Pregnancy should be avoided if there is neurological, renal and cardiac abnormality in SLE.
If the mother has “anti-Ro antibody” (SSA), there may be congenital complete heart block of the baby, due to transplacental transfer of antibody. With anti Ro or anti La antibodies in mother, there is 2% risk of giving birth to a baby with neonatal lupus syndrome.
This is characterized by skin rash, hepatitis and fetal heart block.
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If the mother has “anti-Ro antibody” (SSA), there may be congenital complete heart block of the baby, due to transplacental transfer of antibody. With anti Ro or anti La antibodies in mother, there is 2% risk of giving birth to a baby with neonatal lupus syndrome.
This is characterized by skin rash, hepatitis and fetal heart block.
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Sulfasalazine
Side effects:
-GIT upset (anorexia, nausea, vomiting, diarrhea)
-Skin rash
-Stevens Johnson syndrome
-Reversible sterility in males
-Blood dyscrasias (agranulocytosis,megaloblastic anemia and hemolytic anemia)
-Hemolysis in patients with G6PD deficiency.
Periodic check up:
-CBC
-LFT
-RFT
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Side effects:
-GIT upset (anorexia, nausea, vomiting, diarrhea)
-Skin rash
-Stevens Johnson syndrome
-Reversible sterility in males
-Blood dyscrasias (agranulocytosis,megaloblastic anemia and hemolytic anemia)
-Hemolysis in patients with G6PD deficiency.
Periodic check up:
-CBC
-LFT
-RFT
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Rituximab
In RA, also lymphoma, vasculitis
MOA: is an antibody directed against the CD20 receptor
•Adverse effects include
-Hypogammaglobulinaemia
-Infusion reactions
-Increased risk of infections
-Progressive multifocal leucoencephalopathy a serious and potentially fatal infection of the CNS caused by reactivation of JC virus.Rare.
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In RA, also lymphoma, vasculitis
MOA: is an antibody directed against the CD20 receptor
•Adverse effects include
-Hypogammaglobulinaemia
-Infusion reactions
-Increased risk of infections
-Progressive multifocal leucoencephalopathy a serious and potentially fatal infection of the CNS caused by reactivation of JC virus.Rare.
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Differences between primary and secondary Raynaud’s syndrome.
1-Age
P- 15-30 years, less than 30 years
S- More than 30 years
2-Gender
P- Female >male
S- F: M, 4:1
3-Family history
P- Present
S- Absent
4-Symmetry
P- Symmetrical
S- Asymmetrical
5-Gangrane&Ulceration
P-Absent
S-Present
6-ANA
P- negative
S- positive
7-Capillary nail-fold loops test
P- negative
S- positive "fallout".
P-Primary
S-Secondary
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1-Age
P- 15-30 years, less than 30 years
S- More than 30 years
2-Gender
P- Female >male
S- F: M, 4:1
3-Family history
P- Present
S- Absent
4-Symmetry
P- Symmetrical
S- Asymmetrical
5-Gangrane&Ulceration
P-Absent
S-Present
6-ANA
P- negative
S- positive
7-Capillary nail-fold loops test
P- negative
S- positive "fallout".
P-Primary
S-Secondary
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In Raynaud’s syndrome
Drugs to be avoided:
-Beta-blocker
Non-selective agents
•Alprenolol
•Bucindolol
•Carteolol
•Carvedilol
•Labetalol
•Nadolol
•Penbutolol
•Pindolol
•Propranolol
•Sotalol
•Timolol
-Ergotamine
-Oral contraceptive
-Sympathomimetic:
-Alpha and beta agonists
Salbutamol, phenylephrine, isoproterenol, and dobutamine.
Drugs may be given:
-Calcium antagonist (diltiazem and nifedipine)
-ACE inhibitor
-Angiotensin II receptor blocker
(valsartan)
-Aspirin
-Epoprostenol"prostacyclin analog"
-Sympatholytic" alpha blocker not beta "Prazosin (α1 inverse agonist).
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Drugs to be avoided:
-Beta-blocker
Non-selective agents
•Alprenolol
•Bucindolol
•Carteolol
•Carvedilol
•Labetalol
•Nadolol
•Penbutolol
•Pindolol
•Propranolol
•Sotalol
•Timolol
-Ergotamine
-Oral contraceptive
-Sympathomimetic:
-Alpha and beta agonists
Salbutamol, phenylephrine, isoproterenol, and dobutamine.
Drugs may be given:
-Calcium antagonist (diltiazem and nifedipine)
-ACE inhibitor
-Angiotensin II receptor blocker
(valsartan)
-Aspirin
-Epoprostenol"prostacyclin analog"
-Sympatholytic" alpha blocker not beta "Prazosin (α1 inverse agonist).
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Rheumatic disorders that maybe associated with secondary Raynaud's phenomenon:
[systemic scleroderma (85%), SLE (35%), DM (30%), Sjögren syndrome, rheumatoid arthritis, polyarteritis nodosa].
Others:
Diseases with abnormal blood proteins (cryoproteins, cold agglutinins, macroglobulins)
Drugs (β-adrenergic blockers, nicotine)
Aterial diseases (arteriosclerosis obliterans, thromboangiitis obliterans).
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[systemic scleroderma (85%), SLE (35%), DM (30%), Sjögren syndrome, rheumatoid arthritis, polyarteritis nodosa].
Others:
Diseases with abnormal blood proteins (cryoproteins, cold agglutinins, macroglobulins)
Drugs (β-adrenergic blockers, nicotine)
Aterial diseases (arteriosclerosis obliterans, thromboangiitis obliterans).
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Causes of proximal myopathy:
-Myopathy (limb girdle, fascioscapulohumeral), except myotonic dystrophy which causes distal.
-Myasthenia gravis
-Muscular dystrophy
-Myasthenic myopathic syndrome (Eaton-Lambert syndrome).
1-Inflammatory:
• Polymyositis
• Dermatomyositis
• Inclusion body myositis (predominantly distal effects).
2-Endocrine:
Endocrine/metabolic
• Hypothyroidism
• Hyperthyroidism
• Acromegaly
• Cushing’s syndrome
(including iatrogenic, steroids)
• Addison’s disease
• Conn’s syndrome
• Diabetic amyotrophy
• Hyperparathyroidism.
3-Metabolic:
• Osteomalacia
• Hypokalaemia (liquorice, diuretic and purgative abuse)
• Hypercalcaemia (disseminated bony metastases)
• Paraneoplastic
• Carcinomatous neuromyopathy
• Periodic paralysis
•Carnitinedeficiency
•Phosphofructokinase deficiency
•Myophosphorylase deficiency.
4-Rheumatology:
• Dermatomyositis, Polymyositis, SLE, RA, SScl.
5-Toxic:
• Alcohol (chronic and acute syndromes)
• Amphetamines/cocaine/heroin
• Vitamin E
• Organophosphates
• Snake venoms.
6-Drugs:
• Glucocorticoids
• Statins
• Amiodarone
• β-blockers
• Opiates
• Chloroquine
• Ciclosporin
• Vincristine
• Clofibrate
• Zidovudine
• Fibrates
• Pencillamine
• Colchicine
• Tumour necrosis factor
inhibitors.
7-Infections:
• Viral (HIV, cytomegalovirus, rubella, Epstein–Barr, echo)
• Parasitic (schistosomiasis, cysticercosis, toxoplasmosis)
• Bacterial (Clostridium perfringens, staphylococci, tuberculosis, Mycoplasma).
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-Myopathy (limb girdle, fascioscapulohumeral), except myotonic dystrophy which causes distal.
-Myasthenia gravis
-Muscular dystrophy
-Myasthenic myopathic syndrome (Eaton-Lambert syndrome).
1-Inflammatory:
• Polymyositis
• Dermatomyositis
• Inclusion body myositis (predominantly distal effects).
2-Endocrine:
Endocrine/metabolic
• Hypothyroidism
• Hyperthyroidism
• Acromegaly
• Cushing’s syndrome
(including iatrogenic, steroids)
• Addison’s disease
• Conn’s syndrome
• Diabetic amyotrophy
• Hyperparathyroidism.
3-Metabolic:
• Osteomalacia
• Hypokalaemia (liquorice, diuretic and purgative abuse)
• Hypercalcaemia (disseminated bony metastases)
• Paraneoplastic
• Carcinomatous neuromyopathy
• Periodic paralysis
•Carnitinedeficiency
•Phosphofructokinase deficiency
•Myophosphorylase deficiency.
4-Rheumatology:
• Dermatomyositis, Polymyositis, SLE, RA, SScl.
5-Toxic:
• Alcohol (chronic and acute syndromes)
• Amphetamines/cocaine/heroin
• Vitamin E
• Organophosphates
• Snake venoms.
6-Drugs:
• Glucocorticoids
• Statins
• Amiodarone
• β-blockers
• Opiates
• Chloroquine
• Ciclosporin
• Vincristine
• Clofibrate
• Zidovudine
• Fibrates
• Pencillamine
• Colchicine
• Tumour necrosis factor
inhibitors.
7-Infections:
• Viral (HIV, cytomegalovirus, rubella, Epstein–Barr, echo)
• Parasitic (schistosomiasis, cysticercosis, toxoplasmosis)
• Bacterial (Clostridium perfringens, staphylococci, tuberculosis, Mycoplasma).
مجمع من عدة كتب.
مهم جداً،قد يجي writing، أو بيتكرر كثير على هيئة all of the following except.
#MCQ
#Writing
#Medicine