Connective Tissue Disease

Question 1

what are the two groups of connective tissue diseases

Answer 1

autoimmune diseases or vascular diseases

Question 2

what are diseases included in the autoimmune disease category

Answer 2

systemic lupus erythematosis
systemic sclerosis
sjogrens syndrome
undifferentiated connective tissue disease

Question 3

do the blood antibodies associated with the disease cause the diseases

Answer 3

no they are found in healthy people - the diseases will occur in people who have specific auto-antibodies

Question 4

what are vasculitic diseases

Answer 4

where the problems are in the blood vessel walls

Question 5

what is the large vessel vasculitic disease

Answer 5

giant cell (temporal) arteritis - affects large arteries
polymyalgia rheumatica

Question 6

what are the medium vessel vasculitic diseases

Answer 6

polyarteritis nodosa
kawasaki disease

Question 7

what is the small vessel vasculitic disease

Answer 7

wegener’s granulomatosis

Question 8

what is the general management of vasculitic connective tissue disease

Answer 8

analgesia for pain
immune modulating treatment
systemic steroids

Question 9

what are examples of immune modulating treatment

Answer 9

hydroxychloroquine
methotrexate
azathiopine
mycophenolate

Question 10

what are the four antibodies commonly found in the connective tissue diseases

Answer 10

anti-nuclear antibody
anti-double strand DNA
anti-Ro antibody
anti-La antibody

Question 11

what are the two antibodies commonly found in scleroderma

Answer 11

anti-centromere and anti scl-70

Question 12

what are the two forms of systemic lupus erythematosis

Answer 12

discoid lupus and systemic

Question 13

what is discoid lupus

Answer 13

tissue changes without blood autoantibodies - seen in skin and mouth and looks like lichen planus

Question 14

what is systemic lupus

Answer 14

where multi-systems are involved (joints/ CVS/ CNS? renal/ muscles)

Question 15

what is the major sign of systemic lupus

Answer 15

a butterfly rash across the face due to photosensitivity

Question 16

systemic lupus can cause chronic anaemia, what are the dental implications of this

Answer 16

oral ulceration and GA risk

Question 17

why might a dentist want to check the platelet count of a patient with lupus

Answer 17

could result in thrombocytopenia and have a bleeding tendency

Question 18

what two aspects of prescribing drugs do dentists need to take care with a patient with lupus

Answer 18

drug metabolism due to renal disease
drug reactions producing photosensitivity rash

Question 19

what should you not confuse with lupus reactions in the mucosa

Answer 19

lichen planus

Question 20

what is antiphospholipid anticoagulant lupus

Answer 20

type of lupus that have an antibody called anticoagulant - but only when in a test tube - not when in patients body

Question 21

what might antiphsopholipid antibody syndrome be associated with

Answer 21

lupus
sjogrens syndrome

Question 22

how would you describe the clotting capabilities of a patient with antiphospholipid antibody syndrome

Answer 22

hyper coagulable - thrombophillic

Question 23

due to antiphospholipid antibody syndrome patients being thrombophilic, what might they be at higher risk of developing

Answer 23

DVT or pulmonary embolism

Question 24

what is the treatment for antiphospholipid antibody syndrome

Answer 24

warfarin

Question 25

what is sjogrens syndrome

Answer 25

inflammatory disease associated with circulating autoantibodies ANA, Ro and La

Question 26

symptoms of sjogrens syndromes

Answer 26

dry eyes and dry mouth

Question 27

what are the three aspects of sjogrens syndrome

Answer 27

sicca syndrome primary sjogrens secondary sjogrens

Question 28

what is sicca sjoagrens

Answer 28

dry eyes or dry mouth only

Question 29

what is primary sjogrens

Answer 29

not associated with any other connective tissue disease

Question 30

what is secondary sjogrens

Answer 30

associated with one of the other connective tissue disease (RA or lupus)

Question 31

how is sjogrens diagnosed

Answer 31

antibody findings imaging findings histopathology findings

Question 32

name some dental implications of sjogrens syndrome

Answer 32

oral infection caries risk function loss denture retention sialosis salivary lymphoma

Question 33

what is systemic sclerosis

Answer 33

elastic tissue replaced with connective fibrous tissue - patient loses ability to stretch (skin affected)

Question 34

what are the two types of systemic sclerosis

Answer 34

local or generalised

Question 35

what antibodies are associated with local systemic sclerosis

Answer 35

anticentromere

Question 36

what antibodies are associated with generalised systemic sclerosis

Answer 36

anti scl-70 antibodies

Question 37

what are systemic sclerosis fingers

Answer 37

there is no elasticity in the skin to allow the fingers to stretch at the joints

Question 38

what other medical problems can systemic sclerosis be associated with

Answer 38

raynoud's renal failure malabsorption

Question 39

what are some dental aspects of systemic sclerosis

Answer 39

no elasticity in the cheeks - patient cannot open up wide dysphagia and reflux oesophagitis

Question 40

what occurs in vasculitic diseases

Answer 40

inflammation in the blood vessel that can lead to ischaemia

Question 41

what is giant cell arteritis

Answer 41

affects external carotid artery (near the face) can lead to occlusion of central retinal artery and cause blindness

Question 42

when can giant cell arteritis be recognised

Answer 42

when the erythrocyte sedimentation rate is raised

Question 43

what is polymyalgia rheumatic

Answer 43

pain and morning stiffness of muscles - particularly shoulders

Question 44

what disease responds well to steroids and will settle quickly

Answer 44

polymyalgia rheumatic

Question 45

what is kawasaki disease

Answer 45

affects medium blood vessels

Question 46

what are the three common presentations of kawasaki disease

Answer 46

strawberry tongue and erythema of the hands and feet

Question 47

what is wegener's granulomatosis

Answer 47

inflammatory condition affects small blood vessels can lead to destruction of hard and soft tissues

Question 48

what is fibromyalgia

Answer 48

symptoms without evidence of active disease joint and muscle pain functional disorders where it may be the pain transmitters that aren't working