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204 > Multi-system Autoimmune Disease > Flashcards

Multi-system Autoimmune Disease Flashcards

1
Q

Spondyloarthropathy includes?

A

Psoriatic arthritis
Enteropathic arthritis
Ankylosis spondiltis
Reactive arthritis

All serum negative no rheumatoid factor

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2
Q

STIR sequence?

A

Cuts out fat and highlights inflammation

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3
Q

Peripheral manifestation of spondyloarthropathy?

A

Uveitis
Tendinitis
Psoriasis

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4
Q

What is the average delay in diagnosing ankylosis going spondylitis?

A

8 years

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5
Q

Prevalence of ankylosing spondilitis?

A

0.2-1%

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6
Q

Ratio of ankylosing spondilitis in men and women?

A

3:1, highest in Caucasians

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7
Q

Genetic link for ankylosing spondilitis?

A

Over 90% with it have HLA B27

And there’s a 16 x increased risk If family history of HLA B27

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8
Q

Inflammatory back pain questions?

A

Age of onset less than 40

Insidious onset

Improvement with exercise

No improvement at rest

Pain at night

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9
Q

How would you manage spondyloarthropathy?

A 
Physiotherapy/ hydrotherapy 
NSAIDs
Glucocorticoid injections in joints
Synthetic DMARDs- for peripheral 
Biological DMARDs
Surgery
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10
Q

Signs of vasculitis?

A

Stroke, MI, hypertension, bloody stool. Abdominal pain, arthritis, palpable pupura, fever, headache, weight loss, gloerular nephritis, bloody cough, nose bleeds, reduced visual acuity, muscle pain

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11
Q

What are little red marks on hands called? Sign of vasculitis?

A

Petechiae

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12
Q

What is the most common vasculitis in over 50s?

A

Giant cell arthritis, risk of permanent sight loss, inflammation of external carotid arteries (temporal)

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13
Q

Differential diagnosis of GCA?

A 
Over 50
Acute
Headache
Jaw or scalp tenderness
Claudication of tongue or jaw (pain when chewing)
New visual symptoms
Raised CPR/ESR
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14
Q

How would you confirm GCA?

A

US- halo sign,

Temporal artery biopsy (giant cells)

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15
Q

What is treatment for GCA?

A

High dose steroids

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16
Q

If you have large vessel vasculitis what would symptoms be?

A

Fever weight loss fatigue, because inflammation cuts of blood supply

Weak reduced pulses
Limb claudication
Do an angiogram or PET-CT

17
Q

Investigations for vasculitis?

A 
Raised ESR/CRP
Urine dip: protein, blood or cast cells
Chest abdomen imaging, 
Vessel wall imaging
Tissue biopsy
PET CT
Auto antibodies, anti neutrophil cytoplasmic antibodies ANCA, anti glomerular basement membrane GBM
Infection screen, HIV, hepatitis B/C, TB , varicella
18
Q

How would you treat vasculitis?

A 
Steroids high dose
Manage side effects of steroids
Immunosuppression 
Biological agents
Synthetic DMARDs
19
Q

CTD symptoms?

A

Raynaud’s phenomenon, ulcers of nails

Scarring alopecia

20
Q

Incidence of systemic sclerosis?

A

1 to 20/ million

21
Q

What is pathophysiology of systemic sclerosis?

A

Microvasculopathy, immune activation (anti nuclear antibodies), upregulation of collagen production causing fibrosis of tissues

22
Q

What are the limited signs of systemic sclerosis?

A

Calcinosis- calcium deposition in fingers and toes
Raynauds
Oesophageal dysmotility
Sclerodactylyl- thickening of skin
Telangiectasia - smaller capillaries broken

23
Q

What are the diffuse signs of systemic sclerosis?

A

Multi-organ- interstitial Lung disease, myocardial disease, pulmonary hypertension, renal crisis, GI disease

24
Q

SLE manifestations?

A

Malar rash

Jaccoud’s arthropathy- deformity of hands

25
Q

Idiopathic inflammatory myositis signs?

A

Proximal, symmetrical Painless muscle weakness

26
Q

What is incidence of idiopathic inflammatory myositis?

A

2to 8 per million

27
Q

What are the clinical bio markers you would look for in idiopathic inflammatory myositis?

A

Elevated muscle enzymes CK, LDH, AST/ ALt

28
Q

What are the investigations for IIM

A

MRI, muscle biopsy, EMG

29
Q

What percentage does IIM overlap with other autoimmune diseases?

A

15-20%

30
Q

Dermatomyositis signs?

A 
Gottrons papules 
Nailfolds inflammed
Joint inflammation
Muscle weakness myalgia
Dysphagia
Lung fibrosis
Associated with malignancy
Periorbital helitrope rash

204 (58 decks)

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