autoimmune disorders

Question 1

what type of hypersensitivity is associated with SLE ?

Answer 1

Type 3

Question 2

what are the serological tests used for the identification of SLE ?

Answer 2

ANA non specific
Anti DsDNA specific
Anti smith

Question 3

what is anti smith directed against ?

Answer 3

snRNP

Question 4

what are all the penias in SLE due to ?

Answer 4

type 2 hypersensitivity reaction

Question 5

which type of lupus nephropathy is the most common type in SLE ?

Answer 5

diffuse proliferative GN
which presents as nephritic syndrome

Question 6

what type of endocarditis is associated with SLE ?

Answer 6

libman sacks endocarditis

Question 7

what is very distinctive about libman sacks endocarditis ?

Answer 7

affects both sides of the valve

Question 8

what are the three clinical consequences of antiphospholipid antibody ?

Answer 8

antiphospholipid syndrome
increased PTT
false positive syphillis

Question 9

what are the three types of antiphospholipid antibodies ?

Answer 9

anti cardiolipin
lupus anticoagulant
anti b2 glycoprotein

Question 10

what other disease is associated with anti-cardiolipin ?

Answer 10

syphillus

Question 11

which antibody is associated with a false elevation of PTT ?

Answer 11

lupus anticoagulant

Question 12

which antibody is associated with drug induced lupus ?

Answer 12

anti histone ab

Question 13

which drugs are associated with drug induced lupus ?

Answer 13

isoniazid
hydralaziine
procinamide

Question 13

what is the pathophysiology in rheumatoid arthritis ?

Answer 13

inflammation of the synovium due too TNF and IL 6
Type 3 HS
causing the formation of pannus

Question 14

what is the classical presentation of RA ?

Answer 14

symmetrical joint inflammation
MCP
PIP
but the DIP is spared
Ulnar deviation
Swan Neck deformity - Hyperextended PIP , hyper flexed DIP

Question 15

what antibodies are associated with RA ?

Answer 15

RF ( seroo positive)
anti-ccp

Question 16

whats the target for RF ?

Answer 16

Fc portion of IgG Ab

Question 17

what HLA is associated with RA ?

Answer 17

HLA-DR4

Question 18

what are the long term complications of RA ?

Answer 18

osteoporosis
increased risk of coronary heart disease
secondary amyloidosis

Question 19

what drugs are used for the treatment of RA ?

Answer 19

steroids
NSSAIDS
DMARDS

Question 20

what is the function of infliximab ?

Answer 20

a monoclonal antibody which is directed against TNF alpha

Question 21

what is the problem with the se of infliximab ?

Answer 21

there is a risk of reactivation off TB so a PD test must be done before administration

Question 22

what is thee function of etanercept ?

Answer 22

acts as tumor necrosis factor inhibitor

Question 23

what is felty syndrome ?

Answer 23

rare complication of RA
splenomegaly
anemia
thrombocytopenia
arthiritis

Question 24

what is thee pathophysiology of scleroderma ?

Answer 24

fibroblast activation leading to excess collagen deposition

Question 25

what are the 2 clinical syndromes associated with scleroderma ?

Answer 25

diffuse limited CREST Calcinosis Raynauds Oesophageal motility sclerodactyly telengectasia

Question 26

what is the main risk associated with limited scleroderma ?

Answer 26

pulmonary disease

Question 27

how is renal crisis in association with diffuse scleroderma treated ?

Answer 27

ACE inhibitor

Question 28

what are the antibodies associated with diffuse scleroderma ?

Answer 28

anti scl 70 which is ant topoisomerase 1 anti RNA polymerase II

Question 29

which antibody is associated with limited scleroderma ?

Answer 29

anti centromere

Question 30

if a patient with scleroderma starts presenting with fatigue itching and jaundice what is the most likely diagnosis ?

Answer 30

primary biliary cirrhosis

Question 31

what are the antibodies associated with sjogren syndrome ?

Answer 31

anti ro anti la

Question 32

biopsy off salivary gland off patient with sjogren ?

Answer 32

lymphocytic sialadenitis

Question 33

how do we treat sjogren ?

Answer 33

muscarinic agonists

Question 34

what is the test for thee sicca symptoms of sjogren ?

Answer 34

schrimer test salivary gland scintigraphy

Question 35

if a patient with sjogren presents with persistent unilateral swelling what is this a sign off ?

Answer 35

most probably a b cell lymphoma

Question 36

what are the large vessel vasculitis ?

Answer 36

temporal arteritis takayasu arteritis

Question 37

what are the medium vessel vasculitis ?

Answer 37

polyarteritis nodosa kawasaki disease beurgers disease

Question 38

what are the small vessel vasculitis ?

Answer 38

churg strauss wegners granulomatosis microscopic polyangitis henoch- schonlein purpra

Question 39

what is the main symptom associated with vasculitis ?

Answer 39

palpable purpra do not blanch on pressure

Question 40

what are thee consequences of untreated temporal arteritis ?

Answer 40

blinndness due to affection of the occcular artery

Question 41

where is the affection in takayasu arteritis ?

Answer 41

aortic arch with granulomatous thickening

Question 42

what is thee presentation of takayasu arterritiis ?

Answer 42

weak unilateral pulses BP difference between arm and legs

Question 43

what is thee presentation in kawasaki disease ?

Answer 43

young asian kids strawberry tongue

Question 44

what is the feared complication in kawasaki disease ?

Answer 44

coronary aneurysm

Question 45

what is the treatment for kawasaki ?

Answer 45

IVIg aspirin

Question 46

what disease is commonly confused with kawasaki diseease ?

Answer 46

scarlet disease but the difference is that thee patent present with a sore throat before thee presentation of the strawberry tongue

Question 47

what is thee presentation of reye syndrome ?

Answer 47

encephalopathy confusion often coma after the administration of reye syndrome

Question 48

what group is more liable to get beurgers disease ?

Answer 48

male smokers thromboangitis obliterans

Question 49

what disease is associated with polyarteritis nodosa ?

Answer 49

hepatitis B

Question 50

what is the pathophysiology off polyarteritis nodosa ?

Answer 50

type 3 Hypersenitivty

Question 51

what sign is oft3en seen with polyarteritis nodosa ?

Answer 51

rosary sign seen on arteriogram

Question 52

what is the other name for pANCA and ANCA ?

Answer 52

pANCA - PR3 cANCA - MPO

Question 53

which vasculitis is pANCA and which are cANCA ?

Answer 53

cANCA - Wegner pANCA - Churg Straus microsccopic polyangitis

Question 54

what is thee presentation of churg strauss ?

Answer 54

asthma for thee first time as an adult bizarre presentation of asthma sinusitis and neuropathy

Question 55

what labs are associated with churg strauss ?

Answer 55

high eosinophils high IgE p-ANCA

Question 56

what is the presentation off wegners granulomatosis ?

Answer 56

triad off hemoptysis sinusitis otitis media inflammation of the upper airway and kidney involvement

Question 57

what is thee classic case of polyarteritis nodosa ?

Answer 57

a patient with hep b that starts presenting with neuropathy and renal failure

Question 58

what is seen on biopsy of polyarteritis nodosa ?

Answer 58

fibrinoid necrosis

Question 59

what is the pathophysiology fo henoch schonlein purpra ?

Answer 59

IgA associated nephropathy with C3 complement deposition

Question 60

what i9s the classic presentation of henoch scchonlein purpra ?

Answer 60

childhood vasclitis URI Melena

Question 61

what do all ANCA diseases have in common ?

Answer 61

they all have some form of lung and renal involvement the renal involvement is cresenteric RPGN

Question 62

what is seen on IF in cresenteric RPGN ?

Answer 62

paucimmune ( lack of Ig )

Question 63

what is the presentation off microscopic polyangitis ?

Answer 63

just like wegner but no upper airway affection

Question 64

what is the pathophysiology of goodpasteur syndrome ?

Answer 64

type 2 hypersenitivity anntibodyy too collagen type 4 anti basement membrane immunoflurosence is positive