Episodic diseases - HIV/AIDS, autoimmune dis, hemophilia

Question 1

What does AIDS stand for

Answer 1

Acquired immunodeficiency syndrome

Question 2

Cause of AIDS?

Answer 2

HIV 1 or 2

• Transmission through contact with infected body fluids: blood, saliva, semen CSF, breast milk, vaginal/cervical secretions, mucous membranes, mother to child during pregnancy
• Not transmitted through à urine, sweat, vomit

Question 3

Result of AIDS

Answer 3

Loss of immune system function, decreased CD4+ helper T cells

Question 4

AIDS Dx

Answer 4

• Clinical findings
• Systemic evidence
• Lab evidence à HIV-1 antibody test, CD4 cell count 200-500/ml (normal = 800-1200/ml)

Question 5

People with aids have an increased susceptibility to develop what condition s

Answer 5

Pneumonia, TB, Malignancy, Encephalitis, Meningitis, Dementia, Herpes zoster

Question 6

AIDS Medical Rx

Answer 6

No cure: Want to keep viral load as low as possible

MED RX

1) Multidrug antiviral therapy
a. different drugs w/ different location of actionà adherence is difficult
2) Symptomatic treatment
a. maintain nutrition, maintain functional mobility, education

Question 7

AIDS PT RX

Answer 7

**Check precautions
Exercises:
- mod aerobic, strength
- avoid exhaustive exercise
- ACUTE - focus on mild exercise levels, activity pacing, energy conservation, stress management

Question 8

What is lupus erythematosus

Answer 8

autoimmune disease that can affect any part of the body

Question 9

lupus erythematosus S&S

Answer 9

• Skin - may find butterfly rash
• localized erythema
• localized edema
• alopecia (loss of hair)
• photosensitivity
• mucosal ulcers
• Raynaud’s (fingers are cold sensitive)
• Joint effusion

Question 10

lupus erythematosus Dx

Answer 10

Positive serum “antinuclear antibodies” (ANA) symmetric arthritis

Question 11

What is sclerodema

Answer 11

Systemic sclerosis - chronic disease primarily affecting skin, characterized by sclerosis (hardening of skin)
- Provokes massive fibrotic tissue response

Question 12

Sclerodema can cause…

Answer 12

• joint contractures
• pulmonary fibrosis
• HTN
• renal
• GI dysmotility (especially esophagus)
• Raynaud’s

Question 13

What is Dermatomyositis

Answer 13

inflammatory CT disorder affecting both muscle and skin characterized by proximal limb girdle weakness

Question 14

What is polymyotis

Answer 14

inflammatory CT disorder affecting just muscle characterized by proximal limb girdle weakness

Question 15

Dermatomyositis is associated with…

Answer 15

photosensitive skin rash, purplish erythematous eruption over face, UE’s

Question 16

What is Haemophilia

Answer 16

Hereditary bleeding disorder - body unable to control blood clotting/coagulation

Question 17

Haemophilia causes

Answer 17

• vascular abnormalities
• platelet abnormalities
• coagulation cascade abnormalities

Question 18

What type of genetic disorder is Haemophilia

Answer 18

X-linked recessive - males have condition females carry gene

Question 19

In haemophilia (a x-linked recessive disorder) If mother is carrier and father doesnt have it what is the outcome of the offspring male and female

Answer 19

• Male child has 50% chance of having disorder

- Female child has 50% chance of carrying gene

Question 20

In haemophilia (a x-linked recessive disorder) If mother isn’t carrier and father has it what is the outcome of the offspring male and female

Answer 20

• Male child: not affected by hemophilia, can’t carry gene

- Female child: will be carrier - known as obligate carrier

Question 21

Haemophilia presentation

Answer 21

• profuse post circumcision bleeding
• joint and soft tissue bleeding
• excessive bleeding
• operative & post-traumatic hemorrhage

Question 22

Haemophilia S&S

Answer 22

• Bleeding in the joints is the most common problem.
• large bruises
• bleeding into muscles and joints (esp. knees, elbows, and ankles)
• prolonged bleeding after a cut, tooth removal, surgery, or an accident
• serious trauma causes serious internal bleeding into vital organs

Question 23

Joint bleed symptoms

Answer 23

• JT tightness + no pain -> tightness + pain, no bleeding -> swollen + hot to touch, hard to move -> all ROM lost + severe pain -> bleeding slows in few days (joint full of blood)

Question 24

What is the result if haemophilia goes untreated

Answer 24

• Arthritis: disabling

Question 25

Haemophilia Rx

Answer 25

• recombinant factor VIII infusion (in the 80s, got blood products - died of AIDS, Hep C)
• desmopressin: mild hemophilia