Anti-
disestablishmentarianism
disestablishmentarianism
This autoantibody which is specific and diagnostic for systemic lupus erythematosus at high titers attacks a structure that was discovered by Rosalind Franklin (not Watson and Crick)
What is anti dsDNA antibodies?
An old guy who smokes presents with cough, hemoptysis, weight loss. Odds are, lung cancer is at play. What anticipatory guidance can you give him about treatment options if this is non-small cell? What if it is small cell?
non-small cell: resection
small-cell: likely has mets, so chemo +/- radiation
Gold standard of diagnosis of this disease is 24-hour ambulatory pH monitoring, but we'd likely try lifestyle changes, prn H2 receptor antagonists, or PPIs first instead
GERD
This rash, easily identifiable by its bull’s eye appearance, is pathognomonic for Lyme disease.
What is erythema migrans?
Rhythm increases with inspiration and decreases with expiration
What is sinus arrhythmia?
These autoantibodies which attack an enzyme used in the creation of essential human hormone are the source of Hashimoto’s Disease.
What are anti-TPO (thyroid peroxidase) antibodies?
Look at Aubrey's phone. What general category of pulmonary disease has a PFT like the blue line? Name an example
Obstructive (COPD, asthma, CF and bronchiectasis, alpha-1 antitrypsin def)
Indications to start oxygen therapy for this disease include development of cor pulmonale, SpO2 <88%, or PaO2 <55
COPD
This skin finding, associated with systemic diseases such as Chron’s and Lofgren’s syndrome sarcoidosis, is characterized by erythematous, tender, nonulcerated, immobile lesions on bilateral shins.
Block in bundle of His that causes occasional con-conducted impulses.
What is Mobitz type 2 second degree block?
Sounding like notes from the Sound of Music’s “Do- Re-Mi” these two autoantibodies are positive in approximately 75% of patients with a positive Schirmer’s test.
What are anti-Ro and anti-La?
40 year old male with PMHx DM2, HTN, and alc use d/o presents with severe fever and cough with purple-colored sputum. Toxic-appearing on PE. CXR with cavitary lesions and sputum with gram-negative rods. What is most likely pathogen?
Klebsiella (severe illness, alc, DM, purple sputum, cavitary lesion, GNR)
A young child presents because mom is worried that he color-coordinates and stacks his Legos several times throughout the day, won't eat dinner with the family, and hits his head when they go to Target together. What could be going on?
ASD
This disease, also known as 5th disease, has a rash with a characteristic “slapped cheek” appearance.
What is erythema infectiosum?
Minimum CHADS-VASC score for chronic oral anticoagulation
What is 2?
Attacking the region where two chromatids attach, this auto-antiobody is present in 15-50% of patients with limited systemic sclerosis, and is the most specific autoantibody for CREST syndrome.
What is anti-centromere antibody?
40 year old female presents to ED. She is 1 week post-op of a cholecystectomy, no other PMHx. She is normotensive, SpO2 96% RA, tachy to 120 and feels “fevery.” No cough or swelling anywhere. D-Dimer is 200. What next?
moderate risk Wells --> negative d-dimer --> do NOT need CT PE
Failed septal fusion causes this disorder, which increases risk of strokes from paradoxical embolism
PFO
This rash, which is one of the major criteria for rheumatic fever, appears as a macular rash on the trunk.
What is erythema marginatum?
Length of duration needed on anticoagulation before cardioversion in a patient with atrial fibrillation with unknown onset.
What is 3 weeks?
This small cell vasculitis is commonly associated with positive anti-ANCA autoantibodies. Clinical signs include refractory sinus symptoms, saddle nose deformity, lung nodules, and glomerulonephritis
What is granulomatosis with polyangitis?
A 50 year old female presents with dry cough and purple nodules on her shins. CXR shows bilateral hilar lymphadenopathy. She works as an accountant. Her TST is 4mm. What is the most likely diagnosis?
sarcoidosis (female, dry cough, erythema nodosum, classic CXR)
While ITP presents with isolated thrombocytopenia, TTP, HUS, and DIC will show an increase in this enzyme, which helps interconversion of lactate and pyruvate
LDH
This rash, which sounds scarier than it is, typically appears on the second day of life and is characterized by erythematous macules and papules, vesicles and pustules on the newborn’s face, trunk and extremities (palms and soles spared) with lesions that will appear and disappear within minutes to hours.
What is erythema toxicum neonatorum?
multifocal atrial tachycardia classically associated with this condition
What is severe COPD?