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SBM - Week 4 Skin
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
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
Humoral Adaptive Immunity
Characteristics
B Cell Binds Free Floating Antigen
B Cell Presents Antigen to Helper T Cell
Helper T Cells Help B Cells Develop Antigen Specificity
Plasma B Cells Secrete Antibodies
Memory B Cells Cause Faster Secondary Response
2 mins
Innate Immunity Cellular Response
Characteristics
Natural Killer Lymphocytes Attack Abnormal Cells
Neutrophils in Blood
Infected Cells Release Interferon
Complement Proteins Lyse Pathogens/Infected Cells
Dendritic Cells in Tissue
Macrophages in Tissue
2 mins
Cell-mediated Adaptive Immune Response
Characteristics
Macrophages and Dendritic Cells Present Antigens
T Cell Develops Antigen Specificity
Regulatory T Cells Suppress Response
Memory T Cells Cause Faster Secondary Response
Cytotoxic T Cells Lyse Infected Cells
Infected Cells Present Antigen On Surface
2 mins
Inflammatory Response
Pathogens Infect Tissue
Mast Cells Release Histamine
Histamine Dilates and Increases Capillary Permeability
Macrophages Engulf Pathogens
Macrophage Signals Cells With Cytokines
Responding Neutrophils Cross Capillary Wall
B And T Lymphocytes Arrive At Injury Site
2 mins
Sjögren’s Syndrome
Mechanism
Autoimmune Exocrine Gland Destruction
Symptoms (Classic Triad)
Xerostomia
Xerophthalmia
Arthritis
Diagnosis
Anti SS-B (La)
Anti SS-A (Ro)
Schirmer's Test
Salivary Gland Biopsy
Treatment
Symptomatic Treatment
Complications
Lymphoma
Other
Sicca Syndrome
4 mins
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
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
TNF-Alpha Inhibitors Overview
Mechanism
Downregulates Pro-inflammatory Cytokines
Decreased Lymphocyte Activation and Migration
Granuloma Breakdown
Treats
Crohn's Disease
Rheumatoid Arthritis
Juvenile Rheumatoid Arthritis
Psoriasis
Ankylosing Spondylitis
1 min
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
Vitamin D Mechanism
25 OH in the liver
1,25 OH in the kidney
Absorbs Calcium and Phosphorus
42 secs
Osteoarthritis
Mechanism
Articular Cartilage Destruction
Biomechanical Stress
Aging
Signs and Symptoms
Asymmetric
Pain Decreases with Rest
Morning Stiffness Under 30 Minutes
Crepitus
DIP and PIP Joints
Treatment
Lifestyle Changes
Acetaminophen or NSAIDs
2 mins
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
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
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
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
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
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
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
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