Autoimmune Disorders + degenerative diseases - powerpoint Flashcards
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
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
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
___________ is when amyloid protein builds up in organs with poor function.
Amyloidosis
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
what are the signs and symptoms of amyloidosis? (8)
-swelling
-fatigue
-SOB
-diarrhea
-weight loss
-enlarged tongue
-bruising
-irregular heartbeat
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)
What are the treatment options for amyloidosis?
-chemotherapy
-beta blockers
-blood thinners
-targeted gene therapy
-stem cell transplant
-organ transplant
-dialysis
_______ 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
what is it called to have the severe form of hypothyroidism, or Hashimoto’s?
myxedema
RA is when the immune system is attacking the _______ _______.
healthy joints
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
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
what are 2 diagnostics/ imaging for ankylosing spondylitis?
x-ray and MRI
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)
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)
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
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)
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)
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)
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)
_______ ________ 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
Which kind of anemia occurs when red blood cells are destroyed faster than the body can make them?
hemolytic anemia
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
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.
5
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?
no
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
