SLE - SOAP serositis, oral ulcers, arthritis, photosensitivity (+)ANA, but not diagnostic, make sure you see

other features of SLE Sjogrens - autoimmune, glands dry eye lady, woman (9to1), mouth Mainly treatment elvated ESR sicca(keratoconjutavitis) xerostomea (dry mouth) lymphocytic infiltrate **Peripheral neuropathys thryoid and renal dys(fx) can occur alone (1*) or with others Differential (2ndary) 60% RA, sle, systemic sclerosis 1st 20's-30's following menapause Schirmer - tear test x less than 5 anti-Ro(ss-a) anti-la(ss-b) Technitium-99m, decreased uptake, measures salivary F(x) systemic sclerosis - SCLERODERMA! initially, non-specific fatigue, diffuse swelling of hands,rayna uds, telaecstasia key factors of history ANA, (+) 90% WITH THESE SIGNS connective tissue d(x), 30-50 women atrophy of the skin, and epithelial parts of internal organs distal and upper extremities anticentromere antibody CREST?? treatment to symptoms, renal dys possible but small (treat with ACE inhibitors) cardiac invloment S&S diabetes, only skin, doughy neck back face, TESTS crp esr cbc (possibly) bun, ecg, usually all normal advanced these would be increased

mixed connective tissue disorders - be on all Diff(DX) overlap syndromes of SLE, scleroderma, mysotits, and RA, w/ HIGH Titers of U1-ribonucleoprotien female 20-30 90% have Raynauds phenomenom on presentation arthritis, GERD, swollen hands, mysotits, sclerodermatous skin c hanges TESTS, cbc, esr, esr, bun, ana, High Anti-jo-1 (+) anti synthest ase

RA

sysmmetric, lab and radiograph NSAIDS just for pain, Methotrexate

and plantar fascia.achilles. Felty syndrome . scleroderma. sacroiliac joi nt Common in knee and back more than 6 months is chronic back pain relieved by exercise fever fatique ENTHESITIS. xrays Reiter's syndrome Reactive arthritis Males 20-40. nodules. ASSYMETRIC. neutropenia RA-factor test.morning stiffness great than ONE hour. manifest as heel pain TESTs ESR. 3 more joints. CRP. then tendons invol ved eye inflammatiom/urethritis most often on side with a few joints. splenomegaly. HLA-B27 post gonnococcoal (STD). diff diag. elveated x-rays .Triad of RA. active arhtritis greater than 6 weeks female 50 years.

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