8. CTD Flashcards
(20 cards)
General features of CTD
Fatigue. fever, anorexia, weight loss, lymphadenopathy, depression
Clinical fx of polymyositis and dermatomyositis
Muscles will have proximal weakness ( SYMMETRICAL), typically deltoid and hip flexors are affected.
DM: May have rash in photosensitive areas, eyelids, forehead. helitotrope rash ( on the upper eyelids, sometimes accompanied by eyelid oedema) . Shawl sign. Gottron’s papules on fingers, knees. May have dilated capillary loops
May have raynauds
May have dysphagia and polyarthritis
May have nail signs
How to dx myositis
ELEVATED CPK, abmormal EMG and MRI ( done first before BIOPSY- gold standard)
What Abs are likely +ve in myositis
ANA +Ve, may have Anti Mi-2 ab and Antip155/140 ab
How to treat PM and DM
High dose of predni
metho,aza, cyclo A
IV IG
Fx supporting diagnosis of SLE
Alopecia, raised blood pressure, synovitis
Abs in SLE
ANA, Anti ds-DNA, complemetn, anti smith
Lifestyle for SLE
Should stop smoking, avoid sunlight as it may precipitate flare, be in remission for 2 years before being pregnant,
Sx that prompt SLE pts being reviewed with renal spec
Blood and protein ( exclude UTI), urine casts, severe headaches
What to do if SLE pts presents to clinic with malaise, fever, mouth ulcers and joint pain
Check urine for blood and protein and take blood pressure
Possible hand signs suggest
Early systemic sclerosis, severe inflammatory arthritis
What drugs for lupus
CS and HCQ (skin and joints_ , NSAIDs, metho for arthritis and aza for more general disease
Ritu if refractory and belimumab
Sx of lupus
Fatigue (assoc with sec fibromyalgia), fever, myalgia, weight loss, raynaud’s, alopecia, athralgia and oral ulcers, symmetrical BUT NON-ERSOIVE SYNOVITIS. May have tendon involvement, ulnar deviation, ligament stretching
Lung fx of lupus
Pleurisy, PE, infxn, pneumonitis (Fever, cough, SOB), chronic ILD, pulmonary hypertension
Cardiac features of SLE
Pericarditis, myocvarditis, endocarditis, CAD
Rashes in SLE
Apart from malar rash with photosdensitivity, may also have vasculitic rashes- purpura, petechiae etc.
Neurological sx of lupus
Headache, stroke, seizure, cognitive dysfx, psychosi, chorea, neuropathy, transverse myelitis
How to manage APLS
Warfarin for those with thrombosis. Aspitin +/- LMW Heparin in pregnancy
Mx of Fibromyalgia
aerobic exercise: has the strongest evidence base
cognitive behavioural therapy
medication: pregabalin, duloxetine, amitriptyline
Sx of Fibromyalgia
widespread pain throughout the body with tender points at specific anatomical sites
chronic pain: at multiple site, sometimes ‘pain all over’
lethargy
cognitive impairment: ‘fibro fog’
sleep disturbance, headaches, dizziness are common
