Sjogren's_Polymyalgia Rheumatica Flashcards
(27 cards)
Common symptoms seen with Sjogren’s
- dry eyes with damage to eye surface
- dry mouth with increased tooth decay
Sjogren’s - general information
- women 30’s and 50’s
- systemic autoimmune disease
- characteristic ocular and salivary
- lung (pneumonitis)
- kidney (interstitial nephritis)
- neurological (central and peripheral)
Sjogren’s - causes
- Genetic
- Environment
Genetic factors associated with Sjogren’s
HLA-DR
Environment factors associated with Sjogren’s
- no single agent identified
- virus
What is xerostomia?
dry mouth
Sjogren’s - eye and oral features
- positive ANA
- specific needs for eye and mouth care
Sjogren’s pts need moisture because they are typically very
dry and thirsty
Additional symptoms associated with Sjogren’s
- submandibular salivary gland enlargement
- parotid gland enlargement
- salivary gland infection
- vasculitis
- fatigue
- cognitive loss
Why are salivary gland infections common in pts with Sjogren’s?
lack of production of saliva (dry mouth)
Extraglandular manifestations of Sjogren’s
- Lung: interstitial pneumonitis
- Renal: interstitial nephritis
- Cardiac: pulmonary HTN
- Hematologic: lymphoma
- Joint pain: arthritis
- Neurologic: peripheral neuropathy
Symptoms associated with interstitial pneumonitis
- congestion
- interstitial infiltrate
- intra-alveolar edema
Arthritis associated with Sjogren’s is (symmetrical, asymmetrical)
asymmetrical
Grades of peripheral neuropathy
- 1-4, with 4 being the worst
Medications for Sjogren’s
- Anti-inflammatory
- Corticosteroids
- Antimalarials
- DMARDs
PT implications of Sjogren’s
- Activity modification secondary to fatigue
- Moderate exercise
In pts with Sjogren’s, moderate exercise aids
- Aerobic capacity
- Fatigue
- Physical function
- Depression
PMR stands for
Polymyalgia Rheumatica
What is PMR?
- Autoimmune inflammatory disease
- Genetic predisposition
- Usually after the age of 50 yo
- Women > men
PMR - epidemiology
- Incidence > with age
- Peak at 70 to 80 years
- 3:1 female to male ratio
Clinical features of PMR
- > 2 weeks of bilateral shoulder and/or pelvic aching
- Morning stiffness of 45 minutes
- Elevated ESR and CRP
PMR - musculoskeletal symptoms
- Stiffness
- Pain
- No myositis
- Proximal joint inflammation
- Peripheral joints can also be inflamed
- Rheumatoid factor (-)
Stiffness characteristics of PMR
- usually predominates
- worse after rest and in the morning
Pain characteristics of PMR
- usually diffuse and often worse at night
- muscle strength is normal
