MSK-connective tissue diseases

Question 1

which antibody is positive for drug-induced lupus

Answer 1

anti-histone antibodies

Question 2

SLE highly positive antibody

Answer 2

ANA

Question 3

SLE highly specific antibodies

Answer 3

anti-dsDNA and anti-sm (smith)

Question 4

first line treatment SLE

Answer 4

hydroxychloroquine

Question 5

what is Schirmers test

Answer 5

ocular dryness: Demonstrates reduced tear production using a strip of filter paper on the lower eyelid, with wetting of <5 mm being positive

Question 6

Sjögren’s syndrome complication

Answer 6

ignificantly increases the risk of lymphoma in affected glands and organs (in particular, B-cell lymphoma)

Question 7

Sjögren’s syndrome specific antibodies

Answer 7

Anti-Ro and Anti-La

Question 8

which type of hypersensitivity reaction is SLE

Answer 8

type III

Question 9

first line treatment for Raynaud’s

Answer 9

calcium channel blocker eg nifedipine

Question 10

limited sclerosis

Answer 10

limited to hands, feet, forearms, face. Raynaud’s usually present before onset of skin symptoms

Question 11

diffuse sclerosis

Answer 11

thickening of skin can occur everywhere. Skin symptoms usually occur simultaneously with Raynaud’s

Question 12

limited sclerosis antibody

Answer 12

anti-centromere

Question 13

diffuse sclerosis antibody

Answer 13

anti-SCL and anti-RNA

Question 14

Systemic sclerosis limited CREST

Answer 14

Calcinosis
Raynaud’s
Esophageal dysfunction
Sclerodactyly
Telangiectasias

Question 15

what is calcinosis

Answer 15

calcium deposits in skin

Question 16

what is sclerodactyly

Answer 16

thickening and tightening of the skin of the fingers and hands

Question 17

what is telangiectasias

Answer 17

dilation of capillaries causing red marks on surface of skin

Question 18

SLE abnormalities on blood test

Answer 18

lymphopenia (low lymphocyte count)
thrombocytopenia
leukopenia
haemolytic anaemia

Question 19

what is livedo reticularis

Answer 19

blood clots in capillaries lead to swelling of venules, resulting in a purplish, net-like discolouration of the skin
mottled, lace-like rash usually found on the lower limbs

Question 20

which type of hypersensitivity reaction is sjogrens syndrome

Answer 20

type IV

Question 21

signs presenting with sjogrens syndrome

Answer 21

bilateral parotid gland enlargement
Dental caries, oral candidiasis and fissured tongue often occur

Question 22

anti-phospholipid syndrome antibodies

Answer 22

1. anticardiolipin antibodies
2. anti-β2-GPI antibodies
3. positive lupus anticoagulant assay

Question 23

SLE bloods complements

Answer 23

low C3 and C4

Question 24

recommended treatment through pregnancy for patients with anti-phospholipid syndrome

Answer 24

low-molecular weight heparin and low-dose aspirin

Question 25

diagnosis of APS can be made when ...

Answer 25

positive antibody results on two different occasions at least 12 weeks apart

Question 26

how many patients with SLE will have renal involvement at presentation

Answer 26

up to 50%, up to 60% during course of disease

Question 27

what is sjogrens syndrome

Answer 27

autoimmune condition affecting exocrine glands, characterised by lymphocytic infiltrates