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Med/Surg III Test 2 > Lupus SJB > Flashcards

Lupus SJB Flashcards

1
Q

Three types of Lupus

A
  • Drug-induced
  • Discoid
  • Systemic
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2
Q

What is the “best” type of Lupus to have?

A

Drug-induced

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3
Q

Why is drug-induced Lupus the best type to have?

A

There is complete resolution of symptoms after the drug is stopped

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4
Q

Most common drugs that induce Lupus

A
  • Procainamide (Pronestyl)
  • Hydralazine (Apresoline)
  • Quinidine (Quinaglute)
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5
Q

Procainamide aka

A

Pronestyl

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6
Q

Pronestyl aka

A

Procainamide

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7
Q

Hydralazine aka

A

Apresoline

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8
Q

Apresoline aka

A

Hydralazine

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9
Q

Quinidine aka

A

Quinaglute

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10
Q

Quinaglute aka

A

Quinidine

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11
Q

Procainamide (Pronestyl) is what type of drug?

A

anti-arrhythmia drug

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12
Q

Hydralazine (Apresoline) is what type of drug?

A

anti-HTN

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13
Q

Quinidine (Quinaglute) is what type of drug?

A

anti-arrhythmia drug

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14
Q

Symptoms of drug-induced Lupus

A
  • Muscle joint pain and swelling
  • Flu-like symptoms of fatigue and fever
  • Serositis
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15
Q

What is Serositis?

A

inflammation of serous membrane

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16
Q

What is inflammation of serous membrane called?

A

Serositis

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17
Q

Prognosis for drug-induced Lupus

A

complete resolution of symptoms after the drug is stopped

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18
Q

Discoid and Systemic Lupus are what kinds of diseases?

A

Autoimmune

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19
Q

Discoid Lupus

A
  • limited to the skin
  • rash is not itchy
  • 10% of discoid develop systemic
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20
Q

Malar rash aka

A

butterfly rash

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21
Q

Butterfly rash aka

A

malar rash

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22
Q

Typical skin manifestations of Discoid Lupus

A
  • Malar (butterfly) rash
  • Oral ulcers
  • “Ringworm” rash
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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
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24
Q

Which form of Lupus is limited to the skin?

A

Discoid

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25
Q

Systemic Lupus is diagnosed with ___ out of ___ symptoms.

A

4; 11

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26
Q

The 11 potential symptoms of Systemic Lupus used for diagnosis include

A
  • MaDiP
  • OrArtS
  • ReNHem
  • ImAn
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27
Q

I made up MaDiP to stand for

A
  • Malar rash
  • Discoid rash
  • Photosensitivity
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28
Q

I made up OrArtS to stand for

A
  • Oral ulcers
  • Arthritis
  • Serositis
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29
Q

I made up ReNHem to stand for

A
  • Renal disorder
  • Neurologic disorder
  • Hematologic disorder
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30
Q

I made up ImAn to stand for

A
  • Immunologic disorder

- Antinuclear antibodies

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31
Q

Due to the chance that a pt with Systemic Lupus may have a neurologic disorder, what should the PT watch out for?

A

these pts are at risk for seizures

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32
Q

Which form of Lupus presents with seizure precautions?

A

Systemic

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33
Q

What are Antinuclear antibodies?

A

Antibodies that react to the body’s own cells

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34
Q

What is immunofluorescence used for?

A

to detect antinuclear antibodies

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35
Q

What is used to detect antinuclear antibodies?

A

immunofluorescence

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36
Q

ANA stands for

A

Antinuclear Antibodies

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37
Q

What part of cells do ANAs react with?

A

nucleus

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38
Q

Systemic Lupus Erythematosus - genetic factors

A
  • 30% concordance in monozygotic twins
  • Increased risk in family members
  • HLA-DQ locus and SLE association
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39
Q

What MHC locus is a genetic factor for the development of SLE?

A

HLA-DQ

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40
Q

SLE stands for

A

Systemic Lupus Erythematosus

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41
Q

Systemic Lupus Erythematosus - non-genetic factors

A
  • Sex hormones (estrogens > androgens)

- UV light

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42
Q

Regarding the non-genetic factors for SLE, describe the relationship of sex hormones.

A

estrogens > androgens

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43
Q

True/False: Symptoms vary from pt to pt with SLE.

A

True

44
Q

True/False: All pts with SLE present with similar symptoms.

A

False

45
Q

Renal manifestations of SLE

A
  • Abnormal urinalysis 50-75% of cases
  • 80% of abnormal urinalysis is proteinuria
  • 40% is hematuria and/or pyuria
46
Q

True/False: Renal involvement is common in SLE.

A

True

47
Q

True/False: Renal involvement is uncommon in SLE.

A

False

48
Q

Proteinuria

A

high amounts of protein in urine

49
Q

high amounts of protein in urine

A

Proteinuria

50
Q

Hematuria

A

blood in urine

51
Q

blood in urine

A

Hematuria

52
Q

Pyuria

A

pus in urine

53
Q

pus in urine

A

Pyuria

54
Q

Cardiac disease and SLE

A
  • Cardiac abnormalities: up to 55%
  • Valvular disease: up to 50%
  • Pericardial disease: up to 48%
  • Myocardial dysfunction: up to 78%
55
Q

Because of the common association of cardiac disease with SLE, what is important for the therapist to do during therapy?

A

monitor vital signs and make sure the pt is responding appropriately to the type of therapy you are doing

56
Q

Common medications used to treat Lupus

A
  • Anti-inflammatory
  • Corticosteroids
  • Antimalarials
  • DMARDs
  • Anticoagulants
57
Q

Side effects of anti-inflammatory drugs

A

stomach irritation

58
Q

Side effects of corticosteroids

A
  • increased risk of infection
  • avascular necrosis
  • osteoporosis
  • muscle weakness
  • cataracts
  • suppression of growth
59
Q

Side effects of antimalarials

A
  • upset stomach

- changes in skin color

60
Q

Side effects of DMARDs

A
  • bladder problems
  • hair loss
  • sterility
  • nausea
  • mouth sores
  • headaches
  • pancreatitis
  • allergic hepatitis
61
Q

Side effects of anticoagulants

A

bruises

62
Q

What type of medication commonly presents with the side effect of stomach irritation?

A

Anti-inflammatory drugs

63
Q

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?

A

corticosteroids

64
Q

What type of medication commonly presents with the side effects of upset stomach and changes in skin color?

A

antimalarials

65
Q

What type of medication commonly presents with the side effects of bladder problems, hair loss. sterility, nausea, mouth sores, headaches, pancreatitis, and allergic hepatitis?

A

DMARDS

66
Q

What type of medication commonly presents with the side effect of bruises

A

anticoagulants

67
Q

What type of medication is unique to Lupus?

A

antimalarials

68
Q

What type of medication is unique to most rheumatic diseases?

A

DMARDS

69
Q

DMARDS are unique to what diseases?

A

most rheumatic diseases

70
Q

Antimalarials are unique to what diseases?

A

Lupus

71
Q

PT implications of Lupus

A
  • Fatigue: activity modification
  • Seizure precautions
  • Corticosteroid treatment
72
Q

PT implications of a pt with Lupus who is on corticosteroid treatment

A
  • Depression
  • Osteoporosis
  • Electrolyte imbalances
  • Weakness
73
Q

Two types of Sclerosis

A
  • Limited

- Diffuse

74
Q

Limited Sclerosis aka

A

CREST syndrome

75
Q

Diffuse Sclerosis aka

A

systemic sclerosis

76
Q

CREST syndrome is seen with

A

Limited Sclerosis

77
Q

Systemic Sclerosis is seen with

A

Diffuse Sclerosis

78
Q

CREST stands for

A
  • Calcinosis
  • Raynaud’s phenomenon
  • Esophageal dysfunction
  • Sclerodactyly
  • Telangiectasis
79
Q

Calcinosis

A

calcium deposits underneath the skin

80
Q

Raynaud’s phenomenon

A

circulation cut off to fingers

  • Stage 1: fingers turn white
  • Stage 2: fingers turn blue or black
  • Stage 3: red, painful swelling
81
Q

What is significant about stage 2 of Raynaud’s phenomenon?

A

when fingers turn black, frostbite or tissue damage can occur

82
Q

At what stage of Raynaud’s phenomenon can frostbite occur?

A

stage 2

83
Q

What causes stage 3 of Raynaud’s phenomenon to occur?

A

the fingers warm up and circulation begins to return

84
Q

Sclerodactyly

A

localized thickening and tightness of the skin of the fingers or toes

85
Q

Sclerodactyly often leads to

A

ulceration of the skin of the distal digits

86
Q

Sclerodactyly is commonly accompanied by

A

atrophy of the underlying soft tissues

87
Q

Sclerodactyly literally means

A

“hard fingers or toes”

88
Q

Telangiectasis

A

small dilated (broken) blood vessels near the surface of the skin or mucous membranes

89
Q

Telangiectasis is commonly seen where?

A

on the face around the nose, cheeks, and chin

90
Q

What sort of people is telangiectasis commonly seen in?

A

alcoholics

91
Q

Systemic sclerosis presents with

A

CREST syndrome +

  • GI disturbances
  • Lungs with scarring (fibrosis)
  • Heart wall thickening
  • Kidney failure
92
Q

Medications for Sclerosis

A
  • Anti-inflammatory
  • DMARDS
  • vasodilators
  • calcium channel blockers
93
Q

Side effects of vasodilators

A
  • LiFaFl
  • UPalE
  • CheFaRa
94
Q

I made up LiFaFl to stand for

A
  • light-headedness
  • fainting
  • flu symptoms
95
Q

I made up UPalE to stand for

A
  • urinating more than usual
  • pale skin
  • easy bruising or bleeding
96
Q

I made up CheFaRa to stand for

A
  • chest pain or swelling
  • fast, pounding, or uneven heartbeats
  • rapid weight gain
97
Q

Side effects of calcium channel blockers

A
  • swelling in legs or ankles
  • chest pain
  • fast or pounding heartbeats
  • feeling like you might pass out
98
Q

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?

A

vasodilators

99
Q

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?

A

calcium channel blockers

100
Q

PT implications of Sclerosis

A
  • Skin issues
  • Monitor BP daily
  • Daily exercise helps
101
Q

PT implications of Sclerosis - skin issues

A
  • Avoid scratching
  • Use cooling agents on skin
  • Avoid excessive bathing (dries skin)
  • Sensitive to excess pressure
102
Q

Regarding the PT implications of Sclerosis, why should BP be monitored daily?

A

it fluctuates daily

103
Q

PT implications of Sclerosis - daily exercise

A

Stretching, AROM/PROM

104
Q

Regarding the PT implications of Sclerosis, why is stretching and AROM/PROM so important?

A

to prevent contractures

105
Q

What would cause contractures in a pt with Sclerosis?

A

the tendency of the skin to tighten up

Med/Surg III Test 2 (5 decks)

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