EXAM #2 Autoimmune Diseases-Fibromyalgia Flashcards
An autoimmune disease is present when the body ______ to distinguish ______ from _______
fails; self from non-self
What are some etiologic and risk factors of autoimmune diseases regarding genes?
-Genetic
-single gene not identified
-clusters are present
-gene expression by epigenetics, remember factors that can influence genes
Who are the most affected by autoimmune diseases?
women (hormonal) > men
What is pathogenesis?
immune mechanism attacks self antigens sytemically
What are common S&S with MOST auto-immune conditions?
-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
What are the general PT implications for autoimmune disease? (4)
-infection control
-exercise Rx
-nutritional guidance
-sleep health
What are the PT implications regarding medications for autoimmune disease:
-what medication?
-what does it do?
-side effects?
-corticosteroid medication
-prolonged use to suppress immune system response
-side effects: sleep/mood change, GI irritation, hyperglycemia, bone loss
What is the MOST serious side effect of Corticosteroid medications?
increased susceptibility to infection
What are the PT implications regarding the side effects of autoimmune disease medications?
-more susceptible to?
-PT should offset with?
-PT should avoid?
–more susceptible to fx, osteoporosis, avascular necrosis, etc.
–offset with WB and resistance exercise
–avoid JM
Lupus is seen primarily in ____________ and more common in ______________
young women; minorities
Why does Lupus have unique clinical manifestations & S&S?
no two people are the same
- What are S&S of Lupus involving skin and joints?
- -__________ MOST common S&S and target _____ , _________and _____
skin lesions, butterfly rash (across nose and cheeks)
-Arthralgia (joint P!); hand wrist and knee
What are other possible Lupus S&S?
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
PT implications often intervene during exacerbations by: (4)
-protection w/bracing assistive or ergonomic devices
-energy conservation
-monitor symptoms to maximize movement
-gentle and regular exercise -land and aquatic based
PT implications –exacerbations
–identify?
Identify triggers i.e., physical and environmental factors
Group of diverse auto-inflammatory conditions that affects the spine > extremity joints
Spondyloarthropathies
What is Sjogren syndrome?
spondyloarthropathies or spondyloarthritis
Common Features & S&S of spondyloarthropathies or spondyloarthritis
(6)
-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”)
If a patient tells you that it “hurts to see, pee, and bend my knee” what are they experiencing?
spondyloarthropathies or spondyloarthritis
What are the risk factors of Sjogren Syndrome? (2)
2nd MOST common rheumatic disease but no Rh factor present in the blood test
MOST often in postmenopausal women
Etiology and Pathogenesis of Sjogren’s Syndrome:
-_______ glands (moisture-producing), mainly _______ and _______ gland destruction
-Additional ________ and ______ gland dysfunction
-exocrine glands; salivary & lacrimal (tear)
-pituitary and adrenal
This gland helps regulate growth, blood pressure, and reproduction:
pituitary gland
What is the function of the adrenal gland:
regulate metabolism, immune system, blood pressure, and stress response
Unique clinical manifestations and S&S of Sjogren’s Syndrome?
-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
What is Fibromyalgia Syndrome:
-NOT what?
Chronic widespread myalgia
-NOT the fatigue level of chronic fatigue syndrome
-Systemic and NOT the same as a more localized Myofascial P! Syndrome
Fibromyalgia Syndrome- Incidence/Prevalence: (4)
-MOST common _____________ in the US
-Women _______ Men
-Age?
-Fitness level?
MOST common MSK disorder in the US
Women (90%) > Men (10%)
20-55 years of age
Minimal Fitness levels
Fibromyalgia Syndrome:
Risk factors/ P! Triggers (5)
-Prolonged anxiety and emotional stress
-Trauma
-Infections
-Rapid steroid withdrawal
-Thyroid disorders
- The etiology of Fibromyalgia Syndrome is often _______ but ______ and ______ are possible.
- My be triggered by __________ conditions.
-unknown; risk factors & genetics
-inflammatory
Fibromyalgia Syndrome pathogenesis are:
not entirely understood
Fibromyalgia Syndrome pathogenesis is misprocessing of P! which is ____________
sensitization/nociplastic P!
T or F the nociplastic P! in Fibromyalgia Syndrome alters the ANS, PNS, and CNS?
True
Fibromyalgia Syndrome ANS has an _________ sympathetic (flight or flight) branch and ________ parasympathetic (rest) branch?
Which leads to increased ________—–> which releases ________
hyperactive; underactive
P! ; P! neurotransmitters
Fibromyalgia Syndrome S&S: (6)
Visual problems 95%
Mental and physical fatigue 85%
Sleep disturbance/,morning fatigue 80%
Morning stiffness 75%
Global Anxiety 72%
Cognitive problems 71%
All imaging and blood testing are ________ for Fibromyalgia Syndrome
negative (-)
PT implication for Fibromyalgia Syndrome:
What two initial approaches are strongly supported?
others: (3)
-pt. education
-exercise Rx
-nutritional guidance
-stress management
-often minimal benefits over long-term management
What should the exercise Rx look like for patients with fibromyalgia syndrome?
-intensity
-duration of sessions?
-frequency? wks?
you should monitor?
-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
What are PT implications for Fibromyalgia Syndrome? (3)
-nutritional guidance
-stress management
-often minimal benefits over long-term management
