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Flashcards in Rheumatology Deck (35)
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31

What is the difference between limited systemic sclerosis and diffuse systemic sclerosis?

Limited systemic sclerosis:
Skin involvement limited to the face, hands and feet.
Anti centromere antibodies
CREST syndrome is part of it: Calcinosis, Raynaurds, Esophageal and gut dysmotility, Sclerodactyly and Telangiectasia

Diffuse systemic sclerosis:
Can be whole body, and organ fibrosis.
Anti topoisomerase 1 (Scl70) antibodies and anti RAN polymerase.

32

What is the difference between polymyositis and dermatomyositis?

Polymyositis is progressive symmetrical proximal muscle weakness from striated muscle inflammation.
The muscle weakness can cause dysphagia and dysponia but NEVER dysphasia.

Dermatomyositis is myositis that is associated with skin signs.
Macular rash (shawl sign if over back and shoulders), helliotrope rash on eyelids, nailfold erythema, roughed red papules on knuckles, knees and elbows (Gottron's papules)

Both with have raised muscle enzymes and associated with anti-Mi2 and anti Jo1 antibodies.

EMG shows spontaneous fibrillation potentials at rest, polyphasic potentials on contraction.

33

Which vasculitis are ANCA +ve?

Microscopic polyangitis,
Wegener's granulomastosis: airways disease (nasal obstruction, epistaxis) renal disease( haemtauria with crescent formation) pulmonary involvement
Churg-strauss syndrome: late onset asthma, eosinophilia, and granulomatous small vessel vasculitis affecting the lungs, nerves heart and skin

34

Which vasculitis are ANCA -ve?

HSP,
Goodpastures: Pulmonary renal syndrome, acute glomerulonephritis plus pulmonary symptoms.

35

What is polyarteritis nodosa?

It is a medium vasculitis causing aneurysms and thrombosis leading to infarction of the affected organs.
May be associated with Hep B