Autoimmune Disorders + degenerative diseases - powerpoint Flashcards by Christina Fiorelli

an ANA (antinuclear antibody) test or an autoantibody test is a blood test used to screen for and diagnose autoimmune disorders like lupus, RA or ________.

Scleroderma

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TRUE OR FALSE?
CRP (C-reactive Protein) is a protein produced by the liver in response to inflammation. Now this alone can’t diagnose an autoimmune disease but it can support it.

TRUE

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Erythrocyte Sedimentation Rate (ESR) is a blood test used to see how fast RBCs fall to the bottom of a test tube. If inflammation is present what will the results look like?

when there’s inflammation RBCs tend to clump together, when this happens they will settle to the bottom more quickly

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___________ is when amyloid protein builds up in organs with poor function.

Amyloidosis

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Amyloidosis is NOT an autoimmune disease or type of cancer but it can occur at the same time or result from having cancer, and they can be __________ the same.

treated

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what are the signs and symptoms of amyloidosis? (8)

-swelling
-fatigue
-SOB
-diarrhea
-weight loss
-enlarged tongue
-bruising
-irregular heartbeat

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What are the diagnostic tests used for diagnose amyloidosis?

-blood and urine tests to screen for the protein
-imaging (to see the buildup and the resulting damage)

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What are the treatment options for amyloidosis?

-chemotherapy
-beta blockers
-blood thinners
-targeted gene therapy
-stem cell transplant
-organ transplant
-dialysis

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_______ is used to treat hypothyroidism or Hashimoto’s, and it is important to take it 30 minutes before ADLs in the morning to get the T4.

Synthroid

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what is it called to have the severe form of hypothyroidism, or Hashimoto’s?

myxedema

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RA is when the immune system is attacking the _______ _______.

healthy joints

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What are the clinical manifestations of rheumatoid arthritis (RA)?

-swollen, red, painful joints
-eye sensitivity + dryness
-inflammation in the lungs
-inflammation of the synovial fluid
-joint damage

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What is a type of arthritis in the spine that causes inflammation and a gradual fusing of the vertebrae. Some of the early signs of this arthritis include: pain + stiffness in the lower back and hips. A risk factor of developing this kind of arthritis is already having _______ _______.

Ankylosing Spondylitis; Juvenile RA

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what are 2 diagnostics/ imaging for ankylosing spondylitis?

x-ray and MRI

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what are 3 treatment options for ankylosing spondylitis?

-lifestyle changes (stretching + exercises, diet, sleep habits etc.)
-physical therapy
-surgery (laminectomy, spinal fusion, spinal osteotomy, joint replacements)

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Polymyalgia Rheumatica is an inflammatory disorder causing muscle pain and stiffness in the shoulders and hips. What 3 inflammatory markers will be INCREASED with this condition?

-ESR
-CRP
-IL (interleukins)

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Polymyalgia Rheumatica is a chronic inflammatory condition, characterized by _______ ________, and rapid improvement with a low dose corticosteroid. (methotrexate can be given if steroids can’t be used) most common in women over the age of 50

morning stiffness

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Type: Acute (fast-growing)
Affected Cells: Lymphocytes (a type of white blood cell)
Common in: Children, but can also affect adults
Characteristics: Rapid progression, immature blood cells accumulate in the bone marrow

Which type of blood leukemia is this?

Acute Lymphoblastic Leukemia (ALL)

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Type: Acute (fast-growing)
Affected Cells: Myeloid cells (a type of white blood cell)
Common in: Adults, but can also affect children
Characteristics: Rapid progression, immature blood cells accumulate in the bone marrow

Which type of blood leukemia is this?

Acute Myeloid Leukemia (AML)

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Type: Chronic (slow-growing)
Affected Cells: Lymphocytes
Common in: Middle-aged and older adults
Characteristics: Slow progression, accumulation of relatively mature but abnormal white blood cells

Which type of blood leukemia is this?

Chronic Lymphoblastic Leukemia (CLL)

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Type: Chronic (slow-growing)
Affected Cells: Myeloid cells
Common in: Adults, especially middle-aged
Characteristics: Slow progression, accumulation of relatively mature but abnormal white blood cells, often associated with the Philadelphia chromosome

Which type of blood leukemia is this?

Chronic Myeloid Leukemia (CML)

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_______ ________ is the inflammation of your arteries and veins. Affecting the formation of your blood vessels. This disorder is has 3 general categories based on the size of the vessel affected, what are they?

blood vasculitis

large vessel vasculitis
medium vessel vasculitis
small vessel vasculitis

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Which kind of anemia occurs when red blood cells are destroyed faster than the body can make them?

hemolytic anemia

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which kind of anemia is a type of B12 deficiency due to the body not being able to absorb the B12? (usually due to the intrinsic factor in the stomach that helps the body absorb the B12)

pernicious anemia

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What are 4 complications related to pernicious anemia?

-gastritis -stomach removal -stomach cancer -nerve damage

What are the 4 diagnostic tools used for anemia?

-CBC/ H&H -B12 -gastric biopsy -bone marrow biopsy

if a patient is B12/ intrinsic factor deficient, what kind of shit will they get to treat this?

B12 shots

What are the clinical manifestations of SLE (systemic lupus erythematosus)? **this autoimmune disorder is most common in women of childbearing age**

-fever -fatigue -chest pain -achy joints (erosion of joints) -butterfly shaped rash on face -oral ulcers -kidney disease -weight loss -swollen ankles -skin rashes -discoid rash (disc shaped lesions) -

What is the cause of Lupus?

B cells are overproducing antibodies called B cell stimulators causing the attack on tissues

There is a possibility that estrogen plays a role in lupus, so removing the ___________ organs could help.

reproductive

Baldness CNS symptoms Oral ulcers Pleuritis Pneumonitis Pericarditis Myocarditis Glomerulonephritis Osteoporosis Finger top lesions Myositis Polyarthritis Butterfly rash Anemia Neutropenia Thrombocytopenia Splenomegaly lymphadenopathy ***these are all possible clinical manifestations of what autoimmune disease?***

(SLE) - lupus

***these are all S+S of ______*** -mouth/ nose ulcers -lung issues -headaches -depression -seizures psychosis -face rash (butterfly) -muscle aches -heartburn/ GERD -heart problems -joint pain/ arthritis -kidney problems -poor circulation -extreme fatigue -mild fever -weight loss or gain -anemia/ blood clots -photosensitive skin

lupus

in a patient with lupus it is important to keep their blood pressure low to avoid _______ _______. A dietary consult can help with that. When being treated for lupus it is also important to teach about not missing a _____ of the medication and keeping a log of side effects.

kidney issues; dose

what are 3 things to monitor for when a patient will be on long term corticosteroids?

-high blood sugar -increased risk of infection -osteoporosis

how is diabetes type 1 an autoimmune disease?

beta cells in the pancreas are being attacked and destroyed

_______ ________ is an autoimmune disease that can't be cured, where your body lacks the ability to consume/ absorb gluten protein.

celiac disease

Which autoimmune disease puts you at risk for developing small intestine adenocarcinoma, esophageal carcinoma, papillary thyroid cancer and melanoma? but risk will be decreased as long as a strict gluten free diet is followed.

celiac disease

what are S+S of untreated celiac disease?

-diarrhea -steatorrhea -ABD pain + distention -flatulence -weight loss

what are the 2 immunoglobulins to test for, for celiac disease?

IgA and rTG (antitissue transglutaminase)

When teaching about a gluten free diet, what foods should we educate patients to avoid?

-wheat based products -barley -pasta -processed foods -beer breaded/ fried foods -vegetable starch -cake flour

Inflammatory Bowel Syndrome (IBS) is an umbrella term for what 3 disorders? **all these disorders involve chronic inflammation of digestive tract tissue**

-IBD Inflammatory Bowel Disease -Ulcerative Colitis -Crohn's Disease

_________ _________ is the inflammation and presence of sores (ulcers) on the lining of your large intestine (colon) and rectum.

ulcerative colitis

________ _________ is inflammation of the small bowel/ intestine.

Crohn's Disease

________ ________ ________ is chronic inflammation of the large intestine, colon and rectum.

Irritable Bowel Disease (IBD)

What 5 S+S are you generally going to see with the 3 disorders that fall under IBS?

-diarrhea -weight loss -fatigue -rectal bleeding -abdominal pain

What are the 7 characteristics of an Addison Crisis?

-loss of consciousness -severe dehydration -severe lethargy -hypoglycemia -hyponatremia -hyperkalemia

Multiple Sclerosis the destruction of the ________ __________. Walking, mobility and numbness are the biggest issues to face.

Myelin Sheath

what are some risk factors for developing MS? ** what is the first symptom patients usually come in with before MS is officially diagnosed prior to an MRI?**

-ages 20-40 -low vitamin D -obesity -3x more common in women -Caucasian -genetics -linked to Epstein bar virus -having another autoimmune disease **peripheral neuropathy**

The most common form of MS is _________ _________ MS, this is characterized by flare ups, exacerbations, periods of remission. **disease modifying agents are used**

relapsing remitting (RRMS)

(CIS) Clinically Isolated Syndrome is when patients first have MS symptoms but it's categorized as CIS because .........

this does not automatically mean this patient will go on to develop MS

_________ _________ MS is when the MS symptoms gradually and slowly worsen without any periods of relapse or remission. **disease modifying agents DO NOT work on symptoms**

Primary Progressive

________ _________ MS is the end stage of MS, that is progressively getting worse, with relapses and flares but NO remission.

secondary progressive

Why are we doing an OCT (Optical Coherence Tomography) test with an MS patient to assess the optic nerve?

we are looking at the myelin sheath that is covering the optic nerve because MS can cause blindness

What are 2 simple things we can educate an MS patient to do to manage/ help w/ symptoms?

promote exercise and use walking aids

which kind of MS is the only MS that can be managed with medication?

RRMS - relapsing remitting MS

What 5 autoimmune diseases can cause peripheral neuropathy?

-MS -Sjogren's Syndrome -Lupus -Diabetes T1 -RA

Which autoimmune disorder is RARE and is due to your immune system attacking your body and can lead to paralysis?

GBS (Guillain Barre syndrome)

What are usually the first signs and symptoms of GBS?

weakness and tingling in the hands and feet, and feet are usually first _ this sensation quickly ascends the lower extremities

GBS is usually preceded by a ______.

virus

Why does GBS eventually require mechanical ventilation?

because the paralysis ascends up the body and will eventually be unable to breath (diaphragm will be paralyzed)

___________ __________ is an autoimmune disorder characterized by rapid weakness and fatigue of VOLUNTARY muscles - the breakdown of communication between muscles and nerves.

myasthenia gravis

Myasthenia Gravis can resemble a _______ due to signs and symptoms like dysphagia.

stroke

Immunoglobulins and plasmapheresis is treatment for _________ _________.

myasthenia gravis

Myasthenia Gravis attacks/ destroys ____________ receptors.

acetylcholine

We want an MRI of the thymus gland in patient with Myasthenia Gravis because it can cause the thymus to become ___________.

enlarged

After acetylcholinesterase inhibitor is administered or ice over the eyes for myasthenia gravis, symptoms, Ptosis, dysphonia and dysphagia should resolve in ___ minutes.

Fibromyalgia is musculoskeletal pain ALL OVER. What else is this accompanied with?

fatigue/ sleep issues memory issues mood disturbances

__________ ________ is a chronic, neurodegenerative disease that affects movement in every way, due to insufficient dopamine.

Parkinson's disease

these are manifestations of what autoimmune disease? -tremor in one hand -stiffness/ slowing in movement -bradykinesia -rigidity -gait and balance problems

Parkinson's

_____________ is an anti-Parkinson's to supplement dopamine. An Anti-dyskinetic like Amantadine is used for _________ ___________. And anticholinergics like Procyclidine and Trihexyphenidyl are used to reduce _______.

Carbidopa involuntary movement tremors

What are non pharmacological management techniques used for Parkinson's?

-fall prevention -OT/PT/ST -balanced diet -exercise (yoga) -massages

What happens at end stage Parkinson's?

parkinsonian dementia **they are not the same person**

Is there a cure for Parkinson's?

what is the device/ symptom management used for Parkinson's that gets implanted into the brain and gives off impulses to regulate brain activity and alleviate tremors, rigidity and motor control issues?

Deep Brain Stimulation (DBS)

Which stage of Parkinson's is being described? -unilateral/ mild symptoms -clumsy leg -1 side of face may be affected

Stage 1 (early)

Which stage of Parkinson's is being described? -bilateral/ mild symptoms -loss of facial expression bilaterally -decreased blinking -speech abnormalities -muscle rigidity in trunk

Stage 2 (early)

Which stage of Parkinson's is being described? -moderate symptoms -loss of balance -slow movements -inability to make rapid, autonomic, involuntary adjustments -early/ mild symptoms are present

Stage 3 (mid-stage)

Which stage of Parkinson's is being described? -symptoms are severely debilitating -may be able to walk or stand unassisted, but noticeably disabled -unable to live independently

stage 4 (advanced)

Which stage of Parkinson's is being described? -severe symptoms -inability to rise -falling when standing or turning -freezing or stumbling when walking -experiencing hallucination or delusions

stage 5 (advanced)

Wegener's Granulomatosis AKA Granulomatosis with Polyangiitis - this is vasculitis in the nose, throat, lungs and sometimes kidneys. What manifestations will we see?

-bloody sputum w/ cough -nose bleeds -SOB -weight loss -hematuria -night sweats -fever

Which autoimmune disease needs an x-ray to see the granulomas?

Wegener's - (inflammation of the blood vessels, mostly affecting the respiratory tract)

Atopic dermatitis AKA _______, is not an autoimmune disorder but it has been associated with autoimmune disorders

eczema

_________ is an autoimmune disorder that speeds up the growth cycle of skin cells which is causing them to stretch and break.

Psoriasis

Psoriasis is often seen in children who already have which pre-existing condition?

psoriatic arthritis

___________ AKA systemic sclerosis, is a group of diseases that causes hardening and tightening of the skin. It can also cause issues in your blood vessels, organs and GI tract.

scleroderma

what are the 2 types of scleroderma, based on the degree of skin involvement?

limited - affecting face, hands and forearms, esophageal dysfunction and a slower development diffuse - affecting the trunk and extremities above the knees/elbows, affecting organs and GI tract, develops more rapidly

What type of scleroderma is it when it is only affecting the skin?

localized scleroderma AKA morphea

What other disorders are associated with scleroderma?

-GERD -Raynaud's -heart + lung fibrosis

what is CREST pain, that's associated with scleroderma?

C-calcinosis (abnormal calcium deposits) R-Raynaud's (reduced blood flow w/ cold temperatures) E-Esophageal dysmotility S-Sclerodactyly (thickened skin on fingers + toes T-Telangiectasis (dilation of small blood vessels, appearing under the skin as red/ purple fine lines)

What is vitiligo?

melanocytes are destroyed, which destroys the pigment, causing the affected areas to turn pale, often in patches