Connective Tissue Disorders And Cancer

Question 1

Systemic Lupus Eryuthematosus (SLE)

Answer 1

Autoimmune disease
Multi system inflammation
Periods of exacerbations and remissions

Question 2

SLE common affected sites

Answer 2

Skin
Joints
Kidney (seen in kidneys first)
Heart

Question 3

lupus Triggers (what to avoid)

Answer 3

Sun exposure
Smoking
Stress
Sepsis (infection)

Question 4

SLE signs and symptoms

Answer 4

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

Question 5

Medications for SLE

Answer 5

Steroids “-sone”
Immunosuppressants
- hydroxychloroquine
- methotrexate
- infliximab
- azathioprine

Question 6

Hydroxychloroquine

Answer 6

Helps to decrease inflammation and fatigue
Increased energy with taken drugs
Takes several months to see effects

Question 7

Hydroxychloroquine adverse effects

Answer 7

Retinal damage (check eyes at least once a year)

Question 8

Methotrexate

Answer 8

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)

Question 9

Tumor necrosis factors inhibitors

Answer 9

Etanercept
Infliximab
Adalimumab

Question 10

TNF patient education

Answer 10

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)

Question 11

Immunosuppressants : cyclosporine / azathioprine

Answer 11

Given for organ transplant patients
Prevent body from attacking new organ
(SPARE THE ORGAN FROM REJECTION)

Question 12

Cyclosporine/ azathioprine patient teaching

Answer 12

Avoid grapefruit juice
Avoid crowds
No pregnancy
No live vaccines

Adverse effect: overgrowth of gums and bleeding

take this medication for life

Question 13

Scleroderma (systemic sclerosis)

Answer 13

Too much collagen
Thick tight skin on lungs and kidneys
scarred, hard derma

Question 14

Scleroderma priority

Answer 14

Abrupt onset hypertension and headache

Question 15

Scleroderma signs and symptoms

Answer 15

affects fingers and face first then organs later known as
- CREST SYNDROME

Question 16

CREST SYNDROME

Answer 16

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

Question 17

Scleroderma medications

Answer 17

Immunosuppressants
Ace inhibitors to lower hypertension
- “pril” - lisinopril
Calcium channel blockers
- for Raynaud phenomenon

Question 18

Raynaud’s phenomenon

Answer 18

Induced by cold temperature
Severe pain in the digits in response to cold or stress

Question 19

Leukemia

Answer 19

Overproduction or WBC
Low RBCs, low platelets, low hemoglobin and hematocrit

Question 20

Signs and symptoms of leukemia

Answer 20

Frequent infections
Fatigue, unsteady gait, pale (pallor)
Bruising, petechiae and easy bleeding
Weight loss, anorexia

Question 21

Acute lymphoblastic leukemia (ALL)

Answer 21

Cancer of the blood and bone marrow

*More common in children
Fever, bleeding may appear
CNS manifestations

Question 22

Acute myeloid leukemia

Answer 22

Myeloid cells interfering with production of other blood cells.

*more common in adults (men)
Petechiae and purpura

Question 23

Chronic lymphocytic leukemia (CLL)

Answer 23

Common in adults over 50
Lymphadenopathy

Question 24

Chronic lymphocytic leukemia (CLL)

Answer 24

Common in ages over 50
Lymphadenopathy

Question 25

Chronic myeloid leukemia (CML)

Answer 25

Cancer starting in bone marrow
Infiltration of liver and spleen

Question 26

Lymphoma

Answer 26

Hodgkins= reed-sternberg cells
Non-hodgkins= no reed sternberg cells

Question 27

Lymphoma signs and symptoms

Answer 27

Painless bumps and lumps (under arm)
Enlarged lymph glands
Fever
Weight loss
Night sweats
Infections