connective tissue disease

Question 1

give 4 examples of autoimmune connective tissue diseases

Answer 1

systemic lupus erythmatosis
systemic sclerosis
sjogrens syndrome
undifferentiated connective tissue disease

Question 2

complement activation causes what?

Answer 2

tissue damage

Question 3

name three categories of vasculitic connective tissue diseases

Answer 3

large vessel disease - giant cell arteritis, polymyalgia rheumatica

medium vessel disease - polyarteritis nodosa, Kawasaki disease

small vessel disease- wegeners granulomatosis

Question 4

give an example of small vessel connective tissue disease

Answer 4

wegeners granulomatosis

Question 5

give an example of medium vessel vasculitic connective tissue disease

Answer 5

polyarteritis nodosa
kawasaki disease

Question 6

give an example of large vessel vasculitic connective tissue disease

Answer 6

giant cell arteritis
polymyalgia rheumatica

Question 7

what is fibromyalgia?

Answer 7

non-specific collection of musculoskeletal symptoms
symptoms but no evidence of active disease
joint pain, muscle pain and functional disorders

Question 8

what is fibromyalgia?

Answer 8

non-specific collection of musculoskeletal symptoms
symptoms but no evidence of active disease
joint pain, muscle pain and functional disorders

Question 9

where is most affected by Wegener’s granulomatosis?

Answer 9

renal and respiratory tract

Question 10

what are the effects of Wegeners granulomatosis?

Answer 10

inflammatory - destruction of hard and soft tissues of face and oral cavity
spongy red tissue

Question 11

what age group is most affected by Kawasaki disease?

Answer 11

children

Question 12

what is the clinical presentation of Kawasaki disease?

Answer 12

fever
lymphadenopathy
crusty tongue and lips
strawberry tongue and erythematous mucosa
peeling rash on hands and feet

Question 13

which connective tissue disease is associated with coronary vessel aneurysms?

Answer 13

Kawasaki disease

Question 14

what age group is affected by polymyalgia rheumatica?

Answer 14

elderly - most 60-70

Question 15

what are the symptoms and signs of poly myalgia rheumatica?

Answer 15

pain and morning stiffness of muscles

malaise, weight loss, profound fatigue

Question 16

what treatment does polymyalgia rheumatica respond well to?

Answer 16

steroids

Question 17

how do you treat connective tissue disease?

Answer 17

management is general

analgesic NSAIDS for joint and muscle pain

immune modulating - hydroxychloroquine and methotrexate

systemic steroids e.g. prednisolone

Question 18

what are the two groups of connective tissue disease?

Answer 18

autoimmune diseases
vasculitic diseases

Question 19

what indicates the category and direction autoimmune disease will follow?

Answer 19

pattern of antibodies present in blood

Question 20

what diseases are associated with lupus?

Answer 20

inflammatory organ disease
rheumatoid athiritis
mixed connective tissue dusease
sjogrens syndrome
sclerodoma
raynauds phenomenon

Question 21

what antibodies are associated with autoimmune connective tissue diseases?

Answer 21

anti-nuclear antibody ANA
anti double strand DNA dsDNA
anti-ro antibody Ro
anti-La antibody La

Question 22

what are the two forms of systemic lupus erythematosis?

Answer 22

discoid lupus - without blood antibodies
systemic lupus - with blood antibodies

Question 23

how can discoid lupus present for dentist?

Answer 23

seen in skin and mouth - looks similar to lichen planus

Question 24

what systems are involved in systemic lupus erythematosis?

Answer 24

multi-system
joints, skin, muscle, blood, kidney, CV, RS and CNS
kidney involvement is major cause if death

Question 25

who is at higher risk of systemic lupus erythematosis?

Answer 25

twins women of childbearing age

Question 26

what is a photosensitive butterfly zygomatic rash associated with?

Answer 26

systemic lupus erythematosis

Question 27

how does SLE affect dentistry?

Answer 27

chronic anaemia - oral ulceration and GA risk bleeding tendency renal disease - impaired drug metabolism

Question 28

what marker is found in the blood of an anti phospholipid antibody syndrome patient?

Answer 28

lupus anticoagulant - only shows anticoagulant properties in test tube not in body

Question 29

what is characteristic of anti phospholipid antibody syndrome?

Answer 29

deep vein thrombosis pulmonary embolism

Question 30

what is prescribed for anti phospholipid antibody syndrome patients need?

Answer 30

anticoagulants

Question 31

what autoantibodies are associated with Sjogrens syndrome?

Answer 31

anti nuclear antibody anti Ro and Anti La

Question 32

how does a patient with sjogrens syndrome present?

Answer 32

dry eyes dry mouth/xerostomia due to major salivary gland involvement

Question 33

what are the three groups of sjogrens?

Answer 33

sicca syndrome primary sjogrens secondary sjogrens

Question 34

what is sicca syndrome?

Answer 34

group of sjogrens syndrome causing dry eyes or dry mouth only

Question 35

what is primary sjogrens syndrome?

Answer 35

sjogrens not associated with any other disease

Question 36

what is secondary sjogrens syndrome?

Answer 36

sjogrens associated with another connective tissue disease e.g. RA, SLE

Question 37

how does sjogrens compromise oral health?

Answer 37

oral infection risk caries risk sialosis - swelling of salivary glands salivary lymphoma

Question 38

what causes systemic sclerosis?

Answer 38

excessive collagen deposition connective tissue fibrosis loss of elastic tissue as replaced by connective tissue

Question 39

what antibody is associated with local systemic sclerosis?

Answer 39

anticentromere antibody

Question 40

what antibody is associated with generalised systemic sclerosis?

Answer 40

anti scl-70 antibodies

Question 41

what ability is lost with systemic sclerosis?

Answer 41

stretching and bending affects outside e.g. hands and inside e.g. oesophagus

Question 42

what is one key feature of systemic sclerosis?

Answer 42

Raynouds

Question 43

how does systemic sclerosis pose challenges in dentistry?

Answer 43

affects perioral tissues, tissues do not stretch - limited mouth opening, poor oral access and limited tongue movement dysphasia and acid reflux - erosion plan treatment 10-15 years ahead !

Question 44

what is vasculitis?

Answer 44

inflammation of blood vessels causing infarction of tissue as lumen is narrower

Question 45

how may vasculitis present orally?

Answer 45

ulcers oral inflammatory masses

Question 46

giant cell arteritis is known as temporal arteritis, why?

Answer 46

temporal artery is involved

Question 47

how can giant cell arteritis present?

Answer 47

head ache and facial pain

Question 48

what arteries affected by giant cell arteritis?

Answer 48

external carotid artery branches - commonly temporal central retinal artery can occlude and cause blindness