Giant Cell Arteritis and SLE Overview
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Giant Cell Arteritis and SLE Overview

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Questions and Answers

Which of the following conditions is most commonly linked with optic neuritis?

  • Rheumatoid arthritis
  • Multiple sclerosis (correct)
  • Diabetes mellitus
  • Lupus erythematosus

    • Which statement about lupus retinopathy accurately reflects its characteristics?

  • It frequently causes retinal ischemia.
  • It is characterized by retinal atrophy.
  • It is the most prevalent ocular manifestation of lupus. (correct)
  • It is primarily symptomatic.

    • What finding is typically associated with lupus retinopathy?

  • Flame-shaped hemorrhages
  • Cotton wool spots (correct)
  • Retinal detachment
  • Exudative retinal layers

    • Which joint is most commonly affected by rheumatoid arthritis?

    <p>Interphalangeal and metacarpophalangeal joints</p> Signup and view all the answers

    What is a typical feature of rheumatoid arthritis?

    <p>Bilateral joint involvement</p> Signup and view all the answers

    Which of the following is NOT considered a diagnostic criterion for rheumatoid arthritis?

    <p>Significant elevation of ESR</p> Signup and view all the answers

    Which of the following statements regarding rheumatoid arthritis is correct?

    <p>It can lead to systemic complications.</p> Signup and view all the answers

    Which visual condition is linked with posterior uveitis?

    <p>Serous retinal detachment</p> Signup and view all the answers

    What is a common characteristic of the headache associated with Giant Cell Arteritis?

    <p>It worsens in the morning.</p> Signup and view all the answers

    Which blood test, when elevated, indicates a strong likelihood of Giant Cell Arteritis?

    <p>C-Reactive Protein (CRP)</p> Signup and view all the answers

    What systemic symptom is most commonly associated with Giant Cell Arteritis?

    <p>Fever and weight loss</p> Signup and view all the answers

    In response to treatment with oral steroids, which lab value would likely show elevation?

    <p>Erythrocyte Sedimentation Rate (ESR)</p> Signup and view all the answers

    What is the most likely diagnosis for a patient with sudden painless vision loss and a pale, swollen optic disc?

    <p>Arteritic Anterior Ischemic Optic Neuropathy (AAION)</p> Signup and view all the answers

    Which artery is most commonly ischemic in cases of Arteritic Anterior Ischemic Optic Neuropathy (AAION)?

    <p>Posterior Ciliary Artery</p> Signup and view all the answers

    Which symptom is most characteristic of Arteritic Anterior Ischemic Optic Neuropathy (AAION)?

    <p>Sudden vision loss</p> Signup and view all the answers

    Which of the following conditions is most likely to coexist with a patient diagnosed with Giant Cell Arteritis?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    Which symptom is least likely to be present in Sjogren’s Syndrome?

    <p>Proptosis</p> Signup and view all the answers

    What is the minimum point requirement for a diagnosis of Sjogren’s Syndrome according to its diagnostic criteria?

    <p>4 points</p> Signup and view all the answers

    Which diagnostic finding is awarded the highest point value in the assessment of Sjogren’s Syndrome?

    <p>Lip biopsy with focus ≥ 1 foci/4mm²</p> Signup and view all the answers

    What is considered a key management strategy for patients with Sjogren’s Syndrome?

    <p>Over-the-counter and prescription dry eye treatments</p> Signup and view all the answers

    In the dry eye work-up for Sjogren’s Syndrome, which measurements are typically assessed?

    <p>Tear production, tear osmolarity, tear film stability, and meibomian gland evaluation</p> Signup and view all the answers

    Which of the following symptoms is often associated with Sjogren’s Syndrome?

    <p>Photophobia</p> Signup and view all the answers

    Which of the following tests is not typically part of the diagnostic criteria for Sjogren’s Syndrome?

    <p>Hematologic analysis</p> Signup and view all the answers

    What is the typical unstimulated salivary flow rate indicative of Sjogren’s Syndrome?

    <p>≤ 0.1 mL/min</p> Signup and view all the answers

    Which of the following is a diagnostic criterion for Systemic Lupus Erythematosus (SLE)?

    <p>Malar (butterfly) rash</p> Signup and view all the answers

    What percentage of patients with Systemic Lupus Erythematosus (SLE) experience arthritis?

    <p>90%</p> Signup and view all the answers

    Which laboratory test is most frequently positive in patients with Systemic Lupus Erythematosus (SLE)?

    <p>Antinuclear antibody (ANA)</p> Signup and view all the answers

    A patient with Systemic Lupus Erythematosus presents with chest pain due to inflammation. Which diagnostic criterion does this symptom satisfy?

    <p>Serositis</p> Signup and view all the answers

    Which of the following is NOT considered a potential complication of Systemic Lupus Erythematosus (SLE)?

    <p>Diabetes mellitus</p> Signup and view all the answers

    Which of the following ocular manifestations is most commonly associated with Systemic Lupus Erythematosus?

    <p>Dry eyes</p> Signup and view all the answers

    Which symptom is least likely to be associated with Systemic Lupus Erythematosus (SLE)?

    <p>Weight loss</p> Signup and view all the answers

    Which of the following incorrectly describes arthritis as it pertains to Systemic Lupus Erythematosus (SLE)?

    <p>It is usually accompanied by severe pain</p> Signup and view all the answers

    What should be considered next if NSAID treatment fails in a patient with axial spondyloarthropathy?

    <p>Biologics such as TNF-alpha inhibitors or IL-17 inhibitors</p> Signup and view all the answers

    Which ocular manifestation is most commonly seen in spondyloarthropathies?

    <p>Acute anterior uveitis</p> Signup and view all the answers

    Which type of uveitis is often seen in patients with reactive and psoriatic arthritis?

    <p>Bilateral, recurrent anterior uveitis</p> Signup and view all the answers

    What condition should be a key differential diagnosis when encountering severe dry eye or bilateral uveitis?

    <p>Sarcoidosis</p> Signup and view all the answers

    What is a recommended regular step for patients undergoing hydroxychloroquine therapy?

    <p>Administering monthly retinal exams</p> Signup and view all the answers

    Which of the following is not typically associated with the treatment of axial spondyloarthropathy after NSAIDs?

    <p>DMARDs such as methotrexate</p> Signup and view all the answers

    Which statement about the ocular manifestations of spondyloarthropathies is true?

    <p>Acute anterior uveitis can lead to vision loss if untreated.</p> Signup and view all the answers

    What is the appropriate action if side effects occur in a patient taking hydroxychloroquine?

    <p>Discontinue the medication if side effects arise.</p> Signup and view all the answers

    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.

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