autoimmune dx Flashcards
(37 cards)
1
Q
rheumatoid arthritis (RA)
A
- chronic, systemic autoimmune dz
- inflammation of connective tissue in the synovial joints
- periods of remission and exacerbation
- can occur at any time, incidence increases with age
2
Q
causes of RA
A
- autoimmune
- *genetics
- smoking
3
Q
diagnosing RA
A
- H/P
- +rheumatoid factor
- ESR and CRP=active inflammation
- xray: for later disease
4
Q
RA classification criteria
A
- morning stiffness that lasts at least an hour
- polyarthritis
- arthritis in the wrist, or finger joints
- symmetrical arthritis
- positive rheumatoid factor
- radiological abnormalities of hands or wrist
5
Q
nonspecific s/s of RA
A
- fatigue
- anorexia
- wt loss
- generalized stiffness
6
Q
specific articular s/s of RA
A
- pain
- stiffness
- limited motion
- s/s inflammation
7
Q
extraarticular s/s of RA
A
- rheumatoid nodules
- Sjogren’s syndrome
- Felty syndrome
- pleural effusion, pericarditis, pericardial effusion, cardiomyopathy
- cataracts
- depression
8
Q
rheumatoid nodules
A
firm, non tender granuloma type masses locate over joints
9
Q
Sjogren’s syndrome
A
- diminished lacrimal and salivary gland secretion
- photosensitivity
10
Q
Felty syndrome
A
- splenomegaly
- leukopenia
11
Q
tx for Sjogren’s syndrome
A
- goal: to relieve symptoms
- dry eyes: artificial tears, eye lubricating ointments, or cyclosporine liquid
- dry mouth: H2O, chewing sugarless gum
12
Q
tx for RA
A
- rest
- joint protection
- heat/cold application
13
Q
systemic lupus erythematosus (SLE)
A
- multisystem inflammatory autoimmune dz
- chronic, unpredictable course
- periods of exacerbation and remission
14
Q
causes of SLE
A
- **unknown
- genetics
- hormones
- environment: sun exposure, infx
- drug reactions
15
Q
diagnosing SLE
A
- ANA, anti ENA
- complement system levels
- electrolytes
- renal function
- liver enzymes
- CBC
16
Q
diagnosing SLE
A
- SOAP BRAIN MD
- serositis
- oral ulcers
- arthritis
- photosensitivity
- blood dx
- renal dx
- antinuclear antibody test positive
- immunological dx
- neurological dx
- malar rash
- discoid rash
17
Q
general s/s of SLE
A
- fever
- malaise
- joint pains
- myalgias
- fatigue
- temp loss of cognitive abilities
18
Q
dermatological s/s of SLE
A
- cutaneous vascular lesions
- butterfly rash over cheeks
- oral/nasopharyngeal lesions
- alopecia
19
Q
musculoskeletal s/s of SLE
A
- arthritis
- polyarthralgia with morning stiffness
- swelling
- increased risk for bone loss and fx
20
Q
cardiopulmonary s/s of SLE
A
- increased RR
- cough
- dysrhythmias
- HTN
- increased cholesterol
- increased risk for clots
21
Q
renal s/s of SLE
A
- lupus nephritis
- proteinuria
- ESRD
22
Q
nervous system s/s of SLE
A
- sz
- peripheral neuropathy
- cognitive dysfunction
- depression
- psychosis
- HA
23
Q
hematological s/s of SLE
A
- anemia
- mild leukopenia
- thrombocytopenia
- excessive bleeding
- clot formation
24
Q
infection in SLE
A
- increased susceptibility to infx
- major cause of death
- avoid live virus vaccines
25
tx of SLE
- NSAIDs, antimalarials
- disease modifying anti rheumatic drugs
- immunosuppresants
- analgesics
- lifestyle changes
- renal transplant
26
good prognosis for SLE
- early dx
- prompt recognition of organ involvement
- good therapeutic regimens
27
fibromyalgia
- widespread, non articular musculoskeletal pain and fatigue
| - multiple tender points
28
etiology of fibromyalgia
- genetics
- stress
- central dopamine dysfunction
- abnormal serotonin metabolism
- deficient human growth hormone
29
tender points
* palpation elicits pain
- not all at a time
- can change points throughout the day
30
s/s of fibromyalgia
- burning, widespread pain
- fatigue
- tingling of the skin
- prolonged muscle spasms
- weak limbs
- nerve pain
- TMJ pain
31
gout
- type of recurring acute arthritis
| - accumulation of uric acid crystals in one or more joints
32
causes of gout
- increase in urban acid production
- underexcretion of uric acid
- high purine diet will trigger
33
high purine foods
- shellfish
- lentils
- asparagus
- spinach
- meats
34
diagnosing gout
- serum uric acid level above 6mg/dL
- 24 hour urine: decreased renal excretion vs overproduction
- synovial fluid aspiration
35
s/s of acute phase gout
- arthritis in one or more joints
- joints are dusky or cyanotic
- tenderness
- podagra (inflamed great toe)
36
s/s of chronic phase gout
- multiple joint involvement
- tophi
- kidney/urinary tract stones
37
collaborative care of gout
- terminate acute attack: colchicine
- prevent future attacks
- diet and weight reduction: avoid etoh and purine
- meds
