Connective Tissue Disorders CIS - McGowan Flashcards Preview

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Flashcards in Connective Tissue Disorders CIS - McGowan Deck (26)
1

35 y/o AA female, bipolar disease, joint pain and episodic chest pain. ANA positive w/ speckled pattern. Rash on cheeks.

Why chest pain?

Why bipolar disease?

SLE



Psychiatric disorder common in SLE

2

Peri-oral furrowing

Scleroderma

3

Heliotrope rash

Dermatomyositis

4

?

?

5

45 white female, seizures, fatigue, headache, myalgias, arthralgias, LAD. Rash on face worse after being in sun. ANA positive.

Additional serology?

SLE

Anti-dsDNA

Mood/seizure disorder, Photosensitivity

6

Anti-centromere

Means what?

CREST - limited scleroderma

Calcinosis, Raynauds, Esophageal Dismotility, Sclerodactyly, Telangiectasias

7

Anti-topoisomerase I

Diffuse scleroderma

8

Anti-Scl-70

Diffuse scleroderma

9

Anti-Jo-1

Dermatomyositis (check Polymyositis too)

10

43 Hispanic woman, hematuria, myalgias, arthralgias. Cr = 2.2 on lab work. Anti-dsDNA and Anti-Sm positive.

SLE

11

50, AA female, fatigue and perioral lesions, has had intermittent symptoms for years. PMH of CAD, chronic intermittent abdominal pain, Hashimoto's, seizures. Positive ANA and dsDNA.

Most likely mortality? Or?

What is the abdominal pain?

SLE


Atherosclerosis; CKD/ESRD


Intestinal angina

12

Look up Behcet's

a

13

45 W female, chest pain, history of SLE. Positive phospholipid antibodies. 2D echo shows valve thickening and verrucous valvular lesions. Called what?

Nodules are ___, meaning w/o bacteria

Libman Sacks endocarditis

Sterile

14

Signs of sjogrens

Anti-SSA, Anti-SSB
Enlarged parotid gland
Dry eyes, dry mouth
B-cell lymphoma (MALT)

15

Mood disorder, splenomegaly, diffuse LAD, ARF and chest pain that does not improve w/ position. DVT. Proliferative glomerulonephritis. Cotton wool spots.

Antibody? (3)
What is the chest pain?
IF it was affected w/ position?

SLE + Anti-phospholipid antibody syndrome

Beta2GPI, Anti-Cardiolipin, Antiphospholipid

Pleuritis - position doesn't affect it
Pericarditis

16

Anti-histone antibodies

Drug-induced lupus

17

45 white, joint pains, recently had pyelonephritis. Discharged on hydralazine for BP and Cipro for infection. Developed malar rash on discharge and diffuse joint pains.

Serology?

Drug-induced lupus

Anti-Histone Ab

18

25 Hispanic female, SLE, 16 weeks pregnant. Swelling in legs and elevated BP. Fetal echo shows complete heart block in fetus. Serology in mother?

Swelling and high BP?

What is with this?

These antibodies usually show up in what?

Anti-Ro(SSA) Ab

Preeclampsia

Anti-Ro antibody means high risk of fetal issues

Sjogren's

19

45 white female, finger stiffness. Hard white nodules on fingers. Fingers will go blue sometimes. Perioral furrowing w/ red spots on lips and tongue

What else could go with this?

CREST syndrome

Esophageal dysmotility

20

43 female, dyspnea, gets SOA quickly. Hx of GERD, Raynauds, and carpal tunnel. CXR shows mediastinal LAD and honeycombing. Dry crackles on lung exam. Topoisomerase I Ab positive.

Cause of SOB?

Diffuse scleroderma


Interstitial lung disease

21

Pulmonary artery hypertension...think what disease?

Limited scleroderma - CREST

22

Wet crackles

CHF

23

30 AA female, dry itchy skin. Coal miner. Fingers and mouth feel tight. Having difficulty eating. White patches on skin and is self conscious. Ends of fingers have sores. Frequent heartburn.

Most likely etiology?

Other possible etiologies? (4)

Scleroderma


Silica - Silicosis


Cocaine, HRT, Appetite suppressants, Bleomycin

24

30 AA male, fatigue, stiffness, malaise. Muscle weakness, arthralgia. Hx of Raynauds and carpal tunnel. Confusion and HTN. Protein, blood, and granular casts in urine. Anti-centromere Ab negative. RNA pol's 1 and 3 Ab positive.

What is the confusion?

Treatment?

Scleroderma Renal Crisis

Hypertension encephalopathy


ACEI, steroids

25

7 yo female w/ spot on face. Has been there for weeks. Heathy otherwise.

Called what?

Localized scleroderma

Morphea

26

60, female, facial swelling. Dry eyes, dry mouth, face swollen. Enlarged cheeks.

At risk of developing what?

Sjogren's

Thrush