Lupus SJB Flashcards
1
Q
Three types of Lupus
A
- Drug-induced
- Discoid
- Systemic
2
Q
What is the “best” type of Lupus to have?
A
Drug-induced
3
Q
Why is drug-induced Lupus the best type to have?
A
There is complete resolution of symptoms after the drug is stopped
4
Q
Most common drugs that induce Lupus
A
- Procainamide (Pronestyl)
- Hydralazine (Apresoline)
- Quinidine (Quinaglute)
5
Q
Procainamide aka
A
Pronestyl
6
Q
Pronestyl aka
A
Procainamide
7
Q
Hydralazine aka
A
Apresoline
8
Q
Apresoline aka
A
Hydralazine
9
Q
Quinidine aka
A
Quinaglute
10
Q
Quinaglute aka
A
Quinidine
11
Q
Procainamide (Pronestyl) is what type of drug?
A
anti-arrhythmia drug
12
Q
Hydralazine (Apresoline) is what type of drug?
A
anti-HTN
13
Q
Quinidine (Quinaglute) is what type of drug?
A
anti-arrhythmia drug
14
Q
Symptoms of drug-induced Lupus
A
- Muscle joint pain and swelling
- Flu-like symptoms of fatigue and fever
- Serositis
15
Q
What is Serositis?
A
inflammation of serous membrane
16
Q
What is inflammation of serous membrane called?
A
Serositis
17
Q
Prognosis for drug-induced Lupus
A
complete resolution of symptoms after the drug is stopped
18
Q
Discoid and Systemic Lupus are what kinds of diseases?
A
Autoimmune
19
Q
Discoid Lupus
A
- limited to the skin
- rash is not itchy
- 10% of discoid develop systemic
20
Q
Malar rash aka
A
butterfly rash
21
Q
Butterfly rash aka
A
malar rash
22
Q
Typical skin manifestations of Discoid Lupus
A
- Malar (butterfly) rash
- Oral ulcers
- “Ringworm” rash
23
Q
Systemic Lupus Erythematosus
A
- Incidence 1:2500
- Female: male 10:1
- 2nd/3rd decade of life
- More common in African American, Hispanic, Asian, and Native American
24
Q
Which form of Lupus is limited to the skin?
A
Discoid
25
Systemic Lupus is diagnosed with ___ out of ___ symptoms.
4; 11
26
The 11 potential symptoms of Systemic Lupus used for diagnosis include
- MaDiP
- OrArtS
- ReNHem
- ImAn
27
I made up MaDiP to stand for
- Malar rash
- Discoid rash
- Photosensitivity
28
I made up OrArtS to stand for
- Oral ulcers
- Arthritis
- Serositis
29
I made up ReNHem to stand for
- Renal disorder
- Neurologic disorder
- Hematologic disorder
30
I made up ImAn to stand for
- Immunologic disorder
| - Antinuclear antibodies
31
Due to the chance that a pt with Systemic Lupus may have a neurologic disorder, what should the PT watch out for?
these pts are at risk for seizures
32
Which form of Lupus presents with seizure precautions?
Systemic
33
What are Antinuclear antibodies?
Antibodies that react to the body's own cells
34
What is immunofluorescence used for?
to detect antinuclear antibodies
35
What is used to detect antinuclear antibodies?
immunofluorescence
36
ANA stands for
Antinuclear Antibodies
37
What part of cells do ANAs react with?
nucleus
38
Systemic Lupus Erythematosus - genetic factors
- 30% concordance in monozygotic twins
- Increased risk in family members
- HLA-DQ locus and SLE association
39
What MHC locus is a genetic factor for the development of SLE?
HLA-DQ
40
SLE stands for
Systemic Lupus Erythematosus
41
Systemic Lupus Erythematosus - non-genetic factors
- Sex hormones (estrogens > androgens)
| - UV light
42
Regarding the non-genetic factors for SLE, describe the relationship of sex hormones.
estrogens > androgens
43
True/False: Symptoms vary from pt to pt with SLE.
True
44
True/False: All pts with SLE present with similar symptoms.
False
45
Renal manifestations of SLE
- Abnormal urinalysis 50-75% of cases
- 80% of abnormal urinalysis is proteinuria
- 40% is hematuria and/or pyuria
46
True/False: Renal involvement is common in SLE.
True
47
True/False: Renal involvement is uncommon in SLE.
False
48
Proteinuria
high amounts of protein in urine
49
high amounts of protein in urine
Proteinuria
50
Hematuria
blood in urine
51
blood in urine
Hematuria
52
Pyuria
pus in urine
53
pus in urine
Pyuria
54
Cardiac disease and SLE
- Cardiac abnormalities: up to 55%
- Valvular disease: up to 50%
- Pericardial disease: up to 48%
- Myocardial dysfunction: up to 78%
55
Because of the common association of cardiac disease with SLE, what is important for the therapist to do during therapy?
monitor vital signs and make sure the pt is responding appropriately to the type of therapy you are doing
56
Common medications used to treat Lupus
- Anti-inflammatory
- Corticosteroids
- Antimalarials
- DMARDs
- Anticoagulants
57
Side effects of anti-inflammatory drugs
stomach irritation
58
Side effects of corticosteroids
- increased risk of infection
- avascular necrosis
- osteoporosis
- muscle weakness
- cataracts
- suppression of growth
59
Side effects of antimalarials
- upset stomach
| - changes in skin color
60
Side effects of DMARDs
- bladder problems
- hair loss
- sterility
- nausea
- mouth sores
- headaches
- pancreatitis
- allergic hepatitis
61
Side effects of anticoagulants
bruises
62
What type of medication commonly presents with the side effect of stomach irritation?
Anti-inflammatory drugs
63
What type of medication commonly presents with the side effects of increased risk of infection, avascular necrosis, osteoporosis, muscle weakness, cataracts, and suppression of growth?
corticosteroids
64
What type of medication commonly presents with the side effects of upset stomach and changes in skin color?
antimalarials
65
What type of medication commonly presents with the side effects of bladder problems, hair loss. sterility, nausea, mouth sores, headaches, pancreatitis, and allergic hepatitis?
DMARDS
66
What type of medication commonly presents with the side effect of bruises
anticoagulants
67
What type of medication is unique to Lupus?
antimalarials
68
What type of medication is unique to most rheumatic diseases?
DMARDS
69
DMARDS are unique to what diseases?
most rheumatic diseases
70
Antimalarials are unique to what diseases?
Lupus
71
PT implications of Lupus
- Fatigue: activity modification
- Seizure precautions
- Corticosteroid treatment
72
PT implications of a pt with Lupus who is on corticosteroid treatment
- Depression
- Osteoporosis
- Electrolyte imbalances
- Weakness
73
Two types of Sclerosis
- Limited
| - Diffuse
74
Limited Sclerosis aka
CREST syndrome
75
Diffuse Sclerosis aka
systemic sclerosis
76
CREST syndrome is seen with
Limited Sclerosis
77
Systemic Sclerosis is seen with
Diffuse Sclerosis
78
CREST stands for
- Calcinosis
- Raynaud's phenomenon
- Esophageal dysfunction
- Sclerodactyly
- Telangiectasis
79
Calcinosis
calcium deposits underneath the skin
80
Raynaud's phenomenon
circulation cut off to fingers
- Stage 1: fingers turn white
- Stage 2: fingers turn blue or black
- Stage 3: red, painful swelling
81
What is significant about stage 2 of Raynaud's phenomenon?
when fingers turn black, frostbite or tissue damage can occur
82
At what stage of Raynaud's phenomenon can frostbite occur?
stage 2
83
What causes stage 3 of Raynaud's phenomenon to occur?
the fingers warm up and circulation begins to return
84
Sclerodactyly
localized thickening and tightness of the skin of the fingers or toes
85
Sclerodactyly often leads to
ulceration of the skin of the distal digits
86
Sclerodactyly is commonly accompanied by
atrophy of the underlying soft tissues
87
Sclerodactyly literally means
"hard fingers or toes"
88
Telangiectasis
small dilated (broken) blood vessels near the surface of the skin or mucous membranes
89
Telangiectasis is commonly seen where?
on the face around the nose, cheeks, and chin
90
What sort of people is telangiectasis commonly seen in?
alcoholics
91
Systemic sclerosis presents with
CREST syndrome +
- GI disturbances
- Lungs with scarring (fibrosis)
- Heart wall thickening
- Kidney failure
92
Medications for Sclerosis
- Anti-inflammatory
- DMARDS
- vasodilators
- calcium channel blockers
93
Side effects of vasodilators
- LiFaFl
- UPalE
- CheFaRa
94
I made up LiFaFl to stand for
- light-headedness
- fainting
- flu symptoms
95
I made up UPalE to stand for
- urinating more than usual
- pale skin
- easy bruising or bleeding
96
I made up CheFaRa to stand for
- chest pain or swelling
- fast, pounding, or uneven heartbeats
- rapid weight gain
97
Side effects of calcium channel blockers
- swelling in legs or ankles
- chest pain
- fast or pounding heartbeats
- feeling like you might pass out
98
What type of medication commonly presents with the side effects of light-headedness; fainting; flu symptoms; urinating more than usual; pale skin; easy bruising or bleeding; chest pain or swelling; fast, pounding, or uneven heartbeats; and rapid weight gain?
vasodilators
99
What type of medication commonly presents with the side effects of swelling in legs or ankles, chest pain, fast or pounding heartbeats, and feeling like you might pass out?
calcium channel blockers
100
PT implications of Sclerosis
- Skin issues
- Monitor BP daily
- Daily exercise helps
101
PT implications of Sclerosis - skin issues
- Avoid scratching
- Use cooling agents on skin
- Avoid excessive bathing (dries skin)
- Sensitive to excess pressure
102
Regarding the PT implications of Sclerosis, why should BP be monitored daily?
it fluctuates daily
103
PT implications of Sclerosis - daily exercise
Stretching, AROM/PROM
104
Regarding the PT implications of Sclerosis, why is stretching and AROM/PROM so important?
to prevent contractures
105
What would cause contractures in a pt with Sclerosis?
the tendency of the skin to tighten up
