Connective Tissue Diseases (Msq Drill 183)

1. Since the exocrine glands are affected will patients with Sjorgren syndrome will have watery or dry eyes?

Watery eyes

Dry eyes

2. Sjogren's syndrome is associated with an increased risk of what disease?

A

B

C

Lymphoma

3. Systemis sclerosis is also known as _________ .

A

S

D

Scleroderma

4. Patients with sclerotic skin changes often accompanied by multisystem disease. True or false?

True

False

5. A patient with scleroderma presents to your office complaining of pain in the digitis when they are exposed to cold and a white or bluish color. When rewarmed they trun red before they turn back to the normal color. You determine that this is:

A

Rreynaud's

6. Patients with systemic sclerosis or scleroderma may have progressivwe fibrosis from increased deposition of _________________ in interstitium and intima of small alrteries and connective tissues.

A

Collagen

7. Does scleroderma have a male or female proponderance?

Male

Female

8. **** Systemic scleroderma patients will have what antibody

A

Anti SCL- 70

9. Limited scleroderma:

A

B

C

Anti-centromere antibody

10. A rheumatological emergency in scleroderma is:

A

Scleroderma renal crisis

Creatine level will be elevated and proteinuria

Explanation

Creatine level will be elevated and proteinuria

11. **** What will you treat the patient presenting with a scleroderma renal crisis?

A

ACE inhibitors

12. CTD diseases are ____________ diseases.

Uni system

Multi system

13. What is key to the pathegenesis and therapy of CTD's

A

S

Immune mechanisms

14. Diagnosis of CTD's is __________ based using criteria.

Clinically

B

15. What is the sub serological marker for inflammatory muscle diseases?

A

Anti-Jo-1

16. If you have SLe, scleroderma and polymyositis then you probably have:

A

S

Mixed connectivce tissue disease

17. Usually patients with mixed connective tissue diseases will have high titers of:

Anti-U1RNP

S

18. What do you treat mixed connective tissue diseases with?

A

High dose steroids

19. Polyarteritis nodosa is a prototype of:

A

B

Vasculitis

20. Necrotizing vasculitis of the upper airways affecting the sinuses, sicus cavity, lower airways and kidneys is known as:

Wegener;s granulomatosis

B

21. What is the antibody for Wegener's granulomatoma?

A

S

Antineutrophil cytoplasmic antibody (c-ANCA)

22. In order to cofirm a diagnosis of Wegener's you need to have a:

A

D

Biopsy

23. Polymyositis plus a rash is:

A

Dermatomyositis

24. Is there a variation of scleroderma that is only cutaneous with no systemic involvement?

Yes

No

25. The antibodies of scleroderma AntiSCL-70 and anti-centromere antibodies do not always have to be present in order for you to make a diagnosis of scleroderma. True or false?

True

False

26. Secondary Sjogren syndrome refers to the ______ complex that accompanies any of the connective tissue diseases such as xeropthalmia, keratoconjuctivitis, xerostomia with or without salivary gland enlanrgment.

A

Sicca

27. Can SS-A and SS-B also be seen in other CTD's

Yes, but they are more specific for Sjogren syndrome

No, they will only be seen in Sjogren

28. What is the most common connective tissue disease?

Sjjorgen syndrome

B

SLE

Sjorgren is the second most common CTD.

Explanation

Sjorgren is the second most common CTD.

29. The immune system destroys what organs in Sjogren's dynsrome?

Kidneys

Pancreas

Endocrine glands

Exocrine glands

30. So the typical patient with scleroderma will present with:

Reynaud's phenomenon

Edema fingers and hands

Skin thickening

Visceral manifestation - eg heartburn or gerd (mmost common GI complain), lung, heart, kidneys, & thyroid.

Arthralgias and muscle weakness

Submit

31. Dermatomyositis is an inflammatory muscle disease. Do the patients present with muscle pain or weakness?

Pain

Weakness

32. What three modalities are used to treat polymyositis and dermotomyositis?

Steroids

Methotrexate

C

Immunosuppressants

Submit

33. Is Sjogren syndrome a chronic or acute disorder?

Chronic

Acute

34. Is Sjogren's more common in men or women?

Men

Women

35. The diganostic ciriteria for Sjorgen's also incudes:

Dry eyes > 3 months or use of tear substitutes, or sensation of sand or gravel in eyes

Dry mouth > 3 months or swollen salivary glands or frequenst drinking of liquids to help in swallowing

Schirmer-I-test or Rose Bengal score

Mononuclear cells in glandular tissue

Abnormal salivary flow in the salivary glands or parotid gland

Submit

36. Do patients with Sjorgens have a high or low titer rheumatoid factor?

Low titer

High titer

37. How do you treat Sjogren's syndrome?

Saliva substitutes, artificaial tears

Increased oral fluid intake

Pilocaprine for the eyes to increase tears

Antifungals and close dental follow up

Same drugs as SLE - hydroxychloroquine, methotrexate and low dose immunosuppressive drugs.

Submit

38. What is the most common initial complaint of patient with scleroderma?

Dysphagia

Tight, thin lips with vertical perioral furrows

Trismus & transition zone around dental roots

Xerostomis, xerophthalmiz

Laryngela inolvement with hoarseness

39. Can Sjorgren's affect the parotid gland?

Yes, in fact patrotid biopsy is more sensitive and specific

No, it does not affect the paroid gland

40. Treatment of scleroderma includes:

Same as for SLE - hydrocloroquinone and methotrexate etc..

Using gloves and prostaglandian for raynaud's

Calcium channel blockers, tropical NTG

Submit

41. Treatment of connective tissue disease is specific or non-specific

Specific

Non-specific

Treatment is aimed at specific manifestations of the disease.

Explanation

Treatment is aimed at specific manifestations of the disease.

42. Sjogrens syndrom is divided into primary and secondary. Which of the two is a diagnosis of exclusion?

Primary

Secondary

43. What antibodies are associated with Sjogren's syndrome?

A

SS-A

B

SS-B

Submit

44. Patients with polymyositis may present with:

Difficulty phonating

Nasal regurgitating

Aspiration penumonitis

Rash

Submit

45. Is there an ybony involvement in sclerodactyly of the hands in patients with scleroderma?

Yes

No

46. Is sclerodactyly seen in early or late scleroderma?

Early

Late

Both

Connective Tissue Diseases (Msq Drill 183)

1. Since the exocrine glands are affected will patients with Sjorgren syndrome will have watery or dry eyes?

2.

What first name or nickname would you like us to use?

2. Sjogren's syndrome is associated with an increased risk of what disease?

3. Systemis sclerosis is also known as _________ .

4. Patients with sclerotic skin changes often accompanied by multisystem disease. True or false?

5. A patient with scleroderma presents to your office complaining of pain in the digitis when they are exposed to cold and a white or bluish color. When rewarmed they trun red before they turn back to the normal color. You determine that this is:

6. Patients with systemic sclerosis or scleroderma may have progressivwe fibrosis from increased deposition of _________________ in interstitium and intima of small alrteries and connective tissues.

7. Does scleroderma have a male or female proponderance?

8. **** Systemic scleroderma patients will have what antibody

9. Limited scleroderma:

10. A rheumatological emergency in scleroderma is:

11. **** What will you treat the patient presenting with a scleroderma renal crisis?

12. CTD diseases are ____________ diseases.

13. What is key to the pathegenesis and therapy of CTD's

14. Diagnosis of CTD's is __________ based using criteria.

15. What is the sub serological marker for inflammatory muscle diseases?

16. If you have SLe, scleroderma and polymyositis then you probably have:

17. Usually patients with mixed connective tissue diseases will have high titers of:

18. What do you treat mixed connective tissue diseases with?

19. Polyarteritis nodosa is a prototype of:

20. Necrotizing vasculitis of the upper airways affecting the sinuses, sicus cavity, lower airways and kidneys is known as:

21. What is the antibody for Wegener's granulomatoma?

22. In order to cofirm a diagnosis of Wegener's you need to have a:

23. Polymyositis plus a rash is:

24. Is there a variation of scleroderma that is only cutaneous with no systemic involvement?

25. The antibodies of scleroderma AntiSCL-70 and anti-centromere antibodies do not always have to be present in order for you to make a diagnosis of scleroderma. True or false?

26. Secondary Sjogren syndrome refers to the ______ complex that accompanies any of the connective tissue diseases such as xeropthalmia, keratoconjuctivitis, xerostomia with or without salivary gland enlanrgment.

27. Can SS-A and SS-B also be seen in other CTD's

28. What is the most common connective tissue disease?

29. The immune system destroys what organs in Sjogren's dynsrome?

30. So the typical patient with scleroderma will present with:

31. Dermatomyositis is an inflammatory muscle disease. Do the patients present with muscle pain or weakness?

32. What three modalities are used to treat polymyositis and dermotomyositis?

33. Is Sjogren syndrome a chronic or acute disorder?

34. Is Sjogren's more common in men or women?

35. The diganostic ciriteria for Sjorgen's also incudes:

36. Do patients with Sjorgens have a high or low titer rheumatoid factor?

37. How do you treat Sjogren's syndrome?

38. What is the most common initial complaint of patient with scleroderma?

39. Can Sjorgren's affect the parotid gland?

40. Treatment of scleroderma includes:

41. Treatment of connective tissue disease is specific or non-specific

42. Sjogrens syndrom is divided into primary and secondary. Which of the two is a diagnosis of exclusion?

43. What antibodies are associated with Sjogren's syndrome?

44. Patients with polymyositis may present with:

45. Is there an ybony involvement in sclerodactyly of the hands in patients with scleroderma?

46. Is sclerodactyly seen in early or late scleroderma?