Examkin

Soru

Zorluk: OrtaRheumatology and Immunology

Match each clinical presentation with the specific autoantibody most highly associated with the patient's underlying rheumatologic condition.

  • A 24-year-old woman presenting with oral ulcers, non-deforming arthritis, and a photosensitive erythematous rash across her cheeks and nasal bridge.Anti-double-stranded DNA (anti-dsDNA) antibodies
  • A 52-year-old woman reporting severe, persistent dry eyes, difficulty swallowing dry foods, and bilateral parotid gland enlargement.Anti-Ro/SSA antibodies
  • A 45-year-old man developing progressive difficulty rising from a chair, accompanied by an erythematous rash on his upper eyelids and violaceous papules on his knuckles.Anti-Jo-1 antibodies
  • A 60-year-old woman presenting with diffuse skin thickening extending to her trunk, new-onset oliguric renal failure, and severe hypertension.Anti-topoisomerase I (anti-Scl-70) antibodies

Cevap

The correct pairings link each classic clinical phenotype to its serologic marker: SLE with anti-dsDNA, Sjögren syndrome with Anti-Ro/SSA, dermatomyositis with Anti-Jo-1, and diffuse systemic sclerosis with Anti-topoisomerase I.
Each rheumatologic disease has specific highly-associated autoantibodies that aid in diagnosis and prognosis. The malar rash and arthritis point to SLE (anti-dsDNA). Sicca symptoms indicate Sjögren syndrome (Anti-Ro/SSA). Proximal weakness with heliotrope rash identifies dermatomyositis (Anti-Jo-1). Truncal skin thickening with renal crisis indicates diffuse systemic sclerosis (Anti-Scl-70).

Adım Adım Çözüm

1
Analyze the first patient's symptom cluster: oral ulcers, non-deforming arthritis, and a photosensitive malar rash.
These are key diagnostic criteria for systemic lupus erythematosus (SLE).
Identifying the disease process is required to select the specific autoantibody (anti-dsDNA).
2
Evaluate the second patient's findings: dry eyes (keratoconjunctivitis sicca), dry mouth (xerostomia), and parotid enlargement.
This indicates primary Sjögren syndrome.
Sjögren syndrome is classically associated with anti-Ro/SSA and anti-La/SSB antibodies.
3
Assess the third patient's presentation: proximal muscle weakness, periorbital rash (heliotrope), and knuckle papules (Gottron).
These are the hallmark features of dermatomyositis.
Dermatomyositis falls under idiopathic inflammatory myopathies, which frequently exhibit anti-synthetase antibodies like Anti-Jo-1.
4
Examine the fourth patient's signs: diffuse truncal skin thickening and abrupt malignant hypertension with renal failure.
This defines diffuse systemic sclerosis complicated by scleroderma renal crisis.
Diffuse systemic sclerosis is highly correlated with Anti-topoisomerase I (anti-Scl-70) antibodies, differentiating it from the limited variant.

Anahtar Kavram

Autoantibody associations in connective tissue and rheumatologic diseases
Bu soruyu puanla

Konular

Rheumatology and Immunology

Bu konudan daha fazla soru