Musculoskeletal, Skin, and connective tissue Flashcards
Systemic Lupus erythematosus
Classic Presentation: rash, joint pain, fever. most commonly in female of reproductive age, and African descent
-associated with Libman sacks endocarditis, wart like vegetations on both sides of valve
Lupus nephritis (Type III hypersensitivity reaction)
-Nephritic- diffuse proliferative glomerulonephritis
-Nephrotic-membranous glomerulonephirits
RASH OR PAIN
Rash
Arthritis
Soft tissues/serrositis
Hematologic disorders(cytopenia
Oral/nasopharyngeal ulcers
Renal disease, Raynaud phenomenom
Photosensitivity, Positive VDRL/RPR
Antinuclear antibodies
Immunosuppressants
Neurologic disorders(seizures, psychosis)
Treatment- NSAIDS, steroids, immunosuppressants, hydroxychloroquine
common Cause of Death- CVD, Infections, renal disease
SLE Findings
ANA sensitive, not specific
Anti dsDNA antibodies, specific, poor prognosis
Anti smith antibodies- specific, but not prognostic (directed against snRNPs)
Antihistone antibodies- sensitive for drug induced lupus
Anticardiolipin antibodies- false positive test for syphilis, prolonged PTT (paradoxically, increase risk of arteriovenous thromboembolism).
decreased C3, C4 and CH50 due to immune complex formation
alternative SLE pneumonic
IM DAMN SHARP Immunoglobulins Malar Rash-involves malar eminence and bridge of the nose Discoid Rash Anti-nuclear antibody- elevated but non specific mucousitis Neurologic disorders Serositis Hematologic disorders Arthritis- two or more peripheral joints Renal disorders Photosensitivity
Seronegative spondyloarthropathies
psoriatic arthritis, ankylosing spondylitis, inflammatory bowel disease, reactive arthritis. PAIR
arthritis without Rheumatoid factor, strong association with HLA b27 that codes for HLA MHC class 1- occurs more often in males.
inflammatory bowel disease
crohn disease and ulcerative colitis are often accompanied by ankylosing spondylitis or peripheral arthritis
