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msk and ct - step > pathology - autoimmune > Flashcards

pathology - autoimmune Flashcards

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1
Q

rash
joint pian
fever
female of repro and african

A

SLE

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2
Q

how si the heart invovled in lupus

A 
leibman sacks endocarditis - nonbacterial, wart liek vegetations on both sides of valve
and pericarditis (serositis)
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3
Q

how are the kidneys affected in SLE

A

nephritis- diffuse prolfierative glomerulonpehtiris

neprhotic - membranous gomerulonephtirits

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4
Q

tyep of hypersensitiveit e of SLE

A

type III @ skin, glomeruli/tubules, goints and small vessels

type II @ cytopenias

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5
Q

common causes of :( in SLE

A

cardivascular disease
infections
renal dsiease

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6
Q

why susceptible to infetions?

A

autoimmune hemolytic anaemia - warm IgG extravascular hemoysis
and cytopenais

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7
Q

RASH or PAIN of SLE pease

A 
rash - malar or discoid
arhtirits
soft tissues/seoritis - leuritis and pericarditis
hematogolicy disorders - cytopenias
oral/nasopharyngeal ulcres
renal dsiease
raynouad pneomenon
phostosensitivity
positive VDRL/RPR
antinuclear antibdoies
immunosppressants 
neuslrog - seizures an spsyxhosis
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8
Q

lab findings in sle

A

antinuclear antiboids - senstive but not specific = SCREENING
antidsDNA - renal invovlement and specific - DIAGNOSIS
antiSMith - specifis - DIAGNOSIS
decreased C3 C4 and Ch50 due to immune complex formation

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9
Q

decreased CH50 in SLE?

A

deacreased c3 and c4 due to type III vrs skin, glomeruli/tubules, joitns and small vessels

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10
Q

antibodies foudn in drug induced lupus

A

anti histone

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11
Q

drugs that cause drug induced lupus

A

procainamide

hydralazine

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12
Q

diff in cxpx of drug induced lupus and sle

A

drug induced - seriosits in lugns and heart
arthralgias
fever
anti histone abs
NO ab dsDNA
NO decrease C’
rarely CNS and renal involvment (no dsRNA for renal)

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13
Q

where woudl ics be deposited in skin for sle

A

band liek deposition of IC at the dermal epidermal fuction

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14
Q

how to treat sle

A

nsaids, steroids, immunsupprestants, hydroxychloroquine

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15
Q

what is antiphospholipid syndrome

A

primary or secondary autoimmune disorder in SLE

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16
Q

what is antiphospholipid syndrome asociated with

A

SLE or RA, sjogrens ITP and HIV

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17
Q

dzs associated with:

a) RA
b) OA
c) SLE

A

ra - sjogrens
OA - pseudogout
SLE - antiphospholipid

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18
Q

how to diagnose antiphospholipid syndrome?

A

dx based on history of thromobosis in arterial and venous
spotnarous abortion
and lupus anticoagulat, anticardiolip and anti beta2 glycoprotein

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19
Q

if i say anticardiolipid, anti beta glycoprotein and lupus anticoagulant you think?

A

antiphospholipid syndrome

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20
Q

how to treat antiphospholipid syndrome

A

systemic anticoagulation

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21
Q

how to lupus anticoagulat and cardiolipid abs affect test results in antiphospholipid syndrome

A

lupus anticogulation - increased PTT outside body but acutally cause thrombosis in vivp
cardiolipin - false positive VDRL

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22
Q

where are thrombi foudn in antiphospholipid syndrome

A

venous at calf > renal, ehpatic, axiallry, subclavian, retinal, vena canca, placenta
areterial - can cause strokes

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23
Q 
widespread noncaseating granulomas
increase ACE elvels
increased CD4/CD8 ratio
hypercalcemia
african american women between 20-39
A

saarrrccooiiddoossiiisss

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24
Q

cxpx of sarcoidosis

A

often asymptomatic

enlarged lms

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25
CXR of sarcoidosis
bilateral adenopathy and coarse reticular opaticies
26
ct of sarcoidossi
extensive hilar and mediatstinal adenopathy
27
miscropic sarcoidosis
schaumann bodies - laminated ca concretions | asteroid bodies - stellate infiltrates
28
schaumann bodies
sarcoidosis | laimnated ca concretions
29
asteroid bodies
stellate infiltrates | sarcoidosis
30
what causes hypercalcemia in sarcoidosis
increased 1 alpha-hydroxylase from vitamin D activation in macropahges
31
treatmetn of sarcoidosis
steroids
32
complications fo sarcoidosis
restrictive lung disease lupus pernio erythema nodosum bell palsy
33
restrictive lung dsiease lupus pernio erythema nodosum bell palsy
sarcoidosis
34
pain and stiffness in shoulders and hips
polymylagia rheumatica
35
fever malaise stiffness pain and stiffness in shoulders and hips
polymylagia rheumatica
36
musclar weakness in polylagia rheumatica?
nope. fever, malaise, stiffness and pain in shoulders and hips
37
labs in polymylagia rheumatica
increased ESR increased CRP normal CK (no mustcular weakness)
38
what is polymylagia rheumatica associated with
temporal arterities
39
dzs associated wtih: a) RA b) OA c) polymylagia rheumatica d) SLE
a) ra - sjogren b) oa - pseudogout c) sle - antiphospholipid d) polymylagia rheumatica - temporal arteritis
40
hwo to treat polymylagia rheumatica
rapid response to low dose corticosteroids
41
age fo patient with fibromyalgia?
females 20-50 yaers old
42
chornic widespread musculoskeletal pain associated with stiffness, paresthesias, poor sleep, fatigue
fibromyalgia
43
cxpx fo fibromylagia
chronic widespread msuculoskeletal pain associated with stiffness, paresthesias, poor sleep and fatigue
44
treat fibromyalgia
regular exercise antidepressnats - TCAs and SNRIs anticonvulsants
45
labs of polymyositis and dermatomyositis
``` increased CK (not in polymyalgia rheumatica) positive ANA positive anti Jo-1 positive anti SRP poaisitve anti Mi2 abs jooo srp, me 2 yooo wassup, me 2 ```
46
yoo wassup? me 2
``` abs for polymyositis and dermatomyositis anti jo anti srp anti mi2 ana ```
47
how to treat polymyositis and dermatomyositis
steroids and then long term immunosuppresant tearphy - methotrexate
48
cxpx fo polymyositis
progressive symmetric proximal muscle weakness
49
pathogen of polymyositis
CD8 T cells endomysial inflammation most often in shoulders
50
cxpx for dermatomyositis
progressive symmetric proximal muscle weakness malar rash (liek sle ish) GOTTRON PAPULES, HELIOTROPE/erythematous periorbital rash shawal and face rash mechanis hands
51
what are gottron papules
reddish purple plaques over knuckes and pip | dermatomyositis
52
what are heiotrope eyelids
purplish red eyelid discolouration | dermatomyositis
53
skin deltas seen at dermatomyositis
gottron papules at hands heliotrope at heyes malar rash shawl and face rash
54
pathogenesis of dermatomyositis?
CD4 and perimysial infllmation | ATROPHY
55
atrophy
dermatomyositis
56
no atrophy
polymyositis
57
what is dermatomyositis associated wtih?
increased risk of occult malignancy
58
what has increased risk of osteogenic sarcoma?
paget disease
59
dzs associated with a) pagets b) RA c) OA e) polymylagia rheumatica f) dermatomyositis g) SLE
pagets - osteogenic sarcoma ra - sjogren soa - pseudogout polymylagia rheumatica - temporal arteritis dermatomyositis - increas risk of occult malignancy SLE - antiphospholipid syndrome yaya! good job brain
60
what is the most common NMJ disease
myasthenai gravis
61
pathophsy of MG
autoabs vrs ach receptor | type II
62
cxpx of myasthenai gravis
ptosis, diplopia, weakness that worsens with muscle use
63
what is myasthenai gravis associated with
thymom and thymic hyperplasia bc abs made there
64
a) pagets b) RA c) OA e) polymylagia rheumatica f) dermatomyositis g) SLE h) myasthenia gravis i) lambert eaton
pagets - osteogenic sarcoma RA - sjogrens OA - pseudogout polymyalgia rheumatica - tempral arteritis dermatomyositis - occult maligincnacy risk increases sle - antiphospholipid syndrome myasthenia gravis - thymoma/thymic hyperplasia lambert eaton - small cell lung cam
65
what effect does achase inhibitor have on myasthenia gravis
reversal of symptoms
66
pathophys of lamber eaton
autoabs vrs presynaptic CA channels - decreased ach realse
67
cxpx of lambert eaton
proximal muscle weakness (polymyositis and dermatomyositis), autnomic symptoms - dry mout and impotennce that imptove with mucls use
68
what is lambert eaton associated with
small cell of llung
69
effect of achase inhibitor on lambert eaton
little effect
70
what is myositis ossificans
metaplasia of skeletal muscle into bone following muscular truama
71
where do you most often see metaplasia of skeletal muscle into bone following muscular trauma
myositis ossificans | upper and lower extremity
72
how does myositis ossifican spresent
suspicious mass at site of known trauma or as an incidental finding on radiogtapy
73
what is scleroderma
systemic sclerosis | triad or a) autoimmunity b) noninflammatory vasculopathy and c( collagen deposition with firbosiss
74
sclerosis of skin wtih puffy taut skin without wrinkles dingertip pitting what organs do you worry about?
``` systemic sclerosis/scleroderma renal PULMONARY - cause do f :( cardiovascular git ```
75
autoabs foudn in diffuse scleroderma
anti scl-70 = anti DNA topoisomerase I
76
what aubt ab found in limited scleroderma
anti-centromere abs
77
how does diffuse scleroderma present
widespread skin invovlement rapid progression early viscearl (pulmonary, renal, cardio git) invovlement anti scl-90/anti topoisomerase I abs
78
how does limited scleroderma present
``` limited skin at fingers and face and wtih CREST calcinosis raynaoud phenomenon esophageal dysmotility sclerodactyly telangiectasia more beigin anti-centromere abs ```
79
CREST
limited scleroderma anti centromere Calcinosis, raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia.
80
what is most common cause of :( in scleroderma
resp failure

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