autoimmune disorders Flashcards

1
Q

Normal immune response

A
  • recognition phase: body recongizes something is not suppose to be there
  • amplification phase: start fighting off the antigen
  • effector phase: getting rid of antigen
  • terminator phase: going back to normal
  • memory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dysfunction of the immune system

A
  • genetic alterations: mutations that inactivate receptors (immunodeficiencies)
  • signaling molecules; conditions with inflammatory components
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T

types of autoimmune disease

A
  • organ specific
  • systemic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

organ specific autoimmune

A
  • addisons disease
  • chron disease
  • diabetes
  • graves disease
  • affects a specific organ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Systemic

autoimmune diseases

A
  • Amyloidosis
  • MS
  • Myasthenia gravis
  • psoriasis
  • lupus
  • affects the body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Etiology ad risk factors for developing an autoimmune disease

A
  • genetic
  • hormonal
  • enviromental influences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Immunologic tolerance

what is it and types

A
  • unresponsiveness of the immune system to it’s own tissue
  • self tolerance
  • central
  • peripheral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

self tolerance (immunologic tolerance)

A
  • The ability of the immune system to be unreactive to self/ones tissue
  • therefore t-cells recognize and react against self antigens if this is lost

the immune system’s ability to recognize what is ‘self’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Central immunologic tolerance

A
  • loss of self reactive t cells and b cells
  • produces immature lymphocytes
  • lymphocytes that do not get survivial signals = apoptosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Peripheral immunologic tolerance

A
  • mature lymphocytes recognition becomes inactive or supressed by T-cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pathogenesis

of autoimmune disorders

A
  • disruption of immunoregulatory mechanism
  • change in cell mediated or humoral immune response
  • results in self-destruction of tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Gene susceptibility in autoimmune

A
  • gene maping
  • candidate for Loci for susceptibility: identifiable regions of a chromosome that are inherited with the illness in families,
  • Epigenetic (internal/external factors)
  • HLA locus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Infections, tissue injury and autoimmunity

How are infections and tissue injury related to autoimmunity

A
  • bacteria
  • myocoplasma
  • viruses
  • can precipitate autoimmunity esp. if left untreated
  • there is also a genetic component
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Medical management of autoimmune disorders

A
  • DX: lab tests, and presentation
  • Treatment: meds ie. corticosteriods, saliclates (apsirin), other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Systemic lupus

A
  • Discoid and SLE
  • inflammatory disease
  • more common in women of child bearing age
  • african american more likely
  • first degress relatives having it puts you at risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Etiology of SLE

A
  • interrelated immunologic, environmental, hormonal, genetic
  • periods of intermittent exacerbations and flareups
  • theory of latent virus infection
  • physical or mental stress
  • strep/viral infections
  • sun expoure (unable to protect dermal layer)
  • immunizations
  • pregnancy
  • abnormal estrogen metabolism
17
Q

Pathogeneis of

systemic lupus

A
  • autoantibodies
  • vascular abnormalities
  • infammatory mediators
18
Q

DX of systemic lupus

A
  • clinical findings
  • lab tests (ANA, anti-double-stranded DNA antibody, anti-sm, antiphospholidpid antibody and low complements)
19
Q

Impairments/symptoms of SLE
- MSK
- neuromusuclar
- Cardiovascular/pulmonary
- other

A
  • MSK: arthralgias, polyarthritis
  • neuromusuclar: neuropsychiatric manifestations, cognitive impairments
  • Cardiovascular/pulmonary: vasculitis, pericarditis, dyspnea, myocarditis, endocarditis, tachycardia, pneumonitis, CHF, pulmonary HTN, leg ulcers, raynauds
  • other: fever, wt gain, malaise, fatigue, skin rashs, alepecia, leg ulcers gangrene, renal disease, anemia
20
Q

Medical management of SLE

A
  • prevent flare ups with lifestyle changes and support groups
  • meds
  • treat symptoms
  • cannot push them during flare ups
21
Q

Medications for SLE

A
  • NSAIDs
  • corticosteriod-sparing agents
  • anticoagulants
  • antimalarial agents flare ups
  • immunomodulating drugs
  • cyclophosphamide
  • corticosteriods
  • cytotoxic drugs
22
Q

Special implications for PT with lupus

A
  • skin inspection and care (watch for infection)
  • pacing activities
  • strengthening to tolerance
  • education: awareness of triggers
  • monitor for medication reactions
  • monitor changes in systems
23
Q

Fibromylagia: incidence

A
  • 90% of cases in women
  • age 20-55
  • 1st degress femal relatives
24
Q

Risk factor for fibromyalgia

A
  • prolonged stress
  • anxiety
  • trauma
  • rapid steriod withdrawal
  • hypothyroidism
  • infections
25
Q

Etiological factors for fibromyalgia

A
  • under investigation
  • diet
  • viral
  • sleep disorders
  • occupations
  • seasonal
  • enviornmental influences
26
Q

Pathogenesis of firbomyalgia

A
  • CNA malfunction related to pain transmission and inhibition ??
27
Q

Diagnosis

of fibromyalgia

A

Clinical finding criteria:
1. widespread (4 quadrant pain) both above and below the waist present for at least 3 months
2. subjective report of pain when pressure is applied to 11/18 comon FMS tender points

28
Q

FMS: tender points

A
  • Low cervical (C5-C7)
  • Second rib costochondral junctions
  • Lateral epicondyle
  • knees (medial condyle/fatt pad)
  • occiput (bilateral)
  • trapezius,
  • supraspinatus (above medial border of scapula)
  • gluteal
  • Greater trochanter
29
Q
A
30
Q

System involvemetn with

Fibromyalgia
- MSK:
- neuromuscular
- Cardiovascular/pulmonary
- Other:

A
  • MSK: myalgias, arthralgias, muscule pain, tender points, morning stiffness >30 minutes
  • neuromuscular: hyperactive sympathetic/hypoactive parasympathetic, global anxiety, cognitive problems
  • Cardiovascular/pulmonary: Mitral valve prolapase
  • Other: visual problems, mental and physical fatigue, IBS, headahces, dry eyes and mouth, hypersensitivity to noise odors heat or cold,

`

31
Q

Medical management

fibromyalgia

Treatment

A
  • treatment
  • pharmaceuticals: antidepressants, muscule relaxants, analgesics, anticonvulsants
32
Q

Sepcial implications for PT

fibromyalgia

A
  • screening- composite autonomic symptoms scale (COMPASS)
  • nail bed blanching with pain
  • monitor for response for meds
  • monitor vitals
  • US
  • education to recognize triggers and learn to pace
  • low to moderate intensity aerobic exercise and strengthening
  • aquatic therapy
33
Q

Isoimmune disease

A
  • organ and tissue transplantation
  • prescreening for HLA match
  • immunosuppressants post transplant (selective immunosuppressants)
34
Q

cyclosporine and tacrolimus

A
  • FK, CYA< and rapa
  • affects specalized T cells turning into T help cells or T suppressor cells cytotoxic

Immunosupressant med

35
Q

Azathioprine and mycophenolate mofetil

A
  • act on bone marrow and thymus
  • affects B-cells, T-cells, lympohid tissue
36
Q

Prednisone

what does it affect

A
  • acts on monocytes and immature lymphocytes
  • affects macrophages, lympthocytes (bone marrow, thymus, B-cells, T-cells and lymphoid tissue)
37
Q
A