Diseases of Human Systems - connective tissue disease (lupus) Flashcards

1
Q

What are the two subgroups of systemic connective tissue disease?

A

Multisystem vasculitic inflammatory disease

Vascular vasculitic disease

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2
Q

Name the types of multi system vasculitic vascular disease.

A

Systemic lupus erythrematosis

Systemic sclerosis

Sjogrens syndorme

Undifferentiated connective tissue disease

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3
Q

Name the types of vascular vasculitic disease.

A

Giant vessel disease - giant cell temporal arthritis

Medium vessel disease - kawasaki disease

Small vessel disease - weighers granulomatosis

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4
Q

How do we manage connective tissue diseases? (5)

A

Immunosuppressants

Biological medications - cytokine inhibitors and lymphocyte depleting drugs

Analgesics - NSAIDS

Systemic steroids - prednisolone (short time use only)

Immune modulating treatments - hydroxychloroquine

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5
Q

Name the types of systemic lupus erythrematosis (subtype of multi system vasculitic inflammatory disease)

A

Discoid lupus

Antiphospholipid antibody syndrome

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6
Q

Who is most at risk of discoid lupus?

A

Females of child bearing age

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7
Q

What autoantibodies are likely to be present in an individual with SLE? (3)

A

AntiANA
Anti-double stand DNA
Anti-ro

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8
Q

What are the signs and symptoms of discoid lupus?

A

Photosensitive butterfly rash

Raynauds

Arthritis

Renal disease

CVD

lung diseases

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9
Q

What are the dental implications of discoid lupus? (5)

A

High risk when carrying out GA due to the anaemia

Bleeding tendency due to thrombocytopenia

Impaired drug metabolism from the renal disease

Lichenoid reactions

Oral pigmentation

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10
Q

How can you determine is a patient has antiphospholipid antibody syndrome (subgroup of lupus erythematosis) ?

A

There is the presence of the lupus anticoagulant marker in the blood

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11
Q

What are the type types of antiphospholipid antibody syndrome? (2)

A

Primary - no associated inflammatory diseases

Secondary - associated with other inflammatory conditions e.g. rheumatoid arthritis, sjogrens

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12
Q

What are the signs and symptoms of patients with APS?

A

Recurrent thrombosis - venous, arterial, DVT with pulmonary embolism

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13
Q

What autoantibodies are present in a patient with sjogrens syndrome (subtype of multi system vasculitic inflammatory disease)?

A

Anti-ANA
Anti-la
Anti-ro

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14
Q

What are the 3 main types of sjogrens and what are they characterised by?

A

Sicca - dry eyes and mouth only

Primary - features of the disease mainly affect the eyes and mouth

Secondary - associated with another connective tissue disease e.g. SLE

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15
Q

What is the guaranteed method of diagnosing patient’s with sjogrens?

A

Histopathological sample from the labial salivary gland

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16
Q

What are the dental implications of sjogrens?

A

Oral infections

Caries

Functional loss i.e. swallowing

Problems with denture retention

Sialosis

Salivary lymphoma

17
Q

What is systemic sclerosis (subtype of multi system vasculitic inflammatory disease)?

A

Where elastic tissue is replaced by connective fibrous tissue both internally and externally

18
Q

How can we tell if the systemic sclerosis is localised or generalised?

A

Local = anticentromere antibodies are present

Generalised = anti scl-70 antibodies are present

19
Q

Who is most at risk of systemic sclerosis?

A

Females

20
Q

What are the associated complications of symptoms of systemic sclerosis? (3)

A

Raynauds

Renal failure

Malabsorption via the GIT (slow progression)

21
Q

What are the dental implications of systemic sclerosis? (6)

A

Limited mouth opening and tongue movement

Patient can also have sjogrens

Dysphagia due to loss of elasticity of the oesophagus

Reflux oesophagitis

Poor drug metabolism

Widening of PDL space

(We must plan treatment for 10 years ahead)

22
Q

Describe what occurs in vasculitic diseases

A

There is inflammation of the blood vessels which leads to narrowing and infarction of the tissues.

23
Q

In giant cell arthritis (large vessel vasculitic disease) what vessels are involved?

A

The temporal artery

The external carotid artery and its branches

24
Q

In giant cell arthritis (large vessel vasculitic disease) what will the patient present with?

A

facial pain

headache

chewing claudication from involvement of the carotid branches

Blindness from occlusion of the central renal artery

25
Q

How do we treat In giant cell arthritis?

A

Immunosuppressants e.g. prednisolone

26
Q

who is affected by poly myalgia rheumatica (large vessel vasculitic disease)?

A

Those in their 60/70s

27
Q

What are the sigs and symptoms of poly myalgia rheumatica? (5)

A

Pain and stiffness of muscles around the shoulder and hip

Restricted range of movement

malaise

weight loss

Fatigue

28
Q

What is the key indicator of polymyalgia rheumatica?

A

Rapid response to steroids

29
Q

Who is affected by Kawasaki disease (medium vessel vasculitic disease)?

A

Children

30
Q

How would a child with kawasaki disease present with? (4)

A

strawberry tongue - crusty and cracked

peeling rash on the hands and feet

fever and lymphadenopathy

Coronary vessel aneurysms

31
Q

What is wegner’s granulomatosis (small vessel vasculitic disease)?

A

An inflammatory disease that affects small blood vessels and can lead to the destruction of the hard and soft tissues of the face and oral cavity

32
Q

What does wegner’s granulomatosis affect?

A

Starts in the upper respiratory tract and makes its way down the digestive tract to the lungs, heart and kidney.

The skin is also affected.