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Questions and Answers
Which of the following conditions is most commonly linked with optic neuritis?
Which of the following conditions is most commonly linked with optic neuritis?
Which statement about lupus retinopathy accurately reflects its characteristics?
Which statement about lupus retinopathy accurately reflects its characteristics?
What finding is typically associated with lupus retinopathy?
What finding is typically associated with lupus retinopathy?
Which joint is most commonly affected by rheumatoid arthritis?
Which joint is most commonly affected by rheumatoid arthritis?
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What is a typical feature of rheumatoid arthritis?
What is a typical feature of rheumatoid arthritis?
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Which of the following is NOT considered a diagnostic criterion for rheumatoid arthritis?
Which of the following is NOT considered a diagnostic criterion for rheumatoid arthritis?
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Which of the following statements regarding rheumatoid arthritis is correct?
Which of the following statements regarding rheumatoid arthritis is correct?
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Which visual condition is linked with posterior uveitis?
Which visual condition is linked with posterior uveitis?
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What is a common characteristic of the headache associated with Giant Cell Arteritis?
What is a common characteristic of the headache associated with Giant Cell Arteritis?
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Which blood test, when elevated, indicates a strong likelihood of Giant Cell Arteritis?
Which blood test, when elevated, indicates a strong likelihood of Giant Cell Arteritis?
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What systemic symptom is most commonly associated with Giant Cell Arteritis?
What systemic symptom is most commonly associated with Giant Cell Arteritis?
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In response to treatment with oral steroids, which lab value would likely show elevation?
In response to treatment with oral steroids, which lab value would likely show elevation?
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What is the most likely diagnosis for a patient with sudden painless vision loss and a pale, swollen optic disc?
What is the most likely diagnosis for a patient with sudden painless vision loss and a pale, swollen optic disc?
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Which artery is most commonly ischemic in cases of Arteritic Anterior Ischemic Optic Neuropathy (AAION)?
Which artery is most commonly ischemic in cases of Arteritic Anterior Ischemic Optic Neuropathy (AAION)?
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Which symptom is most characteristic of Arteritic Anterior Ischemic Optic Neuropathy (AAION)?
Which symptom is most characteristic of Arteritic Anterior Ischemic Optic Neuropathy (AAION)?
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Which of the following conditions is most likely to coexist with a patient diagnosed with Giant Cell Arteritis?
Which of the following conditions is most likely to coexist with a patient diagnosed with Giant Cell Arteritis?
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Which symptom is least likely to be present in Sjogren’s Syndrome?
Which symptom is least likely to be present in Sjogren’s Syndrome?
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What is the minimum point requirement for a diagnosis of Sjogren’s Syndrome according to its diagnostic criteria?
What is the minimum point requirement for a diagnosis of Sjogren’s Syndrome according to its diagnostic criteria?
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Which diagnostic finding is awarded the highest point value in the assessment of Sjogren’s Syndrome?
Which diagnostic finding is awarded the highest point value in the assessment of Sjogren’s Syndrome?
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What is considered a key management strategy for patients with Sjogren’s Syndrome?
What is considered a key management strategy for patients with Sjogren’s Syndrome?
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In the dry eye work-up for Sjogren’s Syndrome, which measurements are typically assessed?
In the dry eye work-up for Sjogren’s Syndrome, which measurements are typically assessed?
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Which of the following symptoms is often associated with Sjogren’s Syndrome?
Which of the following symptoms is often associated with Sjogren’s Syndrome?
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Which of the following tests is not typically part of the diagnostic criteria for Sjogren’s Syndrome?
Which of the following tests is not typically part of the diagnostic criteria for Sjogren’s Syndrome?
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What is the typical unstimulated salivary flow rate indicative of Sjogren’s Syndrome?
What is the typical unstimulated salivary flow rate indicative of Sjogren’s Syndrome?
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Which of the following is a diagnostic criterion for Systemic Lupus Erythematosus (SLE)?
Which of the following is a diagnostic criterion for Systemic Lupus Erythematosus (SLE)?
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What percentage of patients with Systemic Lupus Erythematosus (SLE) experience arthritis?
What percentage of patients with Systemic Lupus Erythematosus (SLE) experience arthritis?
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Which laboratory test is most frequently positive in patients with Systemic Lupus Erythematosus (SLE)?
Which laboratory test is most frequently positive in patients with Systemic Lupus Erythematosus (SLE)?
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A patient with Systemic Lupus Erythematosus presents with chest pain due to inflammation. Which diagnostic criterion does this symptom satisfy?
A patient with Systemic Lupus Erythematosus presents with chest pain due to inflammation. Which diagnostic criterion does this symptom satisfy?
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Which of the following is NOT considered a potential complication of Systemic Lupus Erythematosus (SLE)?
Which of the following is NOT considered a potential complication of Systemic Lupus Erythematosus (SLE)?
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Which of the following ocular manifestations is most commonly associated with Systemic Lupus Erythematosus?
Which of the following ocular manifestations is most commonly associated with Systemic Lupus Erythematosus?
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Which symptom is least likely to be associated with Systemic Lupus Erythematosus (SLE)?
Which symptom is least likely to be associated with Systemic Lupus Erythematosus (SLE)?
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Which of the following incorrectly describes arthritis as it pertains to Systemic Lupus Erythematosus (SLE)?
Which of the following incorrectly describes arthritis as it pertains to Systemic Lupus Erythematosus (SLE)?
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What should be considered next if NSAID treatment fails in a patient with axial spondyloarthropathy?
What should be considered next if NSAID treatment fails in a patient with axial spondyloarthropathy?
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Which ocular manifestation is most commonly seen in spondyloarthropathies?
Which ocular manifestation is most commonly seen in spondyloarthropathies?
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Which type of uveitis is often seen in patients with reactive and psoriatic arthritis?
Which type of uveitis is often seen in patients with reactive and psoriatic arthritis?
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What condition should be a key differential diagnosis when encountering severe dry eye or bilateral uveitis?
What condition should be a key differential diagnosis when encountering severe dry eye or bilateral uveitis?
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What is a recommended regular step for patients undergoing hydroxychloroquine therapy?
What is a recommended regular step for patients undergoing hydroxychloroquine therapy?
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Which of the following is not typically associated with the treatment of axial spondyloarthropathy after NSAIDs?
Which of the following is not typically associated with the treatment of axial spondyloarthropathy after NSAIDs?
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Which statement about the ocular manifestations of spondyloarthropathies is true?
Which statement about the ocular manifestations of spondyloarthropathies is true?
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What is the appropriate action if side effects occur in a patient taking hydroxychloroquine?
What is the appropriate action if side effects occur in a patient taking hydroxychloroquine?
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Study Notes
Giant Cell Arteritis
- Age at onset greater than 50 years
- Headache that worsens in the morning
- Scalp tenderness only on palpation
- History of rheumatoid arthritis
- Chronic tinnitus
- Elevated C-Reactive Protein (CRP) in 95% of patients
- Fever and weight loss are commonly associated systemic symptoms
- Oral steroid treatment is expected to elevate Erythrocyte Sedimentation Rate (ESR)
- Sudden, painless vision loss in the right eye is a presenting symptom
- Fundus examination reveals a pale, swollen optic disc
- Arteritic Anterior Ischemic Optic Neuropathy (AAION) is the most likely diagnosis
- Most commonly caused by ischemia of the Posterior Ciliary Artery
Systemic Lupus Erythematosus (SLE)
- Malar (butterfly) rash is a diagnostic criteria
- 50% of patients have arthritis
- Positive Antinuclear antibody (ANA) is likely positive
- Inflammation of the heart and pleura meets the Serositis criteria
- Potential complications include Pneumonitis, Interstitial Lung Disease, Mesenteric Vasculitis, and Raynaud’s phenomenon
Ocular Manifestations of Systemic Lupus Erythematosus (SLE)
- Most common ocular manifestation is Discoid rash of the periocular skin
- Lupus retinopathy is associated with immune complex deposition in the retinal vasculature and RNFL
- Cotton wool spots are a typical finding
Rheumatoid Arthritis (RA)
- Interphalangeal and metacarpophalangeal joints are most commonly affected
- Bilateral and symmetric involvement of joints is common
- Morning stiffness lasting longer than an hour, positive rheumatoid factor, rheumatoid nodules, radiographic evidence of arthritis, and arthritis involving three or more joints are criteria for diagnosis.
Sjogren’s Syndrome
- Proptosis is NOT typically seen
- Polydipsia, Vaginal dryness, Fatigue, and GI symptoms including constipation and acid reflux are commonly seen
- According to the diagnostic criteria, 4 points are required to make a diagnosis
- Anti-Ro/SSA positive provides the highest point value
- Management strategies include over-the-counter and prescription dry eye treatments
- Tear production, tear osmolarity, tear film stability, and meibomian gland evaluation are typically included in a dry eye work-up
Spondyloarthropathies (SpA)
- Genetic mutations are commonly associated
- If NSAID treatment fails, the next step is biologics such as TNF-alpha inhibitors or IL-17 inhibitors
- Most common ocular manifestation is acute anterior uveitis
- Reactive and psoriatic arthritis are typically associated with bilateral, recurrent anterior uveitis
- Sarcoidosis should be a top differential when encountering severe dry eye or uveitis that is not unilateral and acute
- Monthly retinal exams should be taken for patients on hydroxychloroquine therapy
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Description
This quiz covers key characteristics of Giant Cell Arteritis and Systemic Lupus Erythematosus (SLE). It focuses on clinical presentations, diagnostic criteria, and potential complications associated with these conditions. Test your understanding of the pathophysiology and management strategies related to these autoimmune diseases.
