Ben Allin – Autoimmune disease EMQs

A. Type II hypersensitivity reaction

B. Anti-cardiolipin positive

C. Anti-CCP positive

D. Anti-centromere positive

E. Anti-La positive

F. Anti-Ro Positive

G. Anti-SCL70 Positive

H. Low C4

I. RhF negative

J. Type II hypersensitivity reaction

K. Type III hypersensitivity reaction

L. Type IV hypersensitivity reaction

1) A 20 year-old Afro-Caribbean lady presents to the G.P with malaise, fever and oral ulcers. On further questioning the lady admits to having stiff, painful knees.

Answer – H (diagnosis = SLE)

2) A 38 year-old English Lady presents to rheumatology outpatients with a 12-month history of stiffness and pain in the MCP and PIP joints of both hands. On examination you find a soft boggy swelling over her right elbow.

Answer – C (diagnosis Rheumatoid arthritis)

3) A 51 year-old Chinese lady presents is seen by her G.P with dry, cracked hands which she describes as feeling very tight. There is the beginning of ulcers on both the middle and ring fingers of her left hand. On examination you find that small nail bed haemorrhages and some small chalky white lumps in the fingers of her left hand. You’re examination reveals no abnormal findings proximal to her elbows.

Answer – D (diagnosis limited scleroderma)

4) A middle-aged woman presents to her G.P with swelling in her neck, weight loss, diarrhoea and constant sweating. On examination you find a diffuse goitre and a tachycardia.

Answer – J (diagnosis Graves disease)

5) An Asian lady in her mid thirties attending her G.P. for advice on conception. 10 years ago she was diagnosed with SLE. Her G.P. says that if she becomes pregnant there is a risk her baby may have problems with its heart during pregnancy.

Answer - E (diagnosis – complete heart block as part of neonatal SLE)