Chapter 41 - Rheumatologic Disease Flashcards Preview

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Flashcards in Chapter 41 - Rheumatologic Disease Deck (14):

Which hepatic disease has been associated with anticentromere antibodies?

Primary biliary cirrhosis


Which auto-antibody is most associated with neonatal lupus?

Anti-Ro, but also anti-La


Which three antibodies are most closely associated with Sjogren's syndrome?

Alpha-fodrin, Ro, and La
*Alpha-fodrin auto-antibodies are more common that Ro and La auto-antibodies


Which two auto-antibodies are most closely associated with rheumatoid arthritis?

Rheumatoid factor and anti-cyclic citrullinated protein (CCP) antibodies
*Anti-CCP targets citrullinated proteins in the skin (e.g. fillagrin) and joints


What is the molecular target of rheumatoid factor?

Fc portion of IgG


What symptom or sign of SLE is dsDNA autoantibody associated with (i.e. which type of organ dysfunction)?

Lupus nephritis
*dsDNA can also be used to monitor SLE disease activity


Which 3 autoAb have the highest specificity for SLE?

Anti-dsDNA, Sm, rRNP


What serologic marker is common amongst all AI CTDs (ie. SLE, RA, SSc, dermatomyopathy)?

U1RNP, which also defines the concept of mixed CTDs


What are some drugs that can cause drug induced ANA/SLE?

Procainamide, hydralazine, isoniazid, chlorpromazine, phenytoin, methyldopa, minocycline, TNF-alpha inhibitors


What are the signs and symptoms of drug induced ANA/SLE?

MSK (arthritis, arthralgia, myalgia), serositis (pleuritis, pericarditis), positive ANA, positive anti-dsDNA, skin findings (malar rash, SCLE, DLE, photosensitivity and purpura), phlebitis (with anticardiolipin antibodies), leukopenia, thrombocytopenia, general manifestations (fever, weight loss, asthenia)


Does age have an effect on ANA levels?

Yes, up to 15% of otherwise healthy individuals of >55yo can be found to have a significantly elevated ANA titer of no apparent clinical consequence


What type of bloodwork would you order for a patient who you SUSPECT has an AI CTD?

ANA. Then anti-dsDNA, anti-Sm, CBCd, Cr, albumin, total protein, ESR, U/A, C3, C4


What pattern of nucelar immunofluorescence may be clinically significant?

Centromeric/discrete speckled pattern, which is specific for Ab to chromosomal centromers (CENP-B) seen in CREST sydrome


Other than Wegener's granulomatosis, what else may C-ANCA correlate with?

Cystic fibrosis, perform sweat test