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WorksheetsCM - Rheum Skin
Total questions: 27
Worksheet time: 14mins
Chronic, autoimmune, systemic, inflammatory disorder of unknown cause characterized by slow progression of keratoconjunctivitis sicca and xerostomia. What is the diagnosis?
Sjogren Syndrome
Scleroderma
Raynaud's
Polymyositis
Dermatomyositis
What is NOT a lab that should be done to evaluate for Sjogren's Syndrome?
Rheumatoid factor
ANA: SS-A (R0), SS-B (La)
Thyroid function tests
Schirmer test
SCL-70/ Anti-RNA polymerase III antibodies
55 yo female pt presents with slow progression of burning, itching, photophobia, and foreign body sensation in the eyes. Pt also reports dysphagia, feeling of "cotton mouth," dental caries, loss of taste/smell. On PE you note parotid enlargement. What is NOT a possible treatment?
Topical ocular 0.05% cyclosporine
Hard candy/sugar free gum
Phosphodiesterase inhibitors
Pilocarpine/ Cevimeline
Xylimelts
What is NOT something that can impact prognosis of Sjogren's Syndrome patients?
Pulmonary disease
Lymphocytic vasculitis
Painful peripheral neuropathy
Lymphoma
A syndrome of paroxysmal digital ischemia, most commonly caused by an exaggerated response of digital arterioles to cold or emotional stress. Intermittent arteriolar vasospasms. What is the diagnosis?
Sjogren Syndrome
Scleroderma
Raynaud's
Polymyositis
Dermatomyositis
25 yo female pt with no PMH presents with changes to all fingers symmetrically on each hand, but excluding the thumbs. Pt denies pain, ulcers, and hx of peripheral vascular disease. Labs show negative ANA. What diagnsis do you suspect?
Primary Raynaud's
CREST syndrome
Polymyositis
Secondary Raynaud's
Dermatomyositis
Pt with PMH of autoimmune disease presents with changes to fingers asymmetrically. Symptoms exclude the thumbs. Pt admits to pain and ulcers. What diagnsis do you suspect?
Primary Raynaud's
CREST syndrome
Polymyositis
Secondary Raynaud's
Dermatomyositis
Pt presents with rubor, throbbing/pain, paraesthesia, and slight swelling in the fingers down to the distal palm. Initially it only impacted 1 or 2 fingertips affected. The symptoms improve with warmth. What is NOT included in the treatment?
Topical nitrates
Phosphodiesterase inhibitors
CCB
Pilocarpine
Lotion
Pt presents with rubor, throbbing/pain, paraesthesia, and slight swelling in the fingers down to the distal palm. Initially it only impacted 1 or 2 fingertips affected. The symptoms improve with warmth. What is NOT included in the treatment?
Avoid decongestants, diet pills, amphetamines
SSRIs
Endothelin-receptor inhibitors
Cevimeline
Stop smoking
A chronic multisystem disease characterized by autoantibody production, collagen deposition, and vascular dysfunction. Fibrosis of skin and internal organs. Name meaning "hard skin." What is the diagnosis?
Sjogren Syndrome
Scleroderma
Raynaud's
Polymyositis
Dermatomyositis
What is NOT a lab that should be done to evaluate for Scleroderma?
Esophageal manometry
Urine microscopy
ANA (anticentromere antibody)
Schirmer test
SCL-70/ Anti-RNA polymerase III antibodies
What is NOT an imaging test that can be done to evaluate for Scleroderma?
Parotid gland biopsy
CXR
Chest CT
ECHO
Barium swallow
What is NOT part of CREST syndrome?
Esophageal dysmotility
Calcinosis
Sclerodactyly
Telangiectasias
Polymyositis
30 yo female pt presents with calcinosis, raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias, anticentromere antibody (CREST syndrome). PE reveals "salt and pepper" pigment change. What is NOT included in the treatment?
Corticosteroids
Quit smoking
Phosphodiesterase inhibitors
Surgery
Immune modulators
Idiopathic inflammatory myopathy. Autoimmune reaction to muscle tissue in genetically susceptible people. Consider underlying malignancy. Picornavirus-like structures have been found in muscle cells. Cellular damage and atrophy. What is the diagnosis?
Sjogren Syndrome
Scleroderma
Raynaud's
Polymyositis
Dermatomyositis
50 yo female pt presents with gradual and progressive symmetrical proximal muscle weakness (legs prior to arms). Pt admits to pain, tenderness, dysphagia, muscle atrophy, and contractures. What is the diagnosis?
Sjogren Syndrome
Scleroderma
Raynaud's
Polymyositis
Dermatomyositis
All of the following are diagnostic tests for Polymyositis, but what is the gold standard?
Anti-SRP
EMG
Jo-1: interstitial lung disease
Malignancy workup/cancer screening ≥ 60 yo
Muscle biopsy
A multisystem autoimmune connective tissue disease. Complement-mediated vasculopathy. Celluar damage and atrophy. Variable degrees of inflammation. Proximal muscle weakness. What is the diagnosis?
Sjogren Syndrome
Scleroderma
Raynaud's
Polymyositis
Dermatomyositis
50 yo female pt presents with proximal muscle weakness, fatigue, and rash. PE reveals visceral involvement. Erythematous rash that is slightly elevated and smooth/scaly, heliotrope rash, gottron papules, nail changes, desquamating dermatitis, secondary changes, rash on scalp (calcification in children). What is NOT a possible diagnostic test?
ANA - Jo-1
Anti-Mi-2
Esophageal manometry
Anti-155/140
Malignancy workup
All of the following are diagnostic criteria for dermatomyositis, but what is the definitive test?
Proximal muscle weakness
Characteristic rash
Decreased serum muscle enzymes
Characteristic EMG or MRI muscle abnormalities
Muscle biopsy changes
What is NOT a possible part of the treatment for polymyositis and dermatomyositis?
Corticosteroids
Azathioprine
Methotrexate
Surgery
Mycophenolate mofetil
What is NOT a possible part of the treatment for polymyositis and dermatomyositis?
Rituximab
Cyclosporine
IVIG
CCB
What can occur at any age and does not involve the skin?
Primary idiopathic polymyositis
Scleroderma
Primary Raynaud's
Primary idiopathic dermatomyositis
Secondary dermatomyositis
What is similar to primary idiopathic polymyositis, but also involves the skin?
Primary idiopathic polymyositis
Scleroderma
Primary Raynaud's
Primary idiopathic dermatomyositis
Secondary dermatomyositis
In what disease is pulmonary disease the leading cause of mortality?
Sjogren Syndrome
Scleroderma
Raynaud's
Polymyositis
Dermatomyositis
What disease has "salt and pepper" pigment change and CREST syndrome?
Sjogren Syndrome
Scleroderma
Raynaud's
Polymyositis
Dermatomyositis
What disease has keratoconjunctivitis sicca, xerostomia, and parotid enlargement?
Sjogren Syndrome
Scleroderma
Raynaud's
Polymyositis
Dermatomyositis
