Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced MSK - physio > connective tissue disorders > Flashcards

connective tissue disorders Flashcards

1
Q

what is connective tissue?

A

tissue that connects, supports binds or separates other tissues or organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are examples of connective tissues?

A

-nervous tissue
-muscle tissue
-epithelial tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are 3 types of connective tissue disease?

A

-systemic sclerosis/ scleroderma
-systemic lupus erythematosus
-dermatomyositis and polymyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe the epidemiology of scleroderma

A
  • hard thickened areas of skin, can also cause problems with internal organs etc
    -autoimmune condition
    -uncommon connective tissue disorder
    -more common in females
    -age 30-50
    -HLA (human leukocyte antigens- DR5 marker)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe the aetiology of scleroderma

A
  • cause is not known
    -there can be an event that causes cells to start producing collagen as if injury has occured
    -excess collagen formation
    -can affect skin, joints and internal organs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the 2 subtypes of systemic scleroderma

A

-diffuse scleroderma
-limited cutaneous scleroderma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe diffuse scleroderma

A

-skin thickening proximal to elbows and knees
-early internal organ involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe limited cutaneous scleroderma

A

-skin thickening limited to below the elbow
-later involvement of internal organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe clinical features of scleroderma

A

-initial changes in hands, face and feet
-hand swelling initially
-sclerodactyly (ulceration of skin of distal digits)
-raynauds (common early symptom)
-fibrosis - thickening of skin, subcutaneous swelling and contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is localised scleroderma

A

-localised skin changes
-internal organs not affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the clinical features of the skin of a patient with scleroderma

A

-dry shiny hairless coarse skin
-mouth smaller and tight & nose pointed
-loss of wrinkles of facial expression
-hand deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the MSK clinical features of scleroderma?

A

-joint pain
-stiffness
-limited ROM
-fibrosis skin and muscle
-weakness
-synovitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are vascular clinical features of scleroderma

A

-capillary changes
-raynauds syndrome
-numbness and pain in hand and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the most common organs affected in scleroderma?

A

lungs - dry cough, SOB, fibrosis in later stages
-GI - bloating,nausea, vomiting etc
-cardiac - often later in disease
-renal- eg renal failure due to hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how is scleroderma diagnosed?

A

-no definite blood tests - check for absence of Rh F, ACA, elevated C reactive protein
-pulmonary function tests
-chest x ray
-echocardiograms
-renal function- for organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how is scleroderma managed pharmacologically?

A

-corticosteroids
-immune suppressing medications such as MTX
-NSAIDS
-UV therapy for skin
-medications for BP management
-medications for raynauds eg Ca2+ channel blockers eg diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

in terms of a physiotherapy assessment, what are important things to look out for with scleroderma?

A

-observation - skin changes, deformity, postural changes
-ROM- reduced ROM, contracture
-muscle strength- weakness
-lung function - reduced exercise tolerance etc
-general/ functional mobility - reduced function and ADLs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are examples of treatment considerations for scleroderma?

A

-exercise - eg ROM, stretching programme, diaphragmatic breathing exercise, strengthening
-splinting and skin care
-self management programme eg self advocacy, fatigue and energy conservation

19
Q

what is a systemic lupus erythematosus (SLE)? SELENA GOMEZ

A

-a chronic auto-immune disease which can affect any organ
-highly inflammatory
-characterised by multiple exacerbations
& remissions
-variability of symptoms and disease severity
-can affect the joints, lungs, skin, brain , blood vessels etc

20
Q

describe the epidemiology of SLE

A

-higher in females
-age of onset - typically 20-30 years
-milder course in elderly
-cause is unknown
-prevalence is higher than scleroderma

21
Q

describe the pathology of SLE

A

-autoimmune disorder
-pathogenic autoantibodies are the primary cause of tissue damage
-the production of these antibodies arises by means of complex mechanisms involving immune system

22
Q

what are examples of the ACR diagnostic criteria for SLE?

A

-cheek rash
-discoid rash (disk/coin shape rash)
-photosensitivity (to light)
-oral ulcers
-arthritis
-renal disorders

23
Q

what are examples of skin clinical features of SLE?

A

-butterfly rash
-discoid lesions
-photosensitivity
-alopecia (hair loss)

24
Q

describe systemic clinical features of SLE

A

-lethargy
-fatigue
-reduced exercise tolerance

25
Q

describe MSK clinical features of SLE

A

-deformity with or without contracture or joint subluxation
-tenosynovitis
-avascular necrosis
-non erosive arthritis (an inflammation of 1 or more joints without deformity)
-osteoporosis
-muscle weakness and muscle pain

26
Q

what organs can be affected by SLE?

A

-pulmonary
-cardiovascular
-renal - may need dialysis or transplant

27
Q

what is the prognosis of SLE?

A

-1 in 6 chance of dying within 15 years, most often from MI or infection
-increased mortality associated with myocardial infarction, stroke, renal or cardiopulmonary failure, nephropathy

28
Q

what medications are used to manage SLE?

A

-NSAIDS
-corticosteroid creams for rashes
-low dose corticosteroids
-anti- malarials
-antibiotics for associated infections
-warfarin for thrombosis

29
Q

what are examples of physiotherapy interventions that can be used for SLE?

A

-exercise programme
-moderate to high intensity can increase aerobic capacity
-HR and BP should be monitored
-hydrotherapy
-strengthening

30
Q

what things can be involved in self management for SLE?

A

-education
-energy conservation
-aerobic conditioning
-healthy diet
-exercise/rest
-stress management

31
Q

what is dermatomyositis?

A

-characterised by both muscle inflammation and distinctive skin rashes
-cause is unknown
-female more likely
-associated with some cancers eg colon, breast or ovarian

32
Q

what is polymyositis?

A

-only causes inflammatory myopathy
-characterised by symmetrical proximal muscle weakness
-cause is unknown
-no skin rash
-systemic symptoms eg fatigue, anorexia, morning stiffness

33
Q

describe the pathology of dermatomyositis and polymyositis

A

-most common age 40-60
-women more likely than men
-similar pathology for both - inflammation of muscles, degeneration of atrophy of muscle fibres
- HLA -DR3 antibodies

34
Q

what are the muscle clinical features for dermamyositis and polymyositis?

A

-limb girdle muscles (shoulder and pelvis)
-symmetrical weakness
-knees, hips, shoulder and elbow may or may not be affected
-distal strength maintained
-respiratory and bulbar muscle involvement
-functional problems eg stairs, STS, brushing hair

35
Q

what are examples of skin clinical features of dermamyositis?

A

-dermatomyositis only NB
-classical rash
-peri-orbital oedema
-calcinosis
-raynauds syndrome

36
Q

how can dermomyositis or polymyositis affect joints?

A

-pain
-reduced ROM
-deformity
-non erosive arthritis
-risk of subluxation

37
Q

how can dermomyositis and polymyositis affect lungs and cardiac?

A

-alveolitis
-pulmonary fibrosis
-aspiration pneumonia
-pericarditis

38
Q

how is dermomyositis or polymyositis diagnosed?

A

-clinical signs - symmetrical weakness or rash
-blood tests - elevated muscle enzymes CPK, elevated ESR, auto-antibodies
-muscle biopsy- evidence of muscle necrosis

39
Q

what drugs are used to manage dermomyositis or polymyositis?

A

-steroids - standard first line
-immunosuppressive meds eg MTX

40
Q

how can exercise help with polymyositis?

A

-improved mitochondrial function
-improve angiogenesis
-improves muscle growth
-reduces inflammation

41
Q

what is the prognosis of dermomyositis or polymyositis?

A

-responds well to treatment especially steroids
-although residual weakness occurs in approx 30% of patients
-osteoporosis is a common complication of long term corticosteroid therapy

42
Q

case study - 40 y.o female presenting with skin tightness over hands and face, cold hands associated with raynauds, joint pain in hands, shoulders and elbows, difficulty straightening fingers, associated SOB, what is the condition?

A

-systemic scleroderma

43
Q
A

Advanced MSK - physio (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions