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26 Cards in this Set
- Front
- Back
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60. Additional Symptoms in Scleroderma?
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a. Diffuse Scleroderma:
1. Peripheral oedema (of hands and legs) 2. Polyarteritis 3. Fatigue and weakness (muscle involvement) 4. Carpal tunnel ii. Renal failure can occur, but now rare iii. Interstitial lung disease |
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61. Additional Symptoms in CREST (limited Scleroderma)?
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1. Calcinosis of digits
2. Raynaud’s 3. OEsophageal motility dysfunction 4. Sclerodactyly of the fingers 5. Telangiectases (over the digits and under the nails) |
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62. Treatment of scleroderma?
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a. No effective cure
b. treat symptoms: 1. NSAIDs for musculoskeletal pains 2. H2 blockers and proton pump inhibitors for esophageal reflux |
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63. Treatment of Raynaud's phenomenon?
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a. When cold and smoking
b. keep hands warm c. If severe use calcium channel blockers!!! |
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64. What seven conditions should be considered in the differential diagnosis of Raynaud's phenomenon?
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1. Primary-no other disorder exists
2. Scleroderma 3. SLE 4. mixed connective tissue disease 5. vasculitis (e.g., Buerger’s disease) 6. Certain medications 7. Disorders that disrupt blood flow or vessels, such as thromboangiitis obliterans. |
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65. Antiphospholipid Antibody Syndrome?
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a. A hypercoagulable state that can be the idiopathic or associated w/SLE (or other collagen vascular diseases such as scleroderma).
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66. Typical findings with Antiphospholipid Antibody Syndrome?
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1. Recurrent venous thrombosis- pulmonary embolism is a risk
2. Recurrent Arterial Thrombosis 3. Recurrent fetal loss (abortions) 4. Thrombocytopenia 5. Livedo reticularis |
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67. Lab findings w/ Antiphospholipid Antibody Syndrome?
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a. Presence of lupus anticoagulant
b. Anticardiolipin antibody, or both c. Prolonged PTT or PT is not corrected by adding normal plasma |
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68. Tx of Antiphospholipid Antibody Syndrome?
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a. Long-term anticoagulation (INR of 2.5-3.5).
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69. In what 4 conditions is ANA elevated?
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1. SLE (almost all patients)
2. Scleroderma 3. Sjogren's syndrome 4. Polymyositis b. note: ANA is highly sensitive for SLE but not for the others. |
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70. What conditions is RF elevated?
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a. RA (70% of patients)
b. healthy population (up to 3%) c. is neither sensitive nor specific for RA |
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71. In what condition is C-ANCA elevated?
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a. Wegener's granulomatosis
b. It is sensitive and specific! c. can vary with disease activity |
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72. In what condition is P-ANCA elevated?
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a. Polyarteritis Nodosa
b. it is 70-80% sensitive for microscopic PAN c. Not specific |
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73. in what condition is lupus anticoagulant elevated?
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a. Antiphospholipid antibody syndrome
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74. In what conditions is ESR elevated?
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a. Infection (acute or chronic)
b. Malignancy c. rheumatologic diseases d. miscellaneous (Tissue necrosis, pregnancy) e. low sensitivity and specificity |
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75. What are the major uses of ESR?
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a. Diagnose/rule out inflammatory process and monitor course of inflammatory conditions.
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76. What is the value of C-reactive protein?
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a. Inflammatory states and infection
b. Miscellaneous conditions (e.g, MI, vasculitis, trauma, malignancy, pancreatitis). c. Primarily used for infection- much more sensitive and specific than ESR!!!!! d. If levels are markedly elevated (>15), bacterial infection is likely present |
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77. What is Anti-uroporphyrin isomerase Ribonucleoprotein (anti-URP) elevated most often in?
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a. Mixed connective tissue disease.
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78. Anti-RO?
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a. Sjogren’s (50%) and SLE (40%).
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79. Anti-leucine aminopeptidase?
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a. Sjogren’s
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80. Associated HLA of SLE (2)?
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a. HLA-DR2
b. HLA-DR3 |
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81. Associated HLA of Sjogren’s?
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a. HLA-DR3
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82. Associated HLA of RA?
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a. HLA-DR4
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83. Associated HLA of Ankylosing Spondylitis, Reiter’s syndrome, and Psoriatic arthritis?
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a. HLA-B27.
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84. Note the degree of skin involvement predicts prognosis w/scleroderma?
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a. Diffuse scleroderma has a worse prognosis than CREST.
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85. Note: 20% of pts w/Scleroderma have Sjögren’s
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85. Note: 20% of pts w/Scleroderma have Sjögren’s
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