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SBL - Exam 2 > Malaise and Generalized Pain > Flashcards

Malaise and Generalized Pain Flashcards

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1
Q

what Abs are associated with SLE?

A
  • anti-dsDNA - correlates with disease activity
  • anti-Smith - does not correlate with disease activity
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2
Q

what Abs are associated with drug-induced SLE?

A

anti-histone Ab

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3
Q

what Abs are associated with Sjögren’s syndrome?

A
  • anti-Ro
  • anti-La
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4
Q

what Abs are associated with limited systemic sclerosis?

A

anti-centromere

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5
Q

what disease is associated with polymyalgia rheumatica?

A

giant cell (temporal) arteritis

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6
Q

what disease is associated with giant cell (temporal) arteritis?

A

polymyalgia rheumatica

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7
Q

what disease is associated with hepatitis B infection?

A

polyarteritis nodosa

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8
Q

what Abs are associated with diffuse scleroderma?

A
  • anti-Scl70 (anti-DNA topoisomerase I)
  • anti-RNA polymerase III
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9
Q

what Abs are associated with rheumatoid arthritis?

A

anti-CCP (cyclic citrullinated peptide)

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10
Q

homogenous staining patterns are seen with what diseases?

A
  • drug-induced SLE
  • Sjögren’s syndrome
  • SLE
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11
Q

speckled staining patterns are associated with what diseases?

A
  • Sjögren’s syndrome
  • diffuse systemic sclerosis
  • SLE
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12
Q

centromere staining patterns are associated with what disease?

A

limited systemic sclerosis (CREST)

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13
Q

nuclolar staining patterns are associated with what diseass?

A
  • diffuse systemic sclerosis
  • SLE
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14
Q

what demographics are associated with SLE?

A
  • females
  • african americans
  • poor without insurance
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15
Q

what are clinical manifestations of SLE?

A
  • malar rash, photosensitivity
  • arthritis
  • thrombosis
  • atherosclerosis –> MI, pericarditis, libman-sacks endocarditis (vegetations are thrombi)
  • nephritis
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16
Q

what is primary antiphospholipid antibody syndrome?

A

seen in pateints without SLE

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17
Q

type 1 antiphospholipid Abs

A

cause a false positive for syphylis (VLDR or RPR tests)

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18
Q

type 2 antiphospholipid Abs

A

lupus anticoagulant

  • incrase risk for thrombosis and miscarriage
  • prolongs aPTT
  • check for Abs with DRVVT
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19
Q

type 3 antiphospholipid Abs

A

anti-cardiolipin Abs

  • β2GPI Ab
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20
Q

what diseases are associated with cotton wool spots?

A
  • SLE
  • antiphospholipid antibody syndrome
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21
Q

what complications can be seen in babies from mothers with Ro or La (Sjögrens) Abs?

A

permanent complete heart block

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22
Q

what is the treatment for SLE?

A
  • avoid the sun
  • NSAIDs
  • corticosteroids
  • hydroxychloroquine
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23
Q

what is the primary cause of death in early and late SLE?

Study These Flashcards
A
  • early SLE - infection
  • late SLE - myocardial infarction
24
Q

morphology of discoid lupus

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A

well-defined inflammatory plaques that evolve into atrophic, disfiguring scars

25
limited systemic sclerosis
**​C**alcinosis, **R**aynauds (2°), **E**sophageal dysmotility, **S**clerodactyly, **T**elangiectasia * associated with pulmonary **_hypertension_** * renal involvement is uncommon
26
diffuse systemic sclerosis
* infammatory edematous phase --\> fibrotic phase * loss of eccrine/sebaceous glands --\> dry, itchy skin * fibrotic joint --\> **stiffness** * ​**carpal tunnel** * Raynaud's presents **_later_** * associated with **_interstitial lung disease_** * renal crisis is common
27
renal crisis in **diffuse** sclerosis
1. abrupt onset of malignant HTN 2. hemolytic anemia 3. progressive renal insufficiency
28
GI manifestations of scleroderms
* malnutrition * GERD --\> Barrett's --\> increased risk of **esophageal adenoCA** * gastric antral vascular ectasia **(GAVE; watermelon stomach****)**
29
what treatment is contraindicated in scleroderma?
glucocorticoids * they may --\> renal crisis
30
localized scleroderma
* affects **_children_** * **morphea** - discrete areas of discolored skin induration * **no** Raynaud's and **not** systemic
31
what other disease is Sjögren's syndrome associated with?
B cell non-Hodgkin lymphoma (MALT lymphoma)
32
what drugs are contraindicated in Sjögren's syndrome?
atropinic (anti-muscarinic) drugs--they will dry the patient out further
33
dermatomyositis
* weakness w/o sensory symptoms * characteristic lesions * _grotton's patches_ - violaceous lesions on the DIP, PIP, and MCP * **_helitrope rash_** * _poikiloderma_ - "shawl sign", v-neck erythema * _increased risk of **OCCULT MALIGNANCIES**_ * peri**fascicular** atrophy on bx
34
what Abs are associated with dermatomyositis?
* **anti-Jo-1** * anti-Mi2 * anti-MDA5 * anti-PI55/PI40
35
when you see a patient with dermatomyositis, what should you do?
look for **occult malignancy** * **ovarian** \> lung \> pancreatic \> stomach \> colorectal \> non-Hodgkin lymphoma
36
polymyositis
* proximal muscle weakness * **no skin changes** * **endo**mysial inflammation on biopsy
37
what Abs are associated with polymyositis?
anti-Jo-1
38
what is the treatment for dermatomyositis and polymyositis?
corticosteroids
39
inclusion body myositis
* affects **males** * weakness with **finger** flexion and in the **quadriceps** * biopsy shows **endo**mysial inflammation and **rimmed vacuoles**
40
what Abs are associated with inclusion body myositis?
anti-cN1A
41
Henoch-Sconlein purpura
* small vessel disease * affects **kids** * often preceded by a **URI w/ streptococcus** * tetrad of 1. **palpable purpura - no thrombocytopenia** 2. arthritis/arthralgia 3. abdominal pain --\> intussiception 4. renal disease * **IgA deposits** seen on biopsy
42
anti-glomerular basement membrane (GBM; Goodpasture's syndrome)
* small vessel disease * affects capillaries in the lungs and kidney * biopsy shows deposition of **anti-basement membrane Abs**
43
Takayasu arteritis
* large vessel (aorta) * **_asian_ women \< 40 yo** * long, tapered stenosis --\> "pulseless disease" * --\> aortic dilations, regurg, aneurysm, and rupture * renal artery stenosis --\> HTN --\> **copper wire** retinopathy * biopsy shows **granulomas** w **giant cells**
44
Beçet syndrome
* triad of * **recurrent mouth ulcers** * genital ulcers * eye inflammation * mimics multiple sclerosis * ulcers in distal ileum or cecum * **_pathergy_** - pustules at site of needle pricks * associated with **HLA-B51**
45
what is the treatment for Beçect syndrome
low dose glucocorticoids
46
polyarteritis nodosa
* **segmental** involvement * associated with **_hepatitis B virus_** * skin shows **livedo reticularis,** distal gangrene * --\> vasculitis **neuropathy** and **_foot drop_** * **_THE LUNGS ARE SPARED_** * biopsy shows _fibrinoid necrosis_ and no granulomas
47
Kawasaki disease (mucocutaneous lymph node syndrome)
* medium vessel * affects **asians \< 5 yo** * fever, LAD, **STRAWBERRY TONGUE** * aneurysm or MI _years later_ --\> death
48
what is the treatment for Kawasaki diseaes?
IVIG and ASA (even in a peds patient w fever)
49
granulomatosis with polyangiitis (wegener's granulomatosis)
* seen in **males \> 40 yo** * **​**biopsy shows **granulomatous** inflammation, necrotizing vasculitis, and segmental glomerulonephritis * --\> hearing loss, VTE * involves the **respiratory tract** * **_NASAL_** _involvement - **saddle nose**_
50
what disease is saddle nose associated with?
granulomatosis with polyangiitis (wegener's granulomatosis)
51
asthma + eosinophilia
eosinophilic granulomatosis with polyangiitis (Churg-strauss)
52
eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
* **_asthma + eosinophilia_** * prodromal phase - allergic * eosinophilia/tissue infiltration phase * vasculitis phase - **palpable** purpura
53
thromboangiitis obliterans (Buerger disease)
* young **males** * **_ONLY OCCURS IN SMOKERS_** * treat with smoking cessation
54
how should giant cell (temporal) arteritis be treated?
if you suspect GCA, start corticosteroids **before** biopsy
55
polymyalgia rheumatica
* presents with stiffness, soreness, and pain * **weakness** d/t pain * **_its not true weakness_** * trouble combing hair, putting on coat

SBL - Exam 2 (5 decks)

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