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BDS 2: CHHD > Rheumatology I > Flashcards

Rheumatology I Flashcards

1
Q

What are autoimmune diseases?

A

Immune system recognition failure or malfunctions

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2
Q

What occurs during an autoimmune disease?

A

Antibodies and T cells produced and directed against self

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3
Q

What may initiate autoimmune disease? (5)

A
  • Defect in immunological tolerance
  • Presence of sequestrated antigen
  • Infection e.g. viruses
  • Drugs e.g. methyldopa
  • Chemicals
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4
Q

Give 2 common risk factors associated with autoimmune disease

A
  • Being Female

- Positive family history

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5
Q

Give 4 examples of non-organ specific autoimmune diseases

A
  • Rheumatoid arthritis
  • Systemic lupus erythematosus (SLE)
  • Sjögren’s syndrome
  • Systemic sclerosis
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6
Q

Give 4 examples of organ specific autoimmune diseases

A
  • Pernicious anaemia
  • Hashimoto’s thyroiditis
  • Myasthenia gravis
  • Diabetes Mellitus
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7
Q

What is another name for non-organ specific autoimmune diseases?

A

Connective tissue conditions

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8
Q

What occurs to ESR, CPR and Serum protein levels in autoimmune diseases?

A

They all raise

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9
Q

How are non-organ specific autoimmune diseases detected?

A

Non-specific antibodies found in serum and various tissues

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10
Q

Rheumatology is a branch of medicine concerned with the investigation, diagnosis and management of what? (3)

A
  • Joint disorders
  • Bone diseases
  • Muscles and soft tissues diseases
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11
Q

What are the 5 main types of rheumatological diseases

A
  • Inflammatory arthritis
  • Connective tissue disease
  • Metabolic bone disorders
  • Musculoskeletal disorders
  • Degeneratory arthritis
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12
Q

What is Rheumatoid Arthritis?

A

Chronic multisystem autoimmune disease characterised by autoantibody directed against IgG

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13
Q

What is the peak onset of Rheumatoid Arthritis?

A

Peak age of onset 35 – 50 years

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14
Q

What genotype is more susceptible to Rheumatoid Arthritis?

A

HLA-DR4 genotype

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15
Q

What affect can smoking have on Rheumatoid Arthritis?

A

Triggers and maintains joint inflammation

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16
Q

What are some systemic features of Rheumatoid Arthritis? (6)

A
  • Early morning stiffness of affected joints
  • Generalised afternoon fatigue
  • Malaise
  • Anorexia
  • Generalised weakness
  • Occasionally low-grade fever
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17
Q

Why are joints of patients with Rheumatoid Arthritis often held in flexion?

A

To minimise pain

18
Q

What are flexion contractures?

Give 3 examples of these?

A
  • Fixed deformities resulting from long periods of rheumatoid arthritis
  • Ulnar deviation of the fingers
  • Swan-neck deformities
  • Boutonnière deformities
19
Q

What are some pulmonary manifestations of Rheumatoid Arthritis? (3)

A
  • Pulmonary fibrosis
  • Pleurisy
  • Pleural effusion
20
Q

What are some cardiovascular manifestations of Rheumatoid Arthritis? (4)

A
  • Pericarditis
  • Myocarditis
  • Vasculitis
  • Valvulitis
21
Q

What are some cervical spine manifestations of Rheumatoid Arthritis? (2)

A
  • Atlantoaxial subluxation

- Spinal cord compression

22
Q

What are some eye manifestations of Rheumatoid Arthritis? (3)

A
  • Scleritis
  • Uveitis
  • Keratoconjuctivitis sicca
23
Q

What 5 special investigations can be carried out to investigate Rheumatoid Arthritis?

A
  • Serology
  • Inflammatory markers
  • Xrays
  • Full blood count
  • Protein electrophoresis
24
Q

What findings will you get from serology if someone has rheumatoid arthritis? (2)

A
  • Rheumatoid factor (RF) positive

- ACPA positive

25
Q

What findings will you get from inflammatory markers if someone has rheumatoid arthritis? (2)

A

Elevated CRP & ESR

26
Q

What findings will you get from Xrays if someone has rheumatoid arthritis? (4)

A
  • Soft tissue swelling
  • Narrowing of joint space
  • Joint erosion
  • Periarticular osteoporosis
27
Q

What findings will you get from a full blood count if someone has rheumatoid arthritis? (3)

A
  • Normocytic anaemia
  • Neutropenia
  • Thrombocytosis
28
Q

What finding will you get from Protein electrophoresis if someone has rheumatoid arthritis?

A

Hypergamma-globulinaemia

29
Q

How can you manage rheumatoid arthritis? (2)

A
  • Manage symptoms with DMARDs

- Surgery for severely damaged joints

30
Q

What is the dental relevance of rheumatoid arthritis? (5)

A
  • Cant suddenly move the neck as could be spinal problems
  • Restricted manual decertify so bad OH
  • Drugs taken can have oral side effects
  • TMJ could have reduced motility
  • Sjogren syndrome could cause other diseases such as xerostomia or candidiasis
31
Q

What is the most affected group for Ankylosing Spondylitis?

A

Males aged 20-40

32
Q

Which ethnics groups are most affected by Ankylosing Spondylitis? (2)

A
  • Blacks

- Caucasians

33
Q

What are some early clinical presentations of Ankylosing Spondylitis? (3)

A
  • Nocturnal low back pain
  • Morning stiffness
  • Para-spinal muscle spasms
34
Q

What are some late stage clinical presentations of Ankylosing Spondylitis? (3)

A
  • Kyphosis
  • Loss of lumbar lordosis
  • Fixed bent-forward posturing
35
Q

What is an eye manifestation of Ankylosing Spondylitis?

A

Recurrent acute uveitis

36
Q

What are some cardiovascular manifestation of Ankylosing Spondylitis? (4)

A
  • Aortic insufficiency
  • Angina
  • Pericarditis
  • Cardiac conduction abnormalities
37
Q

What are some pulmonary manifestation of Ankylosing Spondylitis? (2)

A
  • Compromised pulmonary function

- Limited chest expansion

38
Q

What are some tendon manifestation of Ankylosing Spondylitis? (2)

A
  • Achilles tendinitis

- Patellar tendinitis

39
Q

What are some investigations that can be carried out to determine Ankylosing Spondylitis? (3)

A
  • Spine Xray
  • Full blood count
  • Inflammatory markers
40
Q

What are the treatment goals of both rheumatoid arthritis and ankylosing spondylitis? (3)

A
  • Pain relief
  • Maintaining joint range of motion
  • Preventing end-organ damage
41
Q

What is Psoriatic Arthritis?

A

Arthritis occurring in about 20% of patients with psoriasis

BDS 2: CHHD (28 decks)

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