11/2: Systemic Diseases II Flashcards
What are examples of autoimmune diseases?
Rheumatoid arthritis
Systemic Lupus erythematous (SLD)
Sjogren’s syndrome
Diabetes (type 1)
Grave’s disease (hyperthyroidism)
This is a group of diseases that affect bones, joints, and muscles
Rheumatic disease
What is an autoimmune and inflammatory disease that causes your immune system to attack itself?
Rheumatic disease
What are the 3 rheumatic diseases?
Osteoarthritis
Rheumatoid
Sjorgens syndrome
Almost everyone older than 60 develops what to some degree?
Osteoarthritis
Is osteoarthritis an autoimmune disease?
No
Can you affect TMJ with osteoarthritis?
Yes
Is rheumatoid arthritis autoimmune?
Yes
What is more severe, osteoarthritis or rheumatoid?
Rheumatoid
What is an autoimmune disease of unknown origin?
Rheumatoid arthritis
You get symmetric inflammation of joints, hand, feet and knees in what?
Rheumatoid arthritis
What is the onset age of rheumatoid arthritis?
35-50 years
Rheumatoid arthritis is more prevalent in male or female?
Female (3:1)
Do you get multiple symmetric joint involvement in RA or OA?
RA
Do you get 1-2 joints involved in RA or OA?
OA
Do you get significant joint inflammation in RA or OA?
RA
Do you get pain usually without inflammation in RA or OA?
OA
Do you get morning stiffness lasting longer than 1 hour in RA or OA?
RA
Do you get morning stiffness lasting less than 15 minutes in RA or OA?
OA
You get systemic manifestations such as fatigue, weakness, and malaise in RA or OA?
RA
You get heberden nodes of DIP joints in RA or OA?
OA
You get no systemic involvement in RA or OA?
OA
What is the most common and most serious type of lupus?
Systemic Lupus erythematous (SLE)
What is a chronic inflammatory disorder that affects both internal and
external systems of the body?
Systemic Lupus erythematous (SLE)
Who does Systemic Lupus erythematous (SLE) effect?
Women at a rate of 6:1 and often occurs between 14-44 years of age when estrogen levels are at their highest
What is the typical presentation of SLE?
A women with polyarthritis and a butterfly-shaped erythematous rash across the nose and cheeks
What kind of rash do you get from SLE?
Mild to severe and include itching and feeling of warmth
In what % of patients with SLE is skin involved?
85%
What are triggers of SLE?
Stress, sunlight exposure, pregnancy
What are oral manifestations of SLE?
Ulcerations, petechiae,
and burning mouth
syndrome
What is common due to the use of corticosteroids in the treatment of SLE?
Oral candidiasis and
infections
This is characterized by eye dryness, hyposalication, and enlargement of the parotid gland
Sjogren’s syndrome
What is Sjogren’s syndrome classified as?
Chronic, autoimmune, inflammatory disorder
What is enlarged in people with Sjogren’s syndrome?
Parotid glands in 1/3-1/2 of people
What is predominant involvement for people with Sjogren’s syndrome?
Women, with female to male ratios over 10:1
What is dry
eyes and dry mouth are seen in the absence of a connective tissue disease?
Primary sjogren syndrome (SS-1)
What is dry eyes and dry mouth are seen together with other autoimmune diseases like RA, systemic lupus erythematous, scleroderma?
Secondary sjogren syndrome (SS-2)
Which sjogren syndrome is more common?
Secondary sjogren syndrome
What are the 2nd outcomes of sjorgen syndrome for persistent oral dryness?
Angular cheilosis, dysgeusia, burning mouth syndrome, secondary infections and increase in caries rate
What is not a specific diagnosis but rather a term that refers to a group of disorders?
Epilepsy
What is cahracterized by chronic and recurrent, paroxysmal changes in neurological function (seizures), altered consciousness, or involuntary movements caused by the abnormal and spontaneous electrical activity in the brain?
Epilepsy
What percentage of patients with epilepsy achieve complete control over their seizures within 5 years?
60-80%
What are the 3 major forms of seizures?
- Grand Mal
- Petit Mal
- Status epilepticus
What is the most common form of seizure?
Grand mal
What is triggered by CV accidents, photic stimulation, fatigue, and intoxication. Seizure last 5-15 minutes but may take up to 2 hours for normal cerebral function to return?
Grand mal (tonic-clonic seizures)
What major form of seizures occur more frequently?
Petit mal
What is charactrized as multiple daily episodes. Usually shortly after awakening or
during periods of inactivity. No aura
Petit mal (absence seizure)
What is the duration of petit mal seizures?
<10 seconds
What is characterized as ontinuous seizure or repetitive recurrence of any type of seizure without recovery between attacks?
Status epilepticus
What do you give someone with status epilepticus?
enzodiazepines (Lorazepam)
What type of seizure is rapid onset, well tolerated and high efficacy?
Status Epilepticus
What are symptoms of epilepsy?
Aura (grand mal)
Unusual smell or vision
Irritability
Epileptic cry (when tonic-clonic seizures begin,
spasms force air out of lungs resulting in a cry or moan)
Loss of consciousness
Muscle regidity
You get what right before epilepsy?
Epileptic cry
What is the long term drug therapy for epilepsy?
Dilantin
Tegretol
You can get what from taking dilantin for epilepsy?
Gingival hyperplasia
What is uncontrolled epilepsy?
> 1-2 seizures/month
Med consult
Avoid triggers
What are well-controlled epilepsy?
<1-2 seizures/month
Med consult
What are epilepsy interview questions?
How long have you had epilepsy?
What type of seizures do you have?
How frequently do your seizures occur?
What type of medication, if any, do you take to
control the seizures?
How do your seizures begin?
Is there a warning at the beginning of the seizure?
Can you talk and respond appropriately during a
seizure?
Do you get confused or tired after a seizure?
When was your last (or most recent) seizure?
Should you restrain or hold a patient who is having epilepsy?
No
What happens in GERD?
Acid reflux - stomach liquids regurgitate
What can increase GERD?
Pregnancy
Bad sphincter
Obesity
Alcohol
Smoking
Can increase with age
What are the dental complications of GERD?
Halitosis
Enael erosion
What medications upset your stomach in GERD?
Codeine
Erythromycin
You get sudden, severe, electric or stabbing pain in what?
Trigeminal neuralgia (= Tic douloureux)
Where is pain in Trigeminal neuralgia?
Side of jaw or cheek
Trigeminal neuralgia is stimulated by what?
Physical stimulus
Trigeminal neuralgia affect mostly
Women >50
Trigeminal neuralgia may disappear
Sporadically
How long does trigeminal neuralgia last?
Several seconds
Medication history includes all?
Rx
OTC
Herbal, natural, aternative
Have pt bring list
What are true allergies?
Itching
Hives
Rash
Swelling
Wheezing
What are symptoms of drug intolerance?
Nausea
Vomiting
Palpitations
Not true allergy
Avoid using drug anyway