Quiz 2 Flashcards by Melanie Siscos

What is systemic Lupus Erythematosus

chronic inflammatory tissue disorder
involve multi systems
mostly young women
Body’s production of antibodies against the tissues

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Diagnosis of Lupus

Must have 4 of the following:
red malar rash, sensitive to sunlight, joint inflammation, kidney dysfunction, fluid around lungs, LOW WBC, RBC, positive ANA

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Symptoms/ clinical manifestations of lupus

unique to the individual

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Symptoms/ clinical manifestations of lupus

Drug induced

hydralazine and procainamide (heart and TB meds)

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Symptoms/ clinical manifestations of lupus

MSK

arthritis (doesn’t have to be symmetrical

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Symptoms/ clinical manifestations of lupus

CNS

headaches, irritable, depression, emotional instability, seizures, cranial neuropathy, CVA

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Symptoms/ clinical manifestations of lupus

Integumentary

Digital vasiculitis (brown splinter)
malar rash
cutaneous lesions
discoid lesions (raised red scaling plaques)
locatoin on face neck and chest

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Symptoms/ clinical manifestations of lupus

Renal

kidney failure

weight gain, edema, HTN

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Symptoms/ clinical manifestations of lupus

Systemic

fever, weight gain, malaise, fatigue

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PT management for LUPUS

regular exercise (prevent weakness)
avoid sunlight
manage stress
monitor for infection, necrosis, and renal involvement

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What is Scleroderma?

Widespread vasculopathy and fibrosis
deposit of collagen in intimate of blood vessels
women > men

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Signs and symptoms of Scleroderma

Systemic

Limited skin thickening
distal extremities
widespread rapid progression
overlap w/ LE polymyolitis and dermatomyolitis

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Signs and symptoms of Scleroderma

Localized

Single or multiple plaques
w/o skin fibrosis
single or multiple bands
involve skin and deeper tissue

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Signs and symptoms of Scleroderma

degenerative changes
vascular abnormalities of skin, articular surfaces
nondeforming symmetric arthritis 
interstitial fibrosis
esophageal dysfunction
hypertension and renal failure
cardiac and circulatory disorders, HTN

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What are the 3 stages of scleroderma

Edematous stage:
- bilateral nonpitting edema in fingers and hands

Sclerotic stage:
- skin taut, waxy, smooth, seems bound to underlying tissue

Atrophic stage:
- skin atrophy, contractures and ulcers at joints

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Sclerodactyly

constrict tendons because of overproduction of collagen

curled and swollen fingers

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Signs and symptoms of Scleroderma

CREST

Calcinosis
Raynauds phenomemnon (cyanosis, blanched)
Esophageal dysmobility
Sclerodactyly
Telangiectasia

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Management of Scleroderma

prevent damage and ulcers
wound care
avoid excessive bathing
Corticosteroids for myolitis
Strengthening, ROM, Aquatic therapy
Soft tissue will be pressure sensitive

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Exercise for patients with Scleroderma

manage based on aerobic capacity
strength and ROM manage based on functional limits
Encourage pt to take BP regularly (prone to HTN)

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What is fibromyalgia?

chronic muscle pain syndrome
NOT a disease
associated with hypothyroidism, RA, SLE, and chronic fatigue
mostly in women, not trained athletes

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Theoretic etiology of fibromyalgia?

diet, sleep, occupation, seasonal, environment, adverse experiences

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Disturbances that occur in fibromyalgia

hypothalamic pituitary adrenal axis (stress system)
ANS (hyperarousal and circulatory)
Reproductive hormone axis
immune system (increased cytokines)

Increased resting muscle tension

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Signs and symptoms of fibromyalgia

multiple tender points and muscle pain
disturbed sleep w/ morning fatigue and stiffness
Aggravation of SX by emotional stress
swelling and numbness
chronic headaches
cold intolerance (raynauds)
dysmenorrhea (painful menstration
Exercise intolerance
Weakness

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PT management of Fibromyalgia

local modalities
relaxation techniques, biofeedback, physiologic quieting, soft tissue
Aquatic PT
Gentle graded exercises (NO vigorous exercise)
monitor for overuse

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What is Type 1 hypersensitivity

IgE is produced NOT IgG genetic predisposition local response to initial encounter will become systemic

Symptoms / Manifestations of Type 1 Hypersensitivity

hay fever, extrinsic asthma, runny nose, allergic rhinitis Severe cases = anaphylactic shock

Causes of Type 1 hypersensitivity

pollen, mold, grass, peanuts, shelfish

What is type 2 hypersensitivity

cyotoxic reaction to self antigens | occur in cross reaction b/w exogenous pathogens and endogenous body tissue

Symptoms / Manifestations of Type 2 Hypersensitivity

Strep

Causes of type 2 hypersensitivity

``` viral infection strep blood transfusion reaction hemolytic disease of newborn autoimmune anemia myasthenia gravis ```

What is type 3 hypersensitivity

antigen- antibody complex | deposit tissues around small blood vessels

Symptoms / Manifestations of Type 3 Hypersensitivity

causes vasiculitis | affect multiple areas of the skin, joints, pleura, kidney, pericardium

Causes of type 3 hypersensitivity

Lupus

What is type 4 hypersensitivity

delayed hypersensitivity antigen produced by macrophages and presented to Tcells T4 cells respond and recruit lymphocytes

Symptoms / Manifestations of Type 4 Hypersensitivity

contract dermatitis | allergic reaction that take a while to show up

Causes of type 4 hypersensitivity

allergens such a poison ivy adhesives latex

What are potential contractures for a trans femoral amputee

hip flexors

What are potential contractures for transtibial amputee

knee flexors

appropriate interventions for transfemoral contracture prevention

position in extension stretching ROM definitive prosthesis

appropriate interventions for transtibial contracture prevention

position hip and knee in extension stretching ROM

Primary goal for prosthetic socks?

Optimal fit for limb to prevent pressure sores

When is an amputee cleared for a definitive prosthesis?

Prep prosthesis is 4-6mo cleared for definitive prosthesis when limb stops shrinking Size and shape remain constant

What is Rheumatoid Arthritis

chronic inflammatory autoimmune disease | occurs in the joints synovium

RA etiology

unknown | high correlation to genetics, smoking, environmental triggers and outside stressors

Signs and symptoms of RA

``` symmetric polyarthritis morning stiffness that takes longer than 30 min to subside pain with motion ulnar deviation of fingers Rheumatoid nodules Ankylosing spondylitis ```

Ankylosing spondylitis

inflammation of the axial skeleton and large peripheral joints

What is SACH

Solid ankle cushion heel | VERY important for prosthesis

Symes amputation

Amputation at the ankle | terrible for prosthesis

Advantages of an endoskeleton prosthesis

cosmesis weight component selection

GRF for a knee that is not stable should be directed anterior or posterior?

anterior (in front of the knee)

Advantages of otto bock C leg

climb and descend stairs and curbs with ease | internal computer with hydraulic controls

What is the most common place for a sore to develop on a AK amputee

lateral distal femur

Functional level 1 for amputee

homebound patient, very basic prosthesis

Functional level 2 for amputee

short community, any knee BESIDES hydraulics | non varying cadence

Functional level 3 for amputees

``` varying cadence (varying speed) hydraulic knee here ```

Functional level 4 for amputees

high end patients

Common stride length deficiency

patient will take long stride with the EFFECTED side, and short stride with non effected side

TKA alignment

find the trochanter and the ankle where does the knee fall in relation to them GRF dependent on this GRF ahead of the knee = more stable

Bench alignment

Foot selection Knee selection TKA alignment

Foot and knee alignment in stance phase

Both 5-7 degrees ER

What is a SAFE foot

Stationary Attachment Flexible Endoskeleton

Where is the most common place for a sore to develop on a transtibial amputee

Anterior distal tibia

Hypersensitivity

increased immune response to the presence of an antigen causing tissue destruction

Graves disease

antibodies against thyroid cell membrane, including thyroid stimulating hormone receptors

What are the constitutional symptoms of autoimmune disorders

Fatigue Malaise Myalgias Arthralgias

Addisons disease

hormone deficiency caused by damage to the outer layer of the adrenal gland

Crohns disease

chronic inflammation of the digestive tract

Giant cell arteritis

inflammation of the arteries | most commonly in the arteries of the head

Polymyositis

skin deposits with calcium build up

Gout

chronic arthritis of peripheral joints | results from hyperuricemic body fluid forming deposits in joints

Do you weight bare a patient with Gout?

NO | Urea crystals in the joints

Management of Gout

improves with weight loss and decreased consumption of alcohol rest / protect joints involved

Scleroderma is also known as...?

Systemic sclerosis

Quiz 2 Flashcards

(73 cards)