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Immune System > A clinical approach to autoimmunity > Flashcards

A clinical approach to autoimmunity Flashcards

1
Q

What does ARD stand for?

A

Autoimmune Rheumatic disease

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2
Q

What happens in ARDS?

A

A breakdown of immune tolerance

produces pathogenic antibodies

Multisystemic features

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3
Q

What is the importance of autoantibodies?

A

Aid to diagnosis

Associated with specific clinical feature

Disease prognosis

To stratify therpy

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4
Q

What does she have?

A

Shoguns

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5
Q

An 25yr old Afro-Caribbean lady goes to her GP with a recurrent history of painful hand joints for the last 18 months. She has a 3 year history of raynauds. She had missed a few days at work due to pleuritic chest pain. She is complaining of disabling fatigue. What is the likely diagnosis?

A

Systemic lupus erthyematosus?

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6
Q

Who is more likely to have systemic lupus erthematosus?

A

Afro caribeean females

Genetic and environmental factors are important

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7
Q

How would you take a history for ARDs?

A

Current symptoms

  • Pain
  • Stiffness
  • Swelling
  • Patternofjointinvolvement

Evolution

  • Acute or chronic?
  • Associated events
  • Responsetotreatment/Familyhistory

Involvement of other systems

  • Skin,eye,lung
  • Malaise,weightloss,fevers,nightsweats?

Impact on patient’s lifestyle

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8
Q

What are constitutional symptoms?

A

Fever

Fatigue

Weightloss

Night sweats

poor appetite

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9
Q

What is the gloves part of gloves and sweater approach?

A

Raynauds

Joint pains and swelling

Hand rash

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10
Q

What is the sweater part of gloves and sweater?

A

Proximal muscle weakness > Myalgia Hair loss
Eye and mouth dryness
Nose bleeds

Mouth ulcers
Pleuritic chest pain

Pericardial pain
Truncal Rash/Photosensitivity

Limb weakness

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11
Q

What is a palendrome?

A

When goes from shoulder, elbow, wrist, wrist, elbow, shoulder

Palendronic arthritis

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12
Q

What would you examine in ARDs?

A
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13
Q

What investigations would you do for ARDs?

A

C reactive protein would be normal

check for autoantibodies- aids diagnosis

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14
Q

With Systemic lupus erthematosis (lupus) what would you see on examination?

A
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15
Q

What would the bloods be like in lupus?

A

low WCC, ANA 1:1600 and anti-Sm antibodies

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16
Q

What is A RASH POINts Medical Diagnosis?

A

ANA positive

Renal abnormalities

Arthralgia/arthritis

Serositis

Haematologic abnormalities

Photosensitivity

Oral ulcers

Immunological abnormalities

Neuologic abnormalites

Malar rash/discoid rash

4/11= definite lupus

17
Q

An 25yr old south Asian lady goes to her GP with a recurrent history of painful bilateral hand joints for the last 3 months. She has no past medical history of note. She has missed a few days at work due to increasing joint pain and swelling also affecting her feet. She is complaining of disabling fatigue.

What is the likely diagnosis?

A

Rheumatoid arthritis

18
Q

Who is most likely to have Rheumatoid arthritis?

A

Females

no race predilection

Genetic factos/environmental factors

19
Q

How would you take a history for RA?

A

Current symptoms

  • Pain
  • Stiffness
  • Swelling
  • Patternofjointinvolvement

Evolution

  • Acute or chronic?
  • Associated events
  • Responsetotreatment/Familyhistory

Involvement of other systems

  • Skin,eye,lung
  • Malaise,weightloss,fevers,nightsweats?

Impact on patient’s lifestyle

20
Q

What is the starting point for reynards?

A

spasm

White

cyanotic- blue

red

21
Q

What would you see on examination of RA?

A

200IU and anti ccp>340

22
Q

What investigations would you do for RA?

A
23
Q

What is the classification RA?

A

At least 10 joints

serology high positive

greater than 6 is defo RA

24
Q

What is the treatment for lupus?

A

Patient education- lifesytle modifications and suncream use

DMARDs

Steroids

severe cases- IV Cyclophophamide

25
Q

What is the treatment for RA?

A

DMARDs asap

steroids

combination therapy

26
Q

What is the role of a rhematologist?

A

Prompt diagnosis of patients with suspected ARDs/non-ARDs

Oversee use of DMARDs

Holistic long term managment of patients with ARDs

27
Q

What are DMARDs?

A

Disease modifying anti-rheumatic drugs

28
Q

What is the prevalence of RA?

A

1% of population

quite common

1 in 100 people have it

Immune System (6 decks)

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