Physical Exam
Category of arthritis with pattern of inflammatory arthritis in the spine and SI joints
Ankylosing Spondylitis
anti-HLA B27
Thick, red, scaly skin patches with well-defined edges, most commonly on knees, elbows, trunk and scalp
Psoriasis
Anti-topoisomerase I (anti-Scl 70)
Most specific antibody for diffuse scleroderma
The first line DOC for SLE
**NOT for COVID :,)
Hydroxychloroquine
Osteoarthritis
Most specific antibody for Lupus
Anti-dsDNA
Round, coin-shaped lesions most often on the face or scalp, usually asymptomatic and provoked by UV light
Discoid lupus erythematosus
Cut-off dilution for significant positive ANA value
1:80
This is the mechanism of action of etanercept
Binds TNF-alpha
Gottron papules + proximal muscle weakness
Most specific for rheumatoid arthritis
Anti-CCP
White Norwegian male woke up 4 days ago with sudden onset of severe shoulder pain and stiffness, as well as pain and stiffness in hands an knees. Never had joint pain until this. He can barely function.
Polymyalgia rheumatica
Positive ANA with speckled pattern & positive anti-Smith
SLE (Lupus)
Drug that acts on CD20 to mark B-cell's for destruction
Rituximab
Swollen, painful, knees with rhomboid crystals in synovial fluid
Pseudogout CPPD gout
Drug-induced lupus
Anti-histone
60 year old female is thrilled that her wrinkles have "disappeared". However, she is complaining of constant wounds at the tips of her fingers, and them turning white and numb in the cold. She has also had increasing shortness of breath, difficulty swallowing, and feeling like her fingers are "tight" and can't bend fully, though not painful.
Systemic scleroderma
Anti-Ro (SSA) and Anti-La (SSB)
Adalimumab (Humira), methotrexate, etanercept (Enbrel), infliximab (Remicade), rituximab (Rituxan), hydroxychloroquine (Plaquenil) and sulfasalazine (among others) are all examples of this class of RA therapy
DMARD (disease modifying anti-rheumatic drugs)