Sclerosis

Question 1

generalized - systemic sclerosis (findings)

Answer 1

ANA+

• Anti-topoisomerase (Scl-70) +
• Anti RNA polymerase III (poor px, more renal crisis/skin thickening/cancer)

Question 2

limited - CREST

Answer 2

Anti-centromere + (higher HTN rate)

Question 3

plus muscles - dermatomyositis (polymyositis + skin changes)

Answer 3

Mi2 (polymyositis + skin changes)
Anti-Jo-1+ (polymyositis)
Anti-PM-1

Question 4

for skin manifestations, treatment of tight face and small mouth?

Answer 4

methotrexate

Question 5

Tx for:

symmetric arthritis, MCP

Answer 5

NSAIDS –> MTX

Question 6

Tx for:

tendon friction rub

Answer 6

MTX

Question 7

Raynaud phenomenon

Answer 7

avoid cold –> calcium channel blockers (nifedipine)

Question 8

Tx Lungs:

Interstitial pneumonitis, interstitial fibrosis/Pulmonary HTN?

Answer 8

Interstitial pneumonitis, interstitial fibrosis - high res CT scan –> MYCOPHENOLATE MOFETIL preferred over cyclophosphamide

Question 9

Tx renal:
renal crisis (HTN, proteinuria, edema)
what precipitates it?

Answer 9

ACEi irrespective of serum creatinine level

what precipitates it? steroids

Question 10

Tx GI:
dysmotility
GERD/wide mouth diverticula
bacterial overgrowth syndrome

Answer 10

dysmotility - erythromycin
GERD/wide mouth diverticula - PPI
bacterial overgrowth syndrome - cipro + metronidazole/rifaximin

Question 11

type of disease in heart?

Answer 11

restrictive pericardial disease

Question 12

clinical features of dermatomyositis

management?

Answer 12

Heliotrope rash
Gottron’s papules
Weakness
management - CPK. If elevated, give STEROIDS NOT methotrexate

Question 13

Acute sarcoid arthritis presents most often as part of Löfgren syndrome, which is characterized by the triad of?

Answer 13

hilar adenopathy, acute arthritis, and erythema nodosum