4: Connective tissue diseases 1 Flashcards Preview

MSK Week 2 2017/18 > 4: Connective tissue diseases 1 > Flashcards

Flashcards in 4: Connective tissue diseases 1 Deck (59)
1

Most connective tissue diseases are ___ diseases.

autoimmune

2

Connective tissue diseases often affect multiple ___.

systems

3

What are some examples of CTDs?

SLE

Sjogren's syndrome

Systemic sclerosis

Dermatomyositis

Polymyositis

Anti-phospholipid syndrome

4

Do connective tissue diseases affect connective tissue?

No

autoimmune disease - antibodies

5

In connective tissues diseases, the immune system attack cells (in one place / all over the body).

all over the body

6

Connective tissue diseases are more common in (men / women).

women

as with all autoimmune diseases

7

What four factors are thought to cause connective tissue diseases?

Genetics

Environment

Faulty immune system

Hormones

8

Which hormone is linked to the onset of CTDs?

Oestrogen

9

Which virus is associated with lupus?

Epstein-Barr virus

10

What environmental factors are linked to lupus?

UV exposure

Cigarette smoking

11

Although lupus is less common in men, it tends to be more ___.

severe

12

Which immune cells are antigens presented to?

T cells

13

In lupus, apoptotic cells aren't cleaned up and their contents float around for longer than normal.

What is the consequence of this?

Immune system recognises nuclear material as foreign antigen

Nuclear material presented to T cells, which activate B cells

Production of autoantibodies

14

In lupus, the immune system treats self nuclear material as an antigen.

Which processes occur?

Cytokines released

Complement released

Inflammation

Necrosis

Scarring

15

Which system is asymptomatic when it's being messed up by lupus?

Renal

16

What are deposited in the kidneys and the skin in lupus?

Immune complexes

17

In lupus, immune complexes get lodged in endothelial walls - what happens next?

Immune response - complement released, acute inflammation

Endothelial damage

Leaky vessels

Oedema

18

What is a very common symptom of lupus?

Rash

19

What are general symptoms of lupus?

Fever

Weight loss

Fatigue

Anorexia

20

What does a malar rash look like?

 

Butterfly rash on face associated with UV exposure

21

What aspect of the face is spared by lupus?

Naso-labial folds

22

___ - the tendency to burn easily - is a skin symptom of SLE.

Photosensitivity

23

What hair condition is associated with lupus?

Alopecia

24

Which lesions appear in the oral and nasal mucosa in some cases of SLE?

Ulcers

25

An MSK symptom of lupus is ___ ___ with no actual joint damage.

joint pain

26

What is serositis?

Inflammation of a lining e.g pleura, pericardium...

27

Serositis secondary to lupus often presents as what?

Pericarditis / Pericardial effusion

Pleurisy / Pleural effusion

28

What is a renal sign of lupus?

Proteinuria

elevated levels of protein in the urine

29

After a positive urinalysis, what is done to confirm that someone has renal disease secondary to lupus?

Renal biopsy

30

Lupus can also cause what brain-related disease?

Neurological disease

31

Name three haematological signs of lupus you might see on a FBC.

Anaemia - low RBCs

Thrombocytopaenia - low platelets

Leukopaenia - low white blood cells (i.e immune cells)

32

Which structures are often enlarged in lupus?

Lymph nodes

33

Which syndrome, associated with lupus, causes hypercoagulability and may result in thrombosis and recurrent miscarriage?

Anti-phospholipid syndrome

34

People with lupus are more susceptible to ___.

Why?

infection

through the haem effects of the disease itself AND the immunosuppressive drugs used to treat it

35

How is suspected SLE diagnosed?

Autoantibody tests

36

Most people with lupus are positive for which antibody?

Anti-nuclear antibody (ANA)

37

ANA is a (specific / non-specific) antibody for lupus.

non-specific

found in other autoimmune diseases, RA, HIV, Hep C....

38

Apart from ANA, what other autoantibodies are associated with lupus?

Anti-dsDNA (anti double stranded DNA antibody)

Anti-Sm

Anti-Ro (non-specific for lupus but uncommon)

Anti-RNP

39

Which antibodies are highly specific for lupus?

Anti-dsDNA

Anti-Sm

40

The higher the titre of anti-dsDNA, the more (active / inactive) the disease.

active

41

Babies of mothers who are anti-Ro positive may present with what?

Neonatal lupus

of which heart block is a significant feature

42

Which autoantibodies are found in anti-phospholipid syndrome?

Anti-cardiolipin antibody

Lupus anticoagulant

Anti-beta 2 glycoprotein

43

Once you've diagnosed someone with lupus, what must you do?

Screen every other system

44

What's the most appropriate first screening test in someone newly diagnosed with lupus?

Urinanalysis

for renal disease

45

What are the two inflammatory markers which rise in people with rheumatoid conditions?

CRP

PV

46

Does CRP rise in flare ups of lupus?

NO

47

When may CRP be raised in a lupus patient?

Infection

Co-existing inflammatory disease e.g RA

48

Which changes in two markers indicate a flare up of lupus?

INCREASED anti-dsDNA (antibody associated with active disease)

DECREASED in C4 (complement being used up)

49

In a flare up of lupus, the level of anti-dsDNA (increases / decreases).

increases

50

In a flare up of lupus, the level of complement (increases / decreases).

decreases

51

SLE tends to get (better / worse) during pregnancy.

worse

52

Patients with lupus are advised to avoid excessive __ __.

sun exposure

because it causes photosensitivity

53

Which drugs are used to treat lupus?

1. NSAIDs, analgesics, HYDROXYCHLOROQUINE

2.

Steroids

Immunosuppressants (mycophenolate mofetil, cyclophosphamide, methotrexate, azathioprine)

Biologic agents

54

If all your drugs aren't controlling lupus symptoms, which drugs can you use?

Biologic agents

55

Which DMARD is used first to treat lupus?

Hydroxychloroquine

56

What are the immediate tests for someone who has suspected SLE?

Urinalysis

Antibodies and complement

57

Does a positive ANA guarantee lupus?

No

58

What is the most common presentation of SLE and who has it?

Fever, joint pain and a rash

In a woman of childbearing age

59

What is the typical distribution of joint pain seen in SLE?

Symmetrical polyarthritis affecting the small joints of hands and feet