Trigger - Rheumatological Diseases

Question 1

What is the sensitivity and specificity of an ANA test

Answer 1

• HIGH sensitivity (because ANA has an “N” in it)
• LOW specificity (because ANA does NOT have a “P” in it)

i know i know, but it might be a question lol

Question 2

does ANA quantitiy correlate with severity of disease?

Answer 2

NO

Question 3

what ANA is indicative of autoimmunity?

Answer 3

• > /= 1:160

Question 4

Is rheumatoid factor sensitive or specific?

Answer 4

no

can be found in healthy patients and is sometimes not positive in pts w rheumatoid diseases

Question 5

when is CRP not a reliable test

Answer 5

when you have liver failure because CRP is produced by the liver!!

Question 6

A chronic, systemic, multi organ autoimmune disease of connective tissues secondary to antibody formation and immune complex deposition.

Answer 6

SLE

Question 7

associated with pericarditis, myocarditis, ILD, and pulm HTN

Answer 7

SLE

Question 7

if you have a + ANA and you are suspecting a possible CT disorder, what should you order

Answer 7

ENA

Question 8

procainamide, hydralazine and penicillamine are all associated with what diagnosis

Answer 8

drug induced SLE

Question 9

Thrombocytopenia suggests a flare up of which disease

Answer 9

SLE

Question 10

what is the treatment of SLE that only involves the skin, joint and mucosa

Answer 10

• hydroxychloroquine +/- NSAID
• <7.5mg prednisone QD PRN

Question 11

what is the tx of SLE that is significant but has not yet become organ threatening

Answer 11

• hydroxychloroquine +/- NSAID
• 5-15 mg prednisone QD PRN
• immunosuppressive (MTX or azothioprine)

Question 12

what is the Tx of SLE with Renal or CNS involvement

Answer 12

• hydroxychloroquine +/- NSAID
• high dose IV prednisone
• immunosuppressive agent (Belimumab, rituximab, cyclosporine)

Question 13

Bull’s eye retinopathy is a SE of what

Answer 13

chloroquine toxicity!

Question 14

What type of scleroderma is distal to the elbows (also on face/neck) and may present with the manifestation of CREST

Answer 14

limited cutaneous systemic sclerosis

Question 15

Which scleroderma presents with proximal and even truncal manifestations

Answer 15

diffuse cutaneous systemic scleroderma

Question 16

Which scleroderma presents with NO skin manifestations but does have all of the other manifestations

rare

Answer 16

systemic sclerosis sine scleroderma

Question 17

telangiectasis and sclerodactyly with associated calcium deposits on their hands and neck. Pt reports rayneuds phenomenon and esophageal dysfunction such as acid reflux and decreased esophageal motility

Answer 17

CREST!! (Limited cutaneous systemic sclerosis)

Question 18

90% of patients with this disorder have GI issues!

Answer 18

Systemic scleroderma

Question 19

Anti-DNA topoisomerase I is for which diagnosis

Answer 19

diffuse cutaneous systemic scleroderma

Question 20

In this disease you want to have baseline testing of the lungs to assess for ILD.

PFTs, Echo, CT chest

Answer 20

scleroderma!

Question 21

Pt presents with dryness of the eyes and decreased salivation/dry mouth

Answer 21

sjogrens

Question 22

Shirmer test is used with which disease? what is a negative test?

Answer 22

sjogrens
negative = >10mm of tears!

Question 23

HLA-DR52

Answer 23

sjogrens

seen in 85% of pts

Question 24

HIV, HCV and Vitamin A deficiency can all mimic which disease?

Answer 24

sjogrens

Question 25

Omega-3-fatty acids are specifically good for this disease

Answer 25

Sjogrens for dry eye

Question 26

when do you use pilocarpine as treatment

Answer 26

Sjogrens

Question 27

sudden symmetrical onset of painless proximal weakness that spares the face and eye muscles

Answer 27

PM and DM

Question 28

pt has raised, violaceous scaly eruptions on the knucles and a blueish purple eruption of rash on the face.

Answer 28

DM

heliotrope eruption, gottrons papules

may also see hyperkeratotic dirty appearing hands (mechanic hands)!

Question 29

heliotrope eruption, gottrons papules

Answer 29

DM

you may also see mechanic hands!

Question 30

these patients should use SPF 55+ and should probs suppplement w vit D!

Answer 30

SLE

Question 31

mechanic hands are seen in which diagnosis

Answer 31

DM

hyperkeratotic, dirty appearing hands

Question 32

hyperkeratotic dirty appearing hands

Answer 32

DM

Question 33

Shawl sign

Answer 33

DM

hyperkeratotic macular rash appearing on pts back!

Question 34

hyperkeratotic macular rash appearing on pts back!

Answer 34

DM

shawl sign!

Question 35

CK is 10x the upper normal limit

Answer 35

DM/PM

Question 36

what is the maxx amount of prednisone that can be taken daily for PM and DM

Answer 36

100mg!!!!

remember its 1mg/kg/day