Galen 265 Exam 4 part 1
1. Discoid Lupus: Affects skin, isn't lethal
2. Discoid lupus presents with ...: Macular Rash or Discoid Rash
3. Discoid rash: red raised patches with scaling skin
4. Malar Rash: Red flat or raised over cheeks (butterfly rash)
5. Discoid Lupus Diagnostics: Skin Biopsy
6. SLE: Chronic, progressive, Inflammation of connective tissue, and affects multiple
body systems
7. SLE in kidneys: Leading cause of death, presents with high creatinine, low
hematocrit, proteinuria
8. SLE is most common in ...: women 20yr- 40yr
9. SLE manifestations: Rash, Photosensitivity, oral ulcers, polyarthritis, pericarditis,
plural effusion, FEVER, fatigue, weakness, anorexia,weight loss, proteinuria,
seizures,peripheral neuropathy, psychosis, Raynauds, alopecia
10. SLE diagnostics: ANA test, C Reactive Protein test( is normal w/ SLE flare up), CBC(
shows pancytopenia)
11. SLE meds: Topical steroids, NSAIDs (caution with kidneys), Hydroxychloroquine,
Glucocorticiods,
Immunosuppressants: Methotrexate, Azathioprine, Belimumab
12. Glucocorticiods: Give before breakfast, take C+ supp, monitor skin integrity.
13. Hydroxychloroquine: Frequent eye exams.
eye exam before starting med and q 6 months
14. Belimumab: DO NOT receive live vaccines for 30 days before tx
15. SLE teaching: MONITOR TEMP!!( first sign of worsening), limit sun exposure, wide
brim hat, long sleeves, sunscreen SPF 30+ , clean w/ mild soap, pat dry, mosturize,
avoid alot of powder cosmetics, avoid large crowds, pregnancy can cause exacerbation.
No harsh hair tx.
16. scleroderma: uncommon, chronic, autoimmune inflammatory disease.
17. Scleroderma causes...: fibrosis in tissue and then hardening of tissue.
18. Diffuse cutaneous scleroderma: = major organ problems
19. Limited cutaneous scleroderma: = esophagus problems
, 20. Diffuse cutaneous scleroderma manifestations: 1st sx= edema in hands an w/ or
w/o bilateral carpel tunnel
thickened skin on trunk, face, proximal and distal extremities. GERD, Dysphagia,
Myocardial fibrosis, malignant hypertension, lung fibrosis and PAH. Complications are
rapid
21. Limited cutaneous scleroderma manifestations: Calcinosis, Raynauds, Esophageal
dysmotility, Sclerodactyly, Telangienctasia
Skin thickens on distal extremities and neck and face
22 Scleroderma Meds: CCBs for Raynuads
Steroids and Immunosupressants for inflammation
ACE in hibitors for high BP
Bosentan for tx of Pulmonary Artery Hypertension (monitor for lever toxicity)
23. Scleroderma: Management: HOB 60 degreees during meals and at least 1 hr after
Maintain skin integrity ( especially when on steroids or vasospam drugs)
Small frequent meals w/ semisoft foods. thicken liquids
Avoid pepper, cafine, spices( because of increase gastric secretions)
Promote bowel elimination because pt can have both diarrhea and constipation
24. scleroderma teaching: wear gloves and socks in cold, no ETOH, no smoking, no
cafine, eliminate high stress, disease gets worse
25. Fibromyalgia: chronic pain syndrome, NOT an autoimmune inflammatory disease
26. Fibromyalgia pain can be described as: a tender stiffness, a burning and nawing
pain that comes and goes
27. fibromyalgia worsens w/...: increased stress, activity, and weather conditions
28. fifbromyagia is most common in...: women 30-50 ( commin in 40 yrs)
29. Fibromyalgia manifestations: morning stiffness Fatigue( most common sign) non
refreshing sleep no stage 4 sleep chronic pain Depression
pt may have IBS, Tension H/A, PMS, numbness and tingling, Raynauds
30. Fibromyalgia Meds: tryptophan= for sleep
Amitriptyline, Nortriptyline(TCA's)= antidepressants
Benzodiazapines= anxiety
NSAIDs= for pain ( may need somethig stronger)
1. Discoid Lupus: Affects skin, isn't lethal
2. Discoid lupus presents with ...: Macular Rash or Discoid Rash
3. Discoid rash: red raised patches with scaling skin
4. Malar Rash: Red flat or raised over cheeks (butterfly rash)
5. Discoid Lupus Diagnostics: Skin Biopsy
6. SLE: Chronic, progressive, Inflammation of connective tissue, and affects multiple
body systems
7. SLE in kidneys: Leading cause of death, presents with high creatinine, low
hematocrit, proteinuria
8. SLE is most common in ...: women 20yr- 40yr
9. SLE manifestations: Rash, Photosensitivity, oral ulcers, polyarthritis, pericarditis,
plural effusion, FEVER, fatigue, weakness, anorexia,weight loss, proteinuria,
seizures,peripheral neuropathy, psychosis, Raynauds, alopecia
10. SLE diagnostics: ANA test, C Reactive Protein test( is normal w/ SLE flare up), CBC(
shows pancytopenia)
11. SLE meds: Topical steroids, NSAIDs (caution with kidneys), Hydroxychloroquine,
Glucocorticiods,
Immunosuppressants: Methotrexate, Azathioprine, Belimumab
12. Glucocorticiods: Give before breakfast, take C+ supp, monitor skin integrity.
13. Hydroxychloroquine: Frequent eye exams.
eye exam before starting med and q 6 months
14. Belimumab: DO NOT receive live vaccines for 30 days before tx
15. SLE teaching: MONITOR TEMP!!( first sign of worsening), limit sun exposure, wide
brim hat, long sleeves, sunscreen SPF 30+ , clean w/ mild soap, pat dry, mosturize,
avoid alot of powder cosmetics, avoid large crowds, pregnancy can cause exacerbation.
No harsh hair tx.
16. scleroderma: uncommon, chronic, autoimmune inflammatory disease.
17. Scleroderma causes...: fibrosis in tissue and then hardening of tissue.
18. Diffuse cutaneous scleroderma: = major organ problems
19. Limited cutaneous scleroderma: = esophagus problems
, 20. Diffuse cutaneous scleroderma manifestations: 1st sx= edema in hands an w/ or
w/o bilateral carpel tunnel
thickened skin on trunk, face, proximal and distal extremities. GERD, Dysphagia,
Myocardial fibrosis, malignant hypertension, lung fibrosis and PAH. Complications are
rapid
21. Limited cutaneous scleroderma manifestations: Calcinosis, Raynauds, Esophageal
dysmotility, Sclerodactyly, Telangienctasia
Skin thickens on distal extremities and neck and face
22 Scleroderma Meds: CCBs for Raynuads
Steroids and Immunosupressants for inflammation
ACE in hibitors for high BP
Bosentan for tx of Pulmonary Artery Hypertension (monitor for lever toxicity)
23. Scleroderma: Management: HOB 60 degreees during meals and at least 1 hr after
Maintain skin integrity ( especially when on steroids or vasospam drugs)
Small frequent meals w/ semisoft foods. thicken liquids
Avoid pepper, cafine, spices( because of increase gastric secretions)
Promote bowel elimination because pt can have both diarrhea and constipation
24. scleroderma teaching: wear gloves and socks in cold, no ETOH, no smoking, no
cafine, eliminate high stress, disease gets worse
25. Fibromyalgia: chronic pain syndrome, NOT an autoimmune inflammatory disease
26. Fibromyalgia pain can be described as: a tender stiffness, a burning and nawing
pain that comes and goes
27. fibromyalgia worsens w/...: increased stress, activity, and weather conditions
28. fifbromyagia is most common in...: women 30-50 ( commin in 40 yrs)
29. Fibromyalgia manifestations: morning stiffness Fatigue( most common sign) non
refreshing sleep no stage 4 sleep chronic pain Depression
pt may have IBS, Tension H/A, PMS, numbness and tingling, Raynauds
30. Fibromyalgia Meds: tryptophan= for sleep
Amitriptyline, Nortriptyline(TCA's)= antidepressants
Benzodiazapines= anxiety
NSAIDs= for pain ( may need somethig stronger)
