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Clinical Medicine Ortho > Sjӧgren’s Syndrome > Flashcards

Sjӧgren’s Syndrome Flashcards

1
Q

What is Sjӧgren’s Syndrome?

A

Autoimmune disorder affecting exocrine glands

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2
Q

What are the 2 types of Sjӧg

A

Primary

Secondary

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3
Q

What is associated with secondary Sjӧgren’s Syndrome?

A

Other autoimmune connective tissue diseases

  • SLE
  • RA
  • Scleroderma
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4
Q

What is Sicca Syndrome?

A

Dryness of the exocrine glands

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5
Q

What are the other causes of Sicca Syndrome?

A 
Aging
DM
Hep C
AIDS
Parkinson’s Dz
Head and neck radiation
Sarcoidosis
Medications
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6
Q

What medications are involved in Sicca Syndrome?

A 
Antidepressants
Antihistamines
Antipsychotics
Incontinence medications
Isotretinoin
Diuretics
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7
Q

Can Sicca Syndrome be independent of Sjӧgren’s Syndrome?

A

YES

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8
Q

What is associated with Sjӧgren’s Syndrome?

A

Genetics

Viruses

  • Epstein-Barr virus
  • Retroviruses
  • Coxsackieviruses
  • CMV
  • Hep C
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9
Q

What the eye manifestations of Sjӧgren’s Syndrome?

A 
Xerophthalmia
Keratoconjunctivitis sicca
Corneal ulcers and scarring
Bacterial keratitis
Eyelid infections
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10
Q

What is keratoconjunctivitis sicca?

A 
Damage to corneal and conjunctival epithelia
Foreign-body senstation
Grittiness
Irritation
Photosensitivity
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11
Q

What is xerostomia?

A 
Difficulty swallowing
Dental caries/infections
- Fungal infections- candidiasis
Pain with eating salty/spicy foods
Difficulty talking
Parotid gland enlargement
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12
Q

What are the constitutional symptoms?

A
  • Fatigue

- Low-grade fever

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13
Q

What are the sin and vascular symptoms?

A
  • Xerosis
  • Vasculitis
  • Raynaud’s phenomenon
  • Photosensitivity
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14
Q

What are the pulmonary symptoms?

A
  • Chronic bronchitis
  • Bronchiectasis
  • COPD
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15
Q

What are the MSK symptoms?

A
  • Polyarthritis

- Polymyositis

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16
Q

What are the renal symptoms?

A
  • Tubular interstitial nephritis

- Glomerulonephritis

17
Q

What are the neurology signs?

A
  • Peripheral neuropathy
18
Q

What are the neoplasia signs?

A
  • Lymphadenopathy

- Lymphoma

19
Q

What is the workup for Sjӧgren’s Syndrome?

A

Ocular and oral exams
- Schirmer test

Labs
CBC w/diff
RA
ANA
- Anti-SS-A (Ro) or anti-SS-B (La)- 40% of pts

Salivary gland biopsy

20
Q

What is the DDX of Sjӧgren’s Syndrome?

A 
Medication related dryness
Age-related exocrine gland dysfunction
Mouth breathing
HIV
Hep C
DM
21
Q

What is I diagnosis criteria of Sjӧgren’s Syndrome?

A

I. Ocular symptoms

  • Dry eyes > 3 mon
  • foreign-body sensation
  • use of tear substitute > 3 x a day
22
Q

What is the NON-Medication treatment for Sjӧgren’s Syndrome?

A

Fluid replacement
Humidifiers
Proper oral hygiene
Annual eye and dental exams

23
Q

What is the Medication treatment for Sjӧgren’s Syndrome?

A 
Artificial tears
Pilocarpine/Cevimeline
- Dry mouth
Hydroxychloroquine
- Arthralgias and cutaneous manifestations
24
Q

What is the patho of Sjӧgren’s Syndrome?

A
  • Lymphocytic and plasma cell infiltration
  • Glands that secrete moisture
  • Salivary and lacrimal glands
25
Q

What is II diagnosis criteria of Sjӧgren’s Syndrome?

A

II. Oral symptoms

  • Dry mouth > 3 mons
  • recurrent swollen salivary glands
  • use of liquids to aid swallowing
26
Q

What is III diagnosis criteria of Sjӧgren’s Syndrome?

A

III. Ocular signs

- Positive test- Schirmer or Rose Bengal score

27
Q

What is IV diagnosis criteria of Sjӧgren’s Syndrome?

A

IV. Salivary gland involvement

  • Abnormal salivary scintigraphy
  • parotid sialography
  • abnormal salivary flow
28
Q

What is V diagnosis criteria of Sjӧgren’s Syndrome?

A

V. Positive minor salivary gland biopsy findings

29
Q

What is VI diagnosis criteria of Sjӧgren’s Syndrome?

A

VI. Positive anti-SSA or anti-SSB antibody results

Clinical Medicine Ortho (42 decks)

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