Connective Tissue Disorders And Cancer Flashcards
Systemic Lupus Eryuthematosus (SLE)
Autoimmune disease
Multi system inflammation
Periods of exacerbations and remissions
SLE common affected sites
Skin
Joints
Kidney (seen in kidneys first)
Heart
lupus Triggers (what to avoid)
Sun exposure
Smoking
Stress
Sepsis (infection)
SLE signs and symptoms
Butterfly shaped rash (cheek and nose)
Fever higher than 100 report to HCP
Joints (painful and swollen)
Lab values
Creatinine = greater than 1.3= bad kidney !
Decreased WBC lower than 5,000
Increased ESR (The speed of your test result is a sign of how much inflammation you have. Faster ESR rates mean higher levels of inflammation.)
and CRP
Medications for SLE
Steroids “-sone”
Immunosuppressants
- hydroxychloroquine
- methotrexate
- infliximab
- azathioprine
Hydroxychloroquine
Helps to decrease inflammation and fatigue
Increased energy with taken drugs
Takes several months to see effects
Hydroxychloroquine adverse effects
Retinal damage (check eyes at least once a year)
Methotrexate
Mainly given for rheumatoid arthritis
Stops folic acid metabolism which stops cellular reproduction ‘’
NO PREGNANCY
NO LIVE VACCINE (REPORT FEVER 100.3)
— FLU VACCINES ARE OKAY
NO RAZORS (BLEEDING RISK)
Tumor necrosis factors inhibitors
Etanercept
Infliximab
Adalimumab
TNF patient education
Tuberculosis reactivations
- negative tb is needed to start therapy
- can make TB worse
No live vaccines (ie. herpes zoster or shingles)
CANNOT TAKE WITH INFECTION
EXAMPLE: SOMEONE ON ANTIBIOTIC (CONTRAINDICATED)
Immunosuppressants : cyclosporine / azathioprine
Given for organ transplant patients
Prevent body from attacking new organ
(SPARE THE ORGAN FROM REJECTION)
Cyclosporine/ azathioprine patient teaching
Avoid grapefruit juice
Avoid crowds
No pregnancy
No live vaccines
Adverse effect: overgrowth of gums and bleeding
take this medication for life
Scleroderma (systemic sclerosis)
Too much collagen
Thick tight skin on lungs and kidneys
scarred, hard derma
Scleroderma priority
Abrupt onset hypertension and headache
Scleroderma signs and symptoms
affects fingers and face first then organs later known as
- CREST SYNDROME
CREST SYNDROME
C- CALCINOSIS - calcium deposits in the skin and organs
R- RAYNAUD PHENOMENON- blue cold finger tips
E- ESOPHAGEAL DYSFUNCTION- difficulty swallowing and heartburn
S- SCLERODACTYLY- fingers curl inwards due to thickened tight skin
T- TELANGIECTASIA- dilation of capillaries cause red threadlike marks
Scleroderma medications
Immunosuppressants
Ace inhibitors to lower hypertension
- “pril” - lisinopril
Calcium channel blockers
- for Raynaud phenomenon
Raynaud’s phenomenon
Induced by cold temperature
Severe pain in the digits in response to cold or stress
Leukemia
Overproduction or WBC
Low RBCs, low platelets, low hemoglobin and hematocrit
Signs and symptoms of leukemia
Frequent infections
Fatigue, unsteady gait, pale (pallor)
Bruising, petechiae and easy bleeding
Weight loss, anorexia
Acute lymphoblastic leukemia (ALL)
Cancer of the blood and bone marrow
*More common in children
Fever, bleeding may appear
CNS manifestations
Acute myeloid leukemia
Myeloid cells interfering with production of other blood cells.
*more common in adults (men)
Petechiae and purpura
Chronic lymphocytic leukemia (CLL)
Common in adults over 50
Lymphadenopathy
Chronic lymphocytic leukemia (CLL)
Common in ages over 50
Lymphadenopathy
Chronic myeloid leukemia (CML)
Cancer starting in bone marrow
Infiltration of liver and spleen
Lymphoma
Hodgkins= reed-sternberg cells
Non-hodgkins= no reed sternberg cells
Lymphoma signs and symptoms
Painless bumps and lumps (under arm)
Enlarged lymph glands
Fever
Weight loss
Night sweats
Infections
