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SBL - Exam 2 > Malaise and Generalized Pain > Flashcards

Malaise and Generalized Pain Flashcards

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?

A
  • early SLE - infection
  • late SLE - myocardial infarction
24
Q

morphology of discoid lupus

A

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

25
Q

limited systemic sclerosis

A

​Calcinosis, Raynauds (2°), Esophageal dysmotility, Sclerodactyly, Telangiectasia

  • associated with pulmonary hypertension
  • renal involvement is uncommon
26
Q

diffuse systemic sclerosis

A
  • 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
Q

renal crisis in diffuse sclerosis

A
  1. abrupt onset of malignant HTN
  2. hemolytic anemia
  3. progressive renal insufficiency
28
Q

GI manifestations of scleroderms

A
  • malnutrition
  • GERD –> Barrett’s –> increased risk of esophageal adenoCA
  • gastric antral vascular ectasia (GAVE; watermelon stomach)
29
Q

what treatment is contraindicated in scleroderma?

A

glucocorticoids

  • they may –> renal crisis
30
Q

localized scleroderma

A
  • affects children
  • morphea - discrete areas of discolored skin induration
  • no Raynaud’s and not systemic
31
Q

what other disease is Sjögren’s syndrome associated with?

A

B cell non-Hodgkin lymphoma (MALT lymphoma)

32
Q

what drugs are contraindicated in Sjögren’s syndrome?

A

atropinic (anti-muscarinic) drugs–they will dry the patient out further

33
Q

dermatomyositis

A
  • 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
  • perifascicular atrophy on bx
34
Q

what Abs are associated with dermatomyositis?

A
  • anti-Jo-1
  • anti-Mi2
  • anti-MDA5
  • anti-PI55/PI40
35
Q

when you see a patient with dermatomyositis, what should you do?

A

look for occult malignancy

  • ovarian > lung > pancreatic > stomach > colorectal > non-Hodgkin lymphoma
36
Q

polymyositis

A
  • proximal muscle weakness
  • no skin changes
  • endomysial inflammation on biopsy
37
Q

what Abs are associated with polymyositis?

A

anti-Jo-1

38
Q

what is the treatment for dermatomyositis and polymyositis?

A

corticosteroids

39
Q

inclusion body myositis

A
  • affects males
  • weakness with finger flexion and in the quadriceps
  • biopsy shows endomysial inflammation and rimmed vacuoles
40
Q

what Abs are associated with inclusion body myositis?

A

anti-cN1A

41
Q

Henoch-Sconlein purpura

A
  • 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
Q

anti-glomerular basement membrane (GBM; Goodpasture’s syndrome)

A
  • small vessel disease
  • affects capillaries in the lungs and kidney
  • biopsy shows deposition of anti-basement membrane Abs
43
Q

Takayasu arteritis

A
  • 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
Q

Beçet syndrome

A
  • 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
Q

what is the treatment for Beçect syndrome

A

low dose glucocorticoids

46
Q

polyarteritis nodosa

A
  • 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
Q

Kawasaki disease (mucocutaneous lymph node syndrome)

A
  • medium vessel
  • affects asians < 5 yo
  • fever, LAD, STRAWBERRY TONGUE
  • aneurysm or MI years later –> death
48
Q

what is the treatment for Kawasaki diseaes?

A

IVIG and ASA (even in a peds patient w fever)

49
Q

granulomatosis with polyangiitis (wegener’s granulomatosis)

A
  • 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
Q

what disease is saddle nose associated with?

A

granulomatosis with polyangiitis (wegener’s granulomatosis)

51
Q

asthma + eosinophilia

A

eosinophilic granulomatosis with polyangiitis (Churg-strauss)

52
Q

eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

A
  • asthma + eosinophilia
  • prodromal phase - allergic
  • eosinophilia/tissue infiltration phase
  • vasculitis phase - palpable purpura
53
Q

thromboangiitis obliterans (Buerger disease)

A
  • young males
  • ONLY OCCURS IN SMOKERS
  • treat with smoking cessation
54
Q

how should giant cell (temporal) arteritis be treated?

A

if you suspect GCA, start corticosteroids before biopsy

55
Q

polymyalgia rheumatica

A
  • 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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