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Medicine

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Rheumatology

Question
45 out of 50
 

Palpable purpura could occur in the following conditions, except: (AI 2005, AIIMS May 94)



A Thrombocytopenia.

B Small-vessel vasculitis.

C Disseminated gonococcal infection.

D Acute meningococcemia.

Ans. A Thrombocytopenia.

Extra Edge : Cause of palpable purpura

Extra Edge

A. Emboli (bacterial fungal or parasitic)

i. Acute meningococcemia ii. Disseminated gonococcal infection

iii. Rocky mountain spotted fever iv. Ecthymagangrenosum

B. Vasculitis

i. Leukocytoclasticvasculitis (predominantly cutaneous vasculitis)

ii. Henoch - Schönleinpurpura iii. Polyarteritisnodosa

Comparison of major types of vasculitis

Vasculitis

Affected organs

Histopathology

1. Cutaneous small-vessel vasculitis

Skin, kidneys

Neutrophils, fibrinoid necrosis

2. Wegener's granulomatosis

Nose, lungs, kidneys

Neutrophils, giant cells

3. Churg–Strauss syndrome

Lungs, kidneys, heart, skin

Histiocytes, eosinophils

4. Kawasaki disease

Skin, heart, mouth, eyes

Lymphocytes, endothelial necrosis

5. Buerger's disease

Leg arteries and veins (gangrene)

Neutrophils, granulomas

Extra Edge

Disease Entity

Associated specific antibody against :

1. Systemic sclerosis

DNATopo-isomerase I {Anti Scl 70 Ab}

2. CREST SYNDROME

Anti Centromere

3. Sjogren syndrome

Anti SSa and Anti SSb and Anti Fodrin antibody

4. Inflammatory myopathies

Anti Jo1 antibody

4. Cold AIHA asso with Mycoplasma pneumonia

Anti I-antibody

5. Cold AIHA asso with Infectious mononucleosis

Anti i-antibody

6. Behcets syndrome

Anti alphaEnolase of endothelial cells and ASCA in late cases

7. Chrohns disease

ASCA

8. Rheumatic fever

Serum 883- A B-cell alloantigen and

Antibody labelled D8/17

9. Type II MPGN and Partial Lipodystrophy

C3 nephritic factor-which binds to alternate complement system C3 convertase and stabilizes it

10. Rheumatoid arthritis

Anti CCP antibody

11. Mixed connective tissue disease

Anti RNP antibodies

12. HCV infection

Anti LKM 1 antibody

13. Autoimmune hepatitis Type 1

ANA

14. Autoimmune hepatitis Type 2a

High titre anti LKM

15. Autoimmune hepatitis Type 2b

Low titre anti LKM

16. Autoimmune hepatitis Type 3

Antibody to Soluble liver antigen { SLA}

17. Primary biliary cirrhosis

Anti mitochondrial-E2 subunit of pyruvate dehydrogenase complex

18. Celiac sprue

IgA anti-gliadin

IgA anti endomysial

IgA anti tissue transglutaminase

IgA anti reticulin antibody

19. Myasthenia gravis

Anti Ach receptor antibody

Anti Muscle specific kinase antibody {MUSK}

20. Lambert Eaton myasthenic syndrome

Anti P/Q type calcium channels

21. Fischer syndrome

Anti ganglioside antibody {GQIb}

22. Chronic Hepatitis D

Anti LKM III

23. Heparin induced thrombocytopenia

Antibody against complex of heparin with Platelet factor 4 membrane protein

24. Polyarticular JRA

Rheumatoid factor and Antinuclear antibodies

25. Pauciarticular JRA

Antinuclear antibodies only

26. Systemic onset JRA

No antibodies

Buerger's disease

Rheumatology Flashcard List

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