Rheumatoid arthritis Flashcards
What is the pathogenesis for bony erosion in RA?
RANKL (in synovial fibroblasts and T-cells) binds RANK on osteoclasts
What is pathogenesis of RA?
- self-reactive CD4+ T-cells produced Th1 and Th17 cytokines—> cascade of inflammation
In RA, ___ and ____ form immune complexes inside joints–>activation of complement
- RF and anti-CCP antibodies
What causes the Majority of cutaneous findings in RA?
- neutrophil-mediated damage (as a result of complement activation)
Gene affected in RA?
- PTPN22
HLA assocation in RA:
HLA-DRB1
(patients with RA cant participate in the home run DRB1)
What is the diagnostic criteria for RA called?
- ACR/EULAR (see pg 116 for criteria)
rheumatoid nodules occur more commonly in RA patients with high _____ titers.
RF
How do rheumatoid nodules present clinically?
- firm, non-tender papules or nodules over bony prominences
![](https://s3.amazonaws.com/brainscape-prod/system/cm/392/599/880/a_image_thumb.png?1630253031)
What is rheumatoid nodulosis?
this is a variant of RA with:
- high RF
- multiple ulcerative rheumatoid nodules
-ABSENCE of active joint disease
Who gets therapy-induced rheumatoid nodulosis? How does it present?
- patients w/ preexisting RA following initiation of MTX or TNF-alpha inhibitor therapy
- Acute onset of numerous symmetrically grouped rheuymatoid nodules that are often PAINFUL (unlike normal rheumatoid nodules which are painless)
Rheumatoid vasculitis management:
- refer to rheum for aggressive therapy (high mortality up to 40%)
In what setting will you see Rheumatoid vasculitis?
- long standing history of erosive RA with high RF titer
What are Bywater’s lesions?
Purpuric papules usually on digital pulp seen in RA
![](https://s3.amazonaws.com/brainscape-prod/system/cm/392/599/888/a_image_thumb.png?1630253696)
If you see numerous atrophic, shiny, telangiectatic, yellow plaques w/ red-brown edges resembling NLD w/ ulceration on the lower extremities in RA patient, this is_____
superficial ulcerating necrobiosis (aka rheumatoid necrobiosis)
- occurs in severe RA w/ high RF titer