48 Differential Diagnosis for PT: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary
Scleroderma Progressive Systemic Sclerosis (PSS): Condition where connective tissue produces too much collagen and causes induration, affecting joints, muscles and connective tissue. The pathogenesis of PSS is unknown and typically seen in 30- to 50-year- olds. PSS can be localize, limited or diffused. • Signs and symptoms ○ Joint pain: Typically first symptom ○ Raynaud’s Polymyositis/Dermatomyositis: Illnesses that result in damage to connective tissue, skin, and muscles, causing weakness • Cause is unknown, though environmental factors (viral infections) may play a role, as may genetic factors • Seen most commonly in 5- to 14-year-olds and 45- to 64-year-olds • Signs and symptoms: skin rash cardinal symptom that precedes weakness (proximal), weight loss, fever/malaise, periods of flares or relapses Ankylosing Spondylitis (AS): “Marie- Strumpell” disease: Inflammation of fibrous tissue affecting the insertions of ligaments and capsules into bone (sacroiliac joints, spine, etc.) • Unknown etiology, possibly a genetic link, typically affecting men under 40 years old • Chronic, progressive, systemic • Insidious onset of low back pain/stiffness for more than three months • Prone to fractures • Prognosis: Varies widely • Diagnosis: Antibody tests
Four stages 1. Synovitis: Inflamed joints; tissue thickens with edema and congestion 2. Pannus formation: Layer of inflammatory granulation forms inside joint ○ Damage to joint and joint capsule ensues 3. Fibrous ankylosis: Subluxation and scar formation prevents joint motion 4. Bony ankylosis: Firm, bony union occurs as fibrous tissue calcifies and changes into osseous tissue Tests • Antibody called rheumatoid factor (RF): Some people with RF never get this disease, and others with the disease never have RF • Some RA patients and lupus patients share a variation in the STAT4 gene Sjogren’s Syndrome: Chronic inflammatory disorder where the body destroys the exocrine glands, especially the salivary and lacrimal glands
LEARNING TIP! Sjogren’s Syndrome signs and symptoms: • Extremely dry eyes/mouth • Enlarged parotid glands • Fatigue • Aches/pains in muscles and joints
Lupus: Chronic systemic inflammatory disease characterized by injury to skin, joints, kidneys, heart, and blood-forming organs as well as nervous system and mucous membranes • Three forms 1. Discoid: Confined to skin 2. Systemic: More severe; can affect any organ; genetic 3. Drug induced: Occurs after use of certain prescription drugs, particularly HTN and cardiac drugs ■ Symptoms usually subside when meds are discontinued • Signs and symptoms: joint pain, butterfly rash, fever, weight loss, fatigue, progression of symptoms: Mild → severe
LEARNING TIP! Ankylosing Spondylitis signs and symptoms: • Fatigue • Anorexia • Fever • Loss of lumbar lordosis • Low back pain
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