Re: Pathology 4
TheOne - 09-25-06 13:06

Explanation: The correct answer is D. The patient described probably has systemic lupus erythematosus (SLE). This is a systemic disorder that often presents with fatigue, malaise, fever, gastrointestinal symptoms, arthralgias, and myalgias. Hematologic abnormalities include anemia of chronic disease, hemolytic anemia, leukopenia, lymphocytopenia, and thrombocytopenia. A circulating anticoagulant may prolong the APTT (activated partial thromboplastin time). Cutaneous manifestations include a malar rash and a generalized maculopapular eruption, both of which are photosensitive. Antibodies to the Smith antigen (core proteins of small ribonucleoproteins found in the nucleus) are present in only 20-30% of patients with SLE, but are quite specific for the disease, occurring only rarely in other autoimmune diseases. Anti-centromere antibody (choice A) is specific for the CREST (Calcinosis, Raynaud's syndrome, Esophageal dysfunction, Sclerodactyly, and Telangiectasia) variant of progressive systemic sclerosis (scleroderma). Rheumatoid factor is actually an autoantibody directed against the Fc portion of the IgG molecule (choice B). It is found in more than two-thirds of patients with rheumatoid arthritis. The majority of patients with SLE (around 95%) develop antinuclear antibodies (ANA; choice C), so this test is quite sensitive, but not very specific for SLE. ANA occur in other inflammatory disorders, autoimmune diseases, viral diseases, and in a number of normal individuals. Antibodies to double-stranded DNA are more specific for SLE, but are not included as an answer choice. Anti-SS-A antigen (choice E) refers to antibodies to certain ribonucleoproteins, which are fairly specific for Sj?gren's syndrome.

Re: Pathology 4
galaxy - 05-27-10 17:48

A 34-year-old woman presents with fatigue, malaise, and swollen, tender joints. Physical examination is significant for a maculopapular eruption over sun-exposed areas, including the face. Examination of a peripheral blood smear reveals mild thrombocytopenia. Which of the following autoantibodies, if present, would be most specific for the diagnosis of the patient's disorder?

D. Anti-Sm (Smith antigen) antibody

Re: Pathology 4
galaxy - 05-27-10 17:57

A 34-year-old woman presents with fatigue, malaise, and swollen, tender joints. Physical examination is significant for a maculopapular eruption over sun-exposed areas, including the face. Examination of a peripheral blood smear reveals mild thrombocytopenia. Which of the following autoantibodies, if present, would be most specific for the diagnosis of the patient's disorder?

D. Anti-Sm (Smith antigen) antibody

Re: Pathology 4
babbu5508 - 06-21-10 14:39

D. Anti-Sm (Smith antigen) antibody is the most specific for diagnosing systemic lupus erythematosis..suspected by her symptoms

Re: Pathology 4
bingousmle - 06-30-10 22:46

Antibodies to the Smith antigen (core proteins of small ribonucleoproteins found in the nucleus) are present IN SLE, are quite specific for the disease

Re: Pathology 4
leenamathew1 - 07-04-10 06:58

d

Re: Pathology 4
dinmenace - 06-30-11 23:44

d