Connective Tissue Disease Flashcards
what are the two groups of connective tissue diseases
autoimmune diseases or vascular diseases
what are diseases included in the autoimmune disease category
systemic lupus erythematosis
systemic sclerosis
sjogrens syndrome
undifferentiated connective tissue disease
do the blood antibodies associated with the disease cause the diseases
no they are found in healthy people - the diseases will occur in people who have specific auto-antibodies
what are vasculitic diseases
where the problems are in the blood vessel walls
what is the large vessel vasculitic disease
giant cell (temporal) arteritis - affects large arteries
polymyalgia rheumatica
what are the medium vessel vasculitic diseases
polyarteritis nodosa
kawasaki disease
what is the small vessel vasculitic disease
wegener’s granulomatosis
what is the general management of vasculitic connective tissue disease
analgesia for pain
immune modulating treatment
systemic steroids
what are examples of immune modulating treatment
hydroxychloroquine
methotrexate
azathiopine
mycophenolate
what are the four antibodies commonly found in the connective tissue diseases
anti-nuclear antibody
anti-double strand DNA
anti-Ro antibody
anti-La antibody
what are the two antibodies commonly found in scleroderma
anti-centromere and anti scl-70
what are the two forms of systemic lupus erythematosis
discoid lupus and systemic
what is discoid lupus
tissue changes without blood autoantibodies - seen in skin and mouth and looks like lichen planus
what is systemic lupus
where multi-systems are involved (joints/ CVS/ CNS? renal/ muscles)
what is the major sign of systemic lupus
a butterfly rash across the face due to photosensitivity
systemic lupus can cause chronic anaemia, what are the dental implications of this
oral ulceration and GA risk
why might a dentist want to check the platelet count of a patient with lupus
could result in thrombocytopenia and have a bleeding tendency
what two aspects of prescribing drugs do dentists need to take care with a patient with lupus
drug metabolism due to renal disease
drug reactions producing photosensitivity rash
what should you not confuse with lupus reactions in the mucosa
lichen planus
what is antiphospholipid anticoagulant lupus
type of lupus that have an antibody called anticoagulant - but only when in a test tube - not when in patients body
what might antiphsopholipid antibody syndrome be associated with
lupus
sjogrens syndrome
how would you describe the clotting capabilities of a patient with antiphospholipid antibody syndrome
hyper coagulable - thrombophillic
due to antiphospholipid antibody syndrome patients being thrombophilic, what might they be at higher risk of developing
DVT or pulmonary embolism
what is the treatment for antiphospholipid antibody syndrome
warfarin
what is sjogrens syndrome
inflammatory disease associated with circulating autoantibodies ANA, Ro and La
symptoms of sjogrens syndromes
dry eyes and dry mouth
what are the three aspects of sjogrens syndrome
sicca syndrome
primary sjogrens
secondary sjogrens
what is sicca sjoagrens
dry eyes or dry mouth only
what is primary sjogrens
not associated with any other connective tissue disease
what is secondary sjogrens
associated with one of the other connective tissue disease (RA or lupus)
how is sjogrens diagnosed
antibody findings
imaging findings
histopathology findings
name some dental implications of sjogrens syndrome
oral infection
caries risk
function loss
denture retention
sialosis
salivary lymphoma
what is systemic sclerosis
elastic tissue replaced with connective fibrous tissue - patient loses ability to stretch (skin affected)
what are the two types of systemic sclerosis
local or generalised
what antibodies are associated with local systemic sclerosis
anticentromere
what antibodies are associated with generalised systemic sclerosis
anti scl-70 antibodies
what are systemic sclerosis fingers
there is no elasticity in the skin to allow the fingers to stretch at the joints
what other medical problems can systemic sclerosis be associated with
raynoud’s
renal failure
malabsorption
what are some dental aspects of systemic sclerosis
no elasticity in the cheeks - patient cannot open up wide
dysphagia and reflux oesophagitis
what occurs in vasculitic diseases
inflammation in the blood vessel that can lead to ischaemia
what is giant cell arteritis
affects external carotid artery (near the face) can lead to occlusion of central retinal artery and cause blindness
when can giant cell arteritis be recognised
when the erythrocyte sedimentation rate is raised
what is polymyalgia rheumatic
pain and morning stiffness of muscles - particularly shoulders
what disease responds well to steroids and will settle quickly
polymyalgia rheumatic
what is kawasaki disease
affects medium blood vessels
what are the three common presentations of kawasaki disease
strawberry tongue and erythema of the hands and feet
what is wegener’s granulomatosis
inflammatory condition affects small blood vessels can lead to destruction of hard and soft tissues
what is fibromyalgia
symptoms without evidence of active disease
joint and muscle pain
functional disorders where it may be the pain transmitters that aren’t working
