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Clin Med I-II > EXAM #2 Autoimmune Diseases-Fibromyalgia > Flashcards

EXAM #2 Autoimmune Diseases-Fibromyalgia Flashcards

1
Q

An autoimmune disease is present when the body ______ to distinguish ______ from _______

A

fails; self from non-self

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2
Q

What are some etiologic and risk factors of autoimmune diseases regarding genes?

A

-Genetic
-single gene not identified
-clusters are present
-gene expression by epigenetics, remember factors that can influence genes

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3
Q

Who are the most affected by autoimmune diseases?

A

women (hormonal) > men

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4
Q

What is pathogenesis?

A

immune mechanism attacks self antigens sytemically

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5
Q

What are common S&S with MOST auto-immune conditions?

A

-GI S&S *gut largest number of immune cells
-Gradual Onset
-Inflammation
-persistent w/possible acute bouts
-local or systemic
-Myalgia/arthralgia
-Swollen lymph node(s)
-Typically affect > 1 part of the body
-Emotional changes

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6
Q

What are the general PT implications for autoimmune disease? (4)

A

-infection control
-exercise Rx
-nutritional guidance
-sleep health

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7
Q

What are the PT implications regarding medications for autoimmune disease:
-what medication?
-what does it do?
-side effects?

A

-corticosteroid medication
-prolonged use to suppress immune system response
-side effects: sleep/mood change, GI irritation, hyperglycemia, bone loss

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8
Q

What is the MOST serious side effect of Corticosteroid medications?

A

increased susceptibility to infection

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9
Q

What are the PT implications regarding the side effects of autoimmune disease medications?
-more susceptible to?
-PT should offset with?
-PT should avoid?

A

–more susceptible to fx, osteoporosis, avascular necrosis, etc.
–offset with WB and resistance exercise
–avoid JM

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10
Q

Lupus is seen primarily in ____________ and more common in ______________

A

young women; minorities

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11
Q

Why does Lupus have unique clinical manifestations & S&S?

A

no two people are the same

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12
Q
  1. What are S&S of Lupus involving skin and joints?
  2. -__________ MOST common S&S and target _____ , _________and _____
A

skin lesions, butterfly rash (across nose and cheeks)

-Arthralgia (joint P!); hand wrist and knee

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13
Q

What are other possible Lupus S&S?

A

Cardiopulmonary abnormalities and risk for thrombosis
Neurological including headaches, irritability, and depression
–cognitive deficits, seizures neuropathies, and even strokes
Urinary w/renal disease
Circulatortory w/anemia and amenorrhea
-Hepatitis may develop

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14
Q

PT implications often intervene during exacerbations by: (4)

A

-protection w/bracing assistive or ergonomic devices
-energy conservation
-monitor symptoms to maximize movement
-gentle and regular exercise -land and aquatic based

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15
Q

PT implications –exacerbations
–identify?

A

Identify triggers i.e., physical and environmental factors

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16
Q

Group of diverse auto-inflammatory conditions that affects the spine > extremity joints

A

Spondyloarthropathies

17
Q

What is Sjogren syndrome?

A

spondyloarthropathies or spondyloarthritis

19
Q

Common Features & S&S of spondyloarthropathies or spondyloarthritis
(6)

A

-gradual
-multi jt. inflammation and P!
- > 30 min of P! after prolonged positions
-improved P! with easy and regular movement
-typically of smaller,extremity joints but can affect larger ones
-localized to insertions of ligaments, tension and fascia (numerous “itis”)

20
Q

If a patient tells you that it “hurts to see, pee, and bend my knee” what are they experiencing?

A

spondyloarthropathies or spondyloarthritis

21
Q

What are the risk factors of Sjogren Syndrome? (2)

A

2nd MOST common rheumatic disease but no Rh factor present in the blood test
MOST often in postmenopausal women

22
Q

Etiology and Pathogenesis of Sjogren’s Syndrome:

-_______ glands (moisture-producing), mainly _______ and _______ gland destruction

-Additional ________ and ______ gland dysfunction

A

-exocrine glands; salivary & lacrimal (tear)
-pituitary and adrenal

23
Q

This gland helps regulate growth, blood pressure, and reproduction:

A

pituitary gland

24
Q

What is the function of the adrenal gland:

A

regulate metabolism, immune system, blood pressure, and stress response

25
Q

Unique clinical manifestations and S&S of Sjogren’s Syndrome?

A

-Hallmark symptom- dry eyes/mouth but the potential effect on all systems
-Fatigue is dominating and disabling
-Sleep disturbance
-Spondyloarthritis S&S plus
-Peripheral neuropathy

26
Q

What is Fibromyalgia Syndrome:
-NOT what?

A

Chronic widespread myalgia
-NOT the fatigue level of chronic fatigue syndrome
-Systemic and NOT the same as a more localized Myofascial P! Syndrome

27
Q

Fibromyalgia Syndrome- Incidence/Prevalence: (4)
-MOST common _____________ in the US
-Women _______ Men
-Age?
-Fitness level?

A

MOST common MSK disorder in the US
Women (90%) > Men (10%)
20-55 years of age
Minimal Fitness levels

28
Q

Fibromyalgia Syndrome:
Risk factors/ P! Triggers (5)

A

-Prolonged anxiety and emotional stress
-Trauma
-Infections
-Rapid steroid withdrawal
-Thyroid disorders

29
Q
  1. The etiology of Fibromyalgia Syndrome is often _______ but ______ and ______ are possible.
  2. My be triggered by __________ conditions.
A

-unknown; risk factors & genetics
-inflammatory

30
Q

Fibromyalgia Syndrome pathogenesis are:

A

not entirely understood

31
Q

Fibromyalgia Syndrome pathogenesis is misprocessing of P! which is ____________

A

sensitization/nociplastic P!

32
Q

T or F the nociplastic P! in Fibromyalgia Syndrome alters the ANS, PNS, and CNS?

A

True

33
Q

Fibromyalgia Syndrome ANS has an _________ sympathetic (flight or flight) branch and ________ parasympathetic (rest) branch?

Which leads to increased ________—–> which releases ________

A

hyperactive; underactive
P! ; P! neurotransmitters

34
Q

Fibromyalgia Syndrome S&S: (6)

A

Visual problems 95%
Mental and physical fatigue 85%
Sleep disturbance/,morning fatigue 80%
Morning stiffness 75%
Global Anxiety 72%
Cognitive problems 71%

35
Q

All imaging and blood testing are ________ for Fibromyalgia Syndrome

A

negative (-)

36
Q

PT implication for Fibromyalgia Syndrome:
What two initial approaches are strongly supported?

others: (3)

A

-pt. education
-exercise Rx

-nutritional guidance
-stress management
-often minimal benefits over long-term management

37
Q

What should the exercise Rx look like for patients with fibromyalgia syndrome?
-intensity
-duration of sessions?
-frequency? wks?

you should monitor?

A

-low to moderate intensity global exercises w/aerobic and resistance activity
-1hr-1.5 hr sessions
-2-3x/wks
-≥13 weeks

-monitor vital signs to avoid hyperactive sympathetic response

38
Q

What are PT implications for Fibromyalgia Syndrome? (3)

A

-nutritional guidance
-stress management
-often minimal benefits over long-term management

Clin Med I-II (21 decks)

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