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Medicine

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Rheumatology

Question
7 out of 12
 

All of the following features about generalized (diffuse) systemic sclerosis are true, Except:



A Raynaud' s phenomenon can be seen years before skin changes occur

B Trunk involvement

C Frequent systemic symptoms

D All statements are true

Ans. D All statements are true

1. Systemic features:

i. Musculoskeletal Manifestations

ii. There is arthralgia and a mild non – erosive inflammatory arthritis.

iii. Inflammation of synovium with hypertrophy and hyperplasia of synovial soft tissues.

iv. Closely reminiscent of rheumatoid arthritis but joint destruction is not common.

Extra edge: Scleroderma is associated with resorption of long bones and not their sclerosis.

2. The Gastrointestinal Tract

i. This is involved in the majority of patients. There is involvement of the lower two thirds of the esophagus resulting in loss o esophageal peristalsis and dysphagia.

ii. GAVE

a. Gastroparesis with early satiety, abdominal distention, and aggravated reflux symptoms is common.

b. Gastric antral vascular ectasia (GAVE) in the antrum may occur.

c. These subepithelial lesions, reflecting the diffuse small-vessel vasculopathy of SSc, are described as "watermelon stomach" due to their endoscopic appearance.

d. Patients with GAVE can have recurrent episodes of gastrointestinal bleeding, resulting in chronic unexplained anemia. (H-18th Pg 2765)

iii. Later on abdominal pain, intestinal obstruction, malabsorption and weight loss occurs due to intestinal involvement.

3. Pulmonary Manifestations

i. Pulmonary interstitial fibrosis

ii. Pulmonary hypertension (AIIMS Nov 09)

iii. RVF

4. Cardiac Manifestations

i. Pericarditis, hypertension

ii. Cardiomyopathy

iii. AR

iv. Ischemic heart disease may occur due to vasospasm of the coronary arteries.

v. Left ventricular failure may occur secondary to hypertension.

Rheumatology Flashcard List

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