerulonephritis, ulcers, abnormal CBC (schistocytes, thrombocytopenia, leukopenia)
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Dermatomyositis pattern
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Gottron's papule, heliotrope rash, muscle weakness, ANA, skin/muscle biopsy, MRI: muscle inflammation, associated malignancies
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SSc pattern
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Sclerodactyly, telangiectasiae, ANA, Raynaud's phenomenon, interstital lung disease, GERD, glomerular damage, anti-centromere Ig
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Sjogren's syndrome pattern
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Dry eyes, dry mouth, ANA< parotitis, Anti-Ro/La, arthralgia, thyroid disease, salivary gland biopsy
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WG pattern
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Cough/hemoptysis, pulmonary nodules, cANCA, RPGN, sinus/orbital granulomas, skin ulcers/purpura, peripheral neuropathy, arthralgias/myalgias, "Saddle nose"/loss of cartilage
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Polyarteritis nodosa
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HTN, limb ischemia, hep B association, tissue biopsy
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Giant Cell Arteritis
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Unilateral headache, scalp tenderness, jaw claudication, polymyalgia rheumatica (morning stiffness), dec/asymmetric pulses, visual loss if untreated
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Fibromyalgia pattern
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Chronic pain (esp muscles, joints) w/o inflammation or structural abnormalities, 90% F
Tender points, chronic fatigue, swollen joints, dry eyes/mouth, chest pain, alpha-delta sleep/alpha wave intrusion |
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Fibromyalgia differential
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Rheumatic diseases, hypothyroidism, drug-induced myopathy, hypermobility syndrome, chronic fatigue syndrome, depression
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