connective tissue diseases

Question 1

what are the 2 categories of connective tissue diseases

Answer 1

autoimmune and vasculitic

Question 2

describe autoimmune connective tissue diseases

Answer 2

tissues themselves which are affected
examples include systemic lupus erythematosis , sjogrens and systemic sclerosis
Have associated blood antibodies - these are not a cause of disease but some patterns can indicate what disease may be a problem

Question 3

describe vasculitic connective tissue diseases

Answer 3

blood vessels affected - inflammation causing thickened walls therefore narrowed lumen and decreased blood flow. leads to infarction of tissues
named according to size of blood vessel affected e.g large vessel, medium vessel and small vessel

Question 4

connective tissue disease treatments

Answer 4

no cure for any as the cause is still unclear
- analgesic NSAIDs for pain
- immune modulators - methotrexate , hydroxychloroquine
- systemic steroids - prednisolone

Question 5

name 3 common autoantibodies assosciated with connective tissue diseases

Answer 5

anti- nuclear, anti -ro and anti - la

Question 6

systemic lupus erythematosis

Answer 6

multi system autoimmune disease causing joint pain, skin rashes, cns issues, cv issues and more
systemic changes and autoantibodies present
genetic and environmental causes

Question 7

external symptom of systemic lupus erythmatosis

Answer 7

butterfly rash on face due to photosensitivity (sunlight)

Question 8

dental effects of systemic lupus erythmatosis

Answer 8

chronic anaemia - ulceration risk
bleeding tendency - thrombocytopenia
renal disease - impaired drug metabolism / excretion
lichenoid oral reactions
some drugs can increase photosensitivity

Question 9

sjogrens syndrome

Answer 9

inflammatory disease affecting fluid producing tissues e.g saliva and lacrimal glands
associated with circulating antibodies - anti nuclear, anti ro and anti la
main symptoms = dry eyes and mouth

Question 10

sjogrens - sicca syndrome

Answer 10

only dry eyes OR dry mouth

Question 11

primary sjogrens syndrome

Answer 11

dry eyes AND dry mouth
no other connective tissue disease

Question 12

secondary sjogrens syndrome

Answer 12

dry mouth AND dry eyes alongside another connective tissue disease e.g rheumatoid arthritis, systemic lupus eythematosis

Question 13

dental impacts of sjogrens

Answer 13

decreased saliva = increased caries and infection risk
decreased denture retention
functional loss
increased risk of sialosis - swelling of salivary glands

Question 14

systemic sclerosis (slerodema)

Answer 14

disease where elastic tissue is replaced by fibrous connective tissue resulting in hard, thickened areas of skin
Inability of organs e.g skin to stretch around joints, oesophagus cant stretch around food bolus etc

Question 15

dental impacts of systemic sclerosis (sclerodema)

Answer 15

poor mouth opening (no elasticity)
poor oral access and therefore often poor OHI
may be compouded with sjogrens
reflux and dysphagia - erosion
plan tx 10 years ahead for these patients

Question 16

giant cell arteritis

Answer 16

vasculitic connective tissue disease affecting large blood vessels
commonly affects temporal artery so may be called temporal arteritis
may present as headache and facial pain , requires emergency tx asap

Question 17

kawasaki disease

Answer 17

vasculitic connective tissue disease affecting medium blood vessels
mainly presents in children
symptoms = strawberry coloured tongue and erythema on hands and feet. peeling crusty lips also common.

Question 18

wegeners granulomatosis

Answer 18

vasculitic connective tissue disease affecting small blood vessels
may initially present as red spongy strawberry like gingiva and/or palate (vascular rash).

Question 19

polymyalgia rheumatica

Answer 19

vasculitic connective tissue disease affecting large blood vessels
usually affects elderly and mainly shoulders