Which one of the following is true regarding the investigation of a patient with dermatomyositis?
Correct Answer C: Anti-Jo-1 antibodies are more common in polymyositis than dermatomyositis.
Dermatomyositis: investigations and management: Investigations:
Raynaud's and fever:
Management:
Which one of the following statements concerning discoid lupus is correct?
Correct Answer C: Discoid lupus erythematosus is characterized by follicular keratin plugs.
Discoid lupus erythematous:
Discoid lupus erythematous is a benign disorder generally seen in younger females. It very rarely progresses to systemic lupus erythematosus (in less than 5% of cases). Discoid lupus erythematous is characterized by follicular keratin plugs and is thought to be autoimmune in aetiology.
Features:
A 31-year-old female with a history of SLE gives birth following a 39 week pregnancy. The newborn is noted to be bradycardic.
Which one of the following autoantibodies are associated with congenital heart block?
Correct Answer A: SLE - antibodies associated with congenital heart block = anti-Ro.
SLE: pregnancy:
Overview:
A 45-year-old woman with a history of primary Sjogren's syndrome is reviewed in clinic. Her main problem is a dry mouth, which unfortunately has not responded to artificial saliva.
Which one of the following medications is most likely to be beneficial?
Correct Answer E:
Sjogren's syndrome:
Sjogren's syndrome is an autoimmune disorder affecting exocrine glands resulting in dry mucosal surfaces. It may be primary (PSS) or secondary to rheumatoid arthritis or other connective tissue disorders, where it usually develops around 10 years after the initial onset. Sjogren's syndrome is much more common in females (ratio 9:1). There is a marked increased risk of lymphoid malignancy (40-60 fold).
Investigation:
A 45-year-old woman is referred to rheumatology outpatients with a 4 month history of joint pains, myalgia and generalized lethargy. An autoantibody screen reveals she is ANA positive and anti-ribonucleoprotein positive. The creatine kinase is elevated at 525.
What is the most likely diagnosis?
Correct Answer B: Anti-ribonuclear protein (anti-RNP) = mixed connective tissue disease.
Mixed connective tissue disease:
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