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SBM.4
Systemic Lupus Erythematosus (SLE) Mechanism, Treatment and Complications
Mechanism and Characteristics
Systemic Autoimmune Disease
9:1 female to male ratio
Treatment
Glucocorticoids
NSAIDS
Hydroxychloroquine
Cyclophosphamide
Complications
Lupus nephritis
Libman-Sacks Endocarditis
Secondary Antiphospholipid Antibody Syndrome
Other
Drug-induced lupus
2 mins
Systemic Lupus Erythematosus (SLE) Diagnosis and Clinical Features
IM DAMN SHARP acronym
Immunoglobulins
Malar rash
Discoid rash
Antinuclear antibody
Mucositis
Neurologic disorders
Serositis
Hematologic disorders
Arthritis
Renal disorders
Photosensitivity
2 mins
Amphetamine Antidote
Antidote
Ammonium Chloride (NH4Cl)
Acidify Urine
34 secs
Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
2 mins
Osteosarcoma
Pathophysiology
Osteogenic Sarcoma
Peak incidence men 10-20 years old
Metaphysis of Long Bones
Knee Region
Radiation
Familial Retinoblastoma
Paget's Disease
Diagnosis
Codman Triangle
Sunburst Pattern from Elevated Periosteum
Grave Prognosis
2 mins
Osteogenesis Imperfecta
Pathophysiology
Autosomal Dominant
Decreased Type I Collagen Production
Symptoms
Phenotypically Diverse
Brittle Bone Disease
Fractures from Minimal Trauma
Confused with Child Abuse
Hearing Loss
Dental Imperfections
Blue Sclera
1 min
Ewing's Sarcoma
Epidemiology
Most Common in Boys < 15 years old
Pathophysiology
11;22 Translocation
Characteristics
Long bones, Pelvis, Ribs
Diaphysis
Small Blue Cells
Malignant
Aggressive
Onion-skin Appearance
TREATMENT
Responsive to Chemotherapy
2 mins
Carpal Tunnel Syndrome
Median Nerve Entrapment
Compression at Carpal Tunnel
Numbness, Tingling and Pain in Hand
Diagnosis
Phalen's Maneuver
Tinel's Sign
Treatment
Splints
Surgery
Steroids
2 mins
TNF-Alpha Inhibitor Drugs and Complications
Etanercept
Decoy TNF- Alpha receptor
Anti-TNF- Alpha antibody
Adalimumab
Infliximab
Complications
Increased risk of infection
Predispose to Tuberculosis (TB) reactivation
Order Baseline PPD- skin test
Quantiferon Gold In-Tube
Order Chest X-Ray
2 mins
Celecoxib
Indications
Rheumatoid Arthritis
Osteoarthritis
Pain
Mechanism of Action
NSAID
Selectively Inhibits COX-2
Side Effects
Sulfa Allergy
Increased Risk of Thrombosis
GI Bleed
Contraindication
Pregnancy > 30 Weeks
1 min
Temporal Arteritis
Giant Cell Arteritis
Granulomatous
Old Females
Clinical Features
Polymyalgia Rheumatica
Unilateral Headache
Jaw Claudication
Blindness
Lab Findings
Increased ESR
Normal Serum Creatine Kinase
Treatment
Steroids
2 mins
Takayasu Arteritis
Pathophysiology
Granulomatous Thickening of Aortic Arch
Pulseless Disease
Asian Females
Signs and Symptoms
Fever
Myalgia
Night Sweats
Arthritis
Ocular Disturbances
Diagnosis
Increased ESR
Different Blood Pressures in Arms
2 mins
Kawasaki Disease
Pathophysiology
Prevalent in Asian Children
Necrotizing Vasculitis
Signs and Symptoms
Fever
Strawberry-Red Tongue and Mucosa
Lymphadenopathy
Desquamative Skin Rash
Erythema and Edema of the Hands and Feet
Conjunctivitis
Coronary Aneurysm
Treatment
Intravenous Immunoglobulin (IVIG)
Aspirin
2 mins
Polyarteritis Nodosa
Pathophysiology
Immune Complex-Mediated Transmural Vasculitis
Hepatitis B Association
Fibrinoid Necrosis
Signs and Symptoms
Black Stool (Melena)
Neurologic Dysfunction
Myalgia
Fever
Hypertension
Diagnosis
Vessels / Lesions in Different Stages
Renal Microaneurysms (On Arteriogram)
Spares Pulmonary Arteries (No Pulmonary Involvement)
Treatment
Corticosteroids
Cyclophosphamide
2 mins
Buerger's Disease
Pathophysiology
Thromboangiitis Obliterans
Segmental Inflammation
Strong Association with Smoking
Signs and Symptoms
Superficial Nodular Phlebitis
Raynaud's Phenomenon
Autoamputation
Treatment
Smoking Cessation
2 mins
Granulomatosis with Polyangiitis (GPA) Characteristics
Pathophysiology
Small Vessel Vasculitis
Necrotizing
Lungs and Upper Airway
Crescentic Glomerulonephritis
DIAGNOSTICS
c-ANCA
X-ray
Multiple Nodules in Lungs
Treatment
Cyclophosphamide
Corticosteroids
Rituximab
3 mins
Granulomatosis with Polyangiitis (GPA) Symptoms
Upper Respiratory Tract
Saddle Nose
Perforation of Nasal Septum
Chronic Sinusitis
Otitis Media
Mastoiditis
Lower Respiratory Tract
Cough
Dyspnea
Hemoptysis
Kidney
Rapidly Progressive Glomerulonephritis
Hematuria
RBC Casts
2 mins
Microscopic Polyangiitis
Pathophysiology
Necrotizing Small Vessel Vasculitis
Signs and Symptoms
Lungs, Kidneys, and Skin Commonly Affected
Palpable Purpura
Rapidly Progressive Cresentic Glomerulonephritis
Diagnosis
Lesions are Same Age
Non-granulomatous
Minimal Nasopharyngeal Involvement
P-ANCA
Treatment
Corticosteroids
Cyclophosphamide
2 mins
Henoch-Schonlein Purpura
Most Common Childhood Vasculitis
Follows Pharyngeal or Respiratory Infection
Palpable Purpura on Legs and Buttocks
Arthralgia
Intestinal Hemorrhage
Black Stool (Melena)
Associated with IgA Nephropathy
2 mins
Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome)
Pathophysiology
Granulomatous Vasculitis
Signs and Symptoms
Sinusitis
Skin Lesions
Peripheral Neuropathy
Asthma
GI Disease
Heart Disease
Kidney Failure
Diagnosis
Eosinophilia
p-ANCA
Treatment
Corticosteroids
4 mins
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