Flashcards in Multi-System Auto-Immune Disease Deck (59)
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1
What is the diagnosis for someone presenting with:
-Mylagia/arthralgia
-Episcleritis
-Sinusitis
-Renal failure
Wegner's granulomatosis
2
What is the diagnosis for someone presenting with:
-Mylagia/arthralgia
-Skin rash
-Pleurisy
-CVA
Lupus
3
What is the diagnosis for someone presenting with:
-Mylagia/arthralgia
-Skin thickening
-GORD
-Pulmonary hypertension
Scleroderma
4
What is the diagnosis for someone presenting with:
-Mylagia/arthralgia
-Sicca
-Skin rash
-Neuropathy
Sjorgen's syndrome
5
Give examples of autoimmune connective tissue diseases.
-Systemic Lupus Erythematosus
-Scleroderma
-Sjogren’s syndrome
-Auto-immune myositis
-Mixed connective tissue disease
6
Give examples of autoimmune systemic vasculitis?
-Giant cell arteritis
-Granulomatosis polyangiitis (Wegeners)
-Microscopic polyangiitis
-Eosinophilic granulomatosis polyangiitis (Churg-Strauss)
7
How are multisystem autoimmune diseases diagnosed?
-Cardinal clinical features: History & Exam
-Immunology
-Imaging
-Tissue
-Exclusion of differential diagnosis
8
What can mimic multisystem autoimmune diseases?
-Drugs such as cocaine, minocycline, PTU
-Infections including HIV, endocarditis, Hepatitis and TB
-Malignancy, in particular lymphoma
-Cardiac myxoma
-Cholesterol emboli
-Scurvey
9
What is the epidemiology of SLE?
-UK Prevalence: 28/100,000
-UK incidence: 4/100,000
-F:M 9:1
-Onset: 15-50 years
-Significant ethnic diversity: Afro-Caribbean> Asian> Caucasian
10
How can SLE affect the skin and hair?
-Butterfly rash
-Photosensitivity
-Alopecia
-Vasculitis
-Purpura
-Urticaria
11
How can SLE affect the nervous system?
-Fits
-Hemiplegia
-Ataxia
-Peripheral neuropathy
-Cranial nerve lesions
12
How can SLE affect the heart and chest?
-Pericarditis
-Endocarditis
-Aortic valve lesions
-Pleurisy
-Pleural effusion
-Lung fibrosis
13
How can SLE affect the MSK system?
-Myopathy
-Aseptic necrosis of the hip
-Arthritis in small joint
14
How can SLE affect the blood?
-Anaemia (nomochromic normocytic Coombs test positive)
-Leukopenia
-Thrombocytopenia
15
How can SLE affect a person in general?
-Fever
-Depression
-Raynaud's phenomenon
-Abdominal pain
16
What is the classification criteria for SLE?
Any 4
-Malar rash (butterfly rash)
-Discoid rash (raised, scarring, permanent marks, alopecia)
-Photosensitivity
-Oral ulcers
-Arthritis (2 joints at least)
-Serositis (pleurisy or pericarditis)
-Renal (significant proteinuria or cellular casts in urine)
-Neurological (unexplained seizures or psychosis)
-Haematological (low WCC, platelets, lymphocytes, haemolytic anaemia)
-Immunological (anti ds-DNA, SM, cardiolipin, lupus anticoagulant, low complement)
-ANA
17
What is the earliest sign of kidney involvement in SLE?
Blood and protein on urine dipstick
18
What is scleroderma characterised by?
Thickening of the skin
19
What is the epidemiology of scleroderma?
-UK Prevalence: 24/100,000
-UK Incidence: 10/1,000,000
-Onset: 30-50 years
-F:M 3:1
20
What is the name for scleroderma limited?
Crest syndrome
21
What are the features of Crest syndrome?
-Calcinosis
-Raynaud's
-Oesophageal dysmotility
-Sclerodactyly
-Telangiectasia
22
What is a possible complication of limited scleroderma?
Pulmonary hypertension
23
What are the possible outcomes of diffuse scleroderma?
-Pulmonary fibrosis
-Renal crisis
-Small bowel bacterial overgrowth
24
What is the epidemiology of Sjogren's syndrome?
-Prevalence: 1 in 100
-Incidence: 4 in 100,000
-Onset: 40-50yrs
-F:M 9:1
25
How can sjogren's syndrome affect the GI system?
-Dysphagia
-Abnormal oesophageal motility
26
How can sjogren's syndrome affect the respiratory system?
Interstitial lung disease
27
How can sjogren's syndrome affect the CNS?
-Fits
-Hemiplegia
-Ataxia
-Cranial nerve lesions
28
How can sjogren's syndrome affect the renal system?
Renal tubular acidosis
29
How can sjogren's syndrome affect the skin?
-Palpable purpura
-Raynaud's syndrome
30
