Systemic Lupus Erythematosus Flashcards
Lupus
inflammatory multi-system disease of unknown etiology with protean clinical and laboratory manifestations and a variable course and prognosis
immunologic aberrations give rise to excessive autoantibody production, some of which cause cytotoxic damage, while others participate in immune complex formation resulting in immune inflammation
etiology and patho physiology SLE
exact etiology unknown: genes, hormones, environment involved
manifestations/ complications of SLE
incidence- 1:2000
women 1-9, child bearing age, african americans
periods remission and exacerbation
stress
environmental factors
SLE characteristics
characterized by periods of remission and exacerbation.
stimulated by sunlight, stress, pregnancy, infections like strep and some drugs.
some drugs like apresoline, pronestyl, dilantin, tetracycline, andphenobarbital may cause a lupus like reaction which disappears when drug is stopped
SOAP BRAIN MD
- Serositis
- Oral ulcers
- arthritis
- photosensitivity
- blood/hematologic diorder
- renal disorder
- antinuclearantibody (positive ANA)
- immunologic disorders
- neurological disorders
Treatment of SLE: arthritis, arthralgias, myalgias
NSAIDS, anti malarials, steroid injections, oral methotrexate
Treatment of SLE: photosensitivity, dermatitis
avoid sun exposure
topical steroids
plaquenil
Treatment of SLE: weight loss and fatigue
steroids
Treatment of SLE: thrombosis
anti-coagulants
Treatment of SLE: glomerulonephritis
steroids, pulse cytotoxics, mycophenylate mofetil
Treatment of SLE: CNS disease
anti-coagulants for thrombosis, steroids and cytotoxics for vasculitis
Treatment of SLE: infarction
steroids, cytotoxics, prostacyclin
Treatment of SLE: cytopenias
steroids, IVIG (short for thrombocytopenia), danazol, cytotoxics if bone marrow status unknown
PT and SLE
most commonly treated symptoms are arthritis of the joints and weakness/fatigue and the plan of care should address reducing pain, stiffness, and inflammation as well as improving joint ROM and functional ability
aquatic therapy
modalities-crytotherapy and thermotherapy
manual therapy
functional/therapeutic exercise
neuro-rehab
Fibromyalgia
chronic musculoskeletal pain syndrome of known etiology but likely neurogenic
characterized by diffusepain, tender points, fatigue, and sleep disturbances
increased scores on neuropathic questionnaires are associated with CNS pain amplification, or “centralization” of pain
prevalence is 2-5% with a female to male predominance of 8:1
mean age is 30-60
