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Clinical Medicine I > Autoimmune Disorders > Flashcards

Autoimmune Disorders Flashcards

1
Q

Cause of general autoimmune disorders

A
  • immune mechanism is directed against self antigens
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2
Q

Etiologic of general autoimmune disorders

A
  • acquired diseases, cause may not be determined
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3
Q

Pathogenesis of general autoimmune disorders

A
  • disruption of immunoregulatory mechanism
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4
Q

Treatment for general autoimmune disorders

A
  • maintain balance between adequate suppression & maintenance of immune function as well as symptom relief
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5
Q

Define lupus erthematosus

A
  • chronic inflammatory autoimmune disorder with highly variable clinical presentation
  • idiopathic
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6
Q

Define discoid lupus erthematosis (DLE)

A
  • affects only the skin
  • rare
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7
Q

Define systemic lupus erthematosis (SLE)

A
  • can affect any organ or system of the body, often in different combinations
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8
Q

Risk factors for lupus

A
  • immunological, environmental, hormonal, & genetic factors
  • physical & mental stressors
  • viral infections
  • sunlight or UV exposure
  • abnormal estrogen metabolism
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9
Q

Pathology of lupus

A
  • autoantibody production
  • inflammation
  • vascular abnormalities
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10
Q

Clinical manifestations of lupus

A
  • fatigue, fever, malaise, & weight loss
  • arthralgia, arthropathy, myalgia, arthritis, & avascular necrosis
  • malar/butterfly rash, photosensitivity, discoid lesions, vasculitis, necrosis, & gangrene
  • acute or chronic renal failure & acute nephritic disease
  • seizure, psychosis, headaches, irritability, & depression
  • pleurisy, pleural effusion, pneumonitis, pulmonary hypertension, & interstitial lung disease
  • nausea, dyspepsia, abdominal pain
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11
Q

Treatment for lupus

A
  • NSAIDS for muscle pains & inflammation
  • Methotrexate for early preservation of bone & cardio protection
  • Antimalarials for dermatological, arthritic, & renal symptoms
  • Immune-modulating drugs
  • Corticosteroids
  • Cytotoxins
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12
Q

Rehab management for lupus

A
  • focus on strength, endurance, activity pacing, & energy conservation
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13
Q

Prognosis of lupus

A
  • no way to prevent
  • no cure only treatment of symptoms
  • prognosis improves with early detection & intervention
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14
Q

Define fibromyalgia

A
  • chronic widespread pain with hyperalgesia to pressure pain
  • can occur as a result of other inflammatory conditions, metabolic dysfunctions, or cancer
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15
Q

Describe chronic fatigue syndrome (CFS)

A
  • it’s an early form of fibromyalgia
  • is associated with viral infections & constitutional symptoms
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16
Q

Risk factors for fibromyalgia

A
  • prolonged anxiety
  • emotional stress
  • trauma
  • rapid steroid withdrawal
  • hypothyroidism
  • viral & non-viral infections
  • exposure to tobacco
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17
Q

Possible causes of fibromyalgia

A
  • diet, viral origin, & sleep disorder
  • occupational, seasonal, or environmental influences
  • psychologic distress
  • adverse childhood experiences, including sexual abuse
  • familial or hereditary link
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18
Q

Clinical manifestations of fibromyalgia

A
  • muscle pain, often described as aching or burning
  • diffuse pain or tender points
  • sleep disturbances = fatigue & exhaustion
19
Q

Treatment for fibromyalgia

A
  • stress management
  • acupuncture
  • yoga
  • nutrition
  • lifestyle training
  • coping strategies
  • activity modification
  • energy conservation
  • psychotherapy
  • medications
20
Q

Define ankylosing spondylitis

A
  • inflammatory disease primarily of the axial skeleton, SI joints, apophyseal joints, costovertebral joints, & intervertebral disk articulations
21
Q

Pathology of ankylosing spondylitis

A
  • disruption of junction of tendon, ligament, cartilage, or synovium with bone
  • reactive bone formation as part of repair process
  • progressive ossification
22
Q

Clinical manifestations of ankylosing spondylitis

A
  • insidious onset of SI joint pain for >3 months
  • patient may complain of lower back pain, stiffness, & fatigue
  • pain begins as a dull ache and become more severe & constant
  • persistent inflammatory symptoms of tendons & ligaments
  • early loss of lumbar lordosis & increased thoracic kyphosis
23
Q

Complications of ankylosing spondylitis

A
  • osteoporosis
  • axial subluxation
  • spinal stenosis
  • flexion contractures
  • rigid gait
  • crouched stance
24
Q

Rehab management for ankylosing spondylitis

A
  • maintain spinal extension
  • breathing
  • postural training
  • endurance
  • gait training
25
Q

Describe polymyalgia rheumatica (PMR)

A
  • pain in the muscles
  • diffuse pain & stiffness, pelvic & shoulder girdles mostly
  • initial symptoms are subtle & lead to bursitis
  • usually resolves on its own in 5 years
  • with progression ADLs & transfers become more difficult
26
Q

What other disease can increase your chances of developing polymyalgia rheumatica

A
  • giant cell arthritis which is the inflammation of the arteries in head & neck
27
Q

Suspected factors for polymyalgia rheumatica

A
  • genetics
  • infection
  • autoimmune dysfunction
28
Q

Pathogenesis of polymyalgia rheumatica

A
  • joint inflammation
  • bursitis
  • hip synovitis
  • no other histologic changes within muscle
  • MRI & ultrasound
29
Q

Elevation in what lab tests will indicate inflammation

A
  • elevated ESR
  • elevated C-reactive protein
30
Q

Clinical manifestations of polymyalgia rheumatica

A
  • onset could be insidious or abrupt
  • may be unilateral or bilateral
  • pain & stiffness but not muscle weakness lasting 1 hour in the A.M.
  • flu like symptoms & depression
  • ADLs limited
31
Q

Treatment of polymyalgia rheumatica

A
  • corticosteroids: prednisone
  • may require maintain therapy up to 5 years
32
Q

Rehab management for polymyalgia rheumatica

A
  • pain control
  • ROM
  • management of bursitis/tendinitis
  • correction of muscle imbalance
  • patient education
33
Q

Describe scleroderma

A
  • generalized connective tissue disorder characterized by immune dysregulation, microangiopathy, fibrosis of skin, synovium, & vital organs
  • excessive amounts of collagen are placed in the tissue
  • chronic disease lasting months to years to lifetime
34
Q

Define limited cutaneous systemic scleroderma

A
  • skin thickening of hands & face, that does not progress proximal to elbow/knee
35
Q

Define diffuse cutaneous systemic scleroderma

A
  • extends proximally to elbow/knee, less common, more debilitating
36
Q

Define systemic sclerosis sine systemic scleroderma

A
  • fibrosis of internal organs without skin manifestations
37
Q

Define localized scleroderma

A
  • affects skin in 1 or more areas, without visceral organ effects, not to confuse with limited
38
Q

Pathogenesis of scleroderma

A
  • triggered by bacteria, autoimmune, chemicals from occupational exposure
  • widespread small vessel vasculopathy & fibrosis
  • persistent deposition of collagen
  • microvascular changes
39
Q

Clinical manifestations of scleroderma

A
  • pitting edema
  • bilateral & symmetrical involvement
  • Raynaud’s phenomenon
  • stiff, bound down skin
  • decreased joint ROM
  • mask-like facial features
  • calcium deposits
  • nephritis
  • GI dysfunction
  • CNS disorders
40
Q

Define edematous stage (1st stage) of scleroderma

A
  • bilateral edema of fingers & hands that progress to the forearms, arms, upper chest, abdomen, & back
41
Q

Define sclerotic stage (2nd stage) of scleroderma

A
  • edema is replaced by thick hard skin that becomes tight, smooth, waxy, or shinny in appearance
42
Q

Define atrophic stage (3rd stage) of scleroderma

A
  • particularly over joints at sites of flexion contractures, thinning of skin = ulcerations
43
Q

Diagnosis of scleroderma

A
  • skin biopsy
  • blood tests: increased ESR, + ANA, & decreased WBC count
44
Q

Rehab management of scleroderma

A
  • joint protection
  • ROM
  • education
  • skin & wound care
  • ADL’s

Clinical Medicine I (26 decks)

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