Rheumatology: Key Clinical Conditions
Autoimmune and inflammatory joint diseases — presentation and diagnosis.
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Which autoantibody is considered the most specific marker for the diagnosis of Rheumatoid Arthritis?
Anti-cyclic citrullinated peptide (anti-CCP) antibodies.
In Rheumatoid Arthritis, which specific joints of the hand are typically spared, helping to distinguish it from osteoarthritis?
The distal interphalangeal (DIP) joints.
What is the primary mechanism of action of Methotrexate, the first-line DMARD for Rheumatoid Arthritis?
It is a folate antimetabolite that inhibits dihydrofolate reductase, interfering with DNA synthesis.
Which laboratory test is the most sensitive initial screening tool for Systemic Lupus Erythematosus (SLE)?
Antinuclear Antibody (ANA) test.
Which antibody is highly specific for Systemic Lupus Erythematosus and correlates with disease activity and the presence of lupus nephritis?
Anti-double-stranded DNA (anti-dsDNA) antibodies.
Describe the characteristic cardiac valvular lesion associated with Systemic Lupus Erythematosus.
Libman-Sacks endocarditis, which consists of small, sterile vegetations on both sides of the heart valves.
How are the crystals in Gout described when viewed under polarized light microscopy?
Needle-shaped and negatively birefringent (yellow when parallel to the slow axis).
What is the first-line pharmacological agent used for long-term urate-lowering therapy in patients with chronic gout?
Allopurinol.
What is the chemical composition of the crystals found in Pseudogout?
Calcium pyrophosphate dihydrate (CPPD).
How do pseudogout crystals appear under polarized light microscopy compared to gout crystals?
They are rhomboid-shaped and positively birefringent (blue when parallel to the slow axis).
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