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Flashcards in Joint Pathology Deck (39)
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1

What is bone congruence?

How well the bones fit each other, important for the distribution of pressure

2

What is the content of cartilage matrix?

Collagen, GAGs, hyaluronic acid

3

What is the function of GAG in the cartilage

attract water

4

Why isn't the synovial membrane classified as an epithelium

It doesn't have basement membrane or junctional complexes like desmosomes

5

What are the type A chondrocytes like?

Macrophage

6

What are the type B chondrocytes like?

Fibroblast

7

What is the function of type B chondrocyte?

produce ECM (hyaluronic acid production)

8

How can we tell between type A and type B chondrocytes on histology?

Type A cells are multi-nucleated giant cells

9

What are the treatments of osteoarthritis?

physiotherapy, pain relief and joint replacement

10

What are the main differences between RA and osteoarthritis?

RA tends to be diffused. It can affect skin, heart and lung

RA stiffness gets better through the day. OA gets worst with use

11

T/F RA usually starts in the major large joints of the body

False, they start in the small joints of hands and feet

12

T/F Gout is an acute form of osteoarthritis

True, inflammation is caused by crystalisation of uric acid

13

What are the treatments of gout?

anti-inflammatory medication, urate lowering therapy, lifestyle changes

14

What are the major enzymes and cytokines involved is OA?

collagenase, MMP
IL-1

15

What is the trigger of OA?

chondrocyte damage, leading to proliferation and enzyme/cytokine secretion

16

What are some bone changes that can occur with OA?

bone thickening, microfractures,

17

What is fibrillation of cartilage

erosion of cartilage

18

What is bone eburnation?

thickening, and bone appears white and shiny

19

T/F OA is a diffused degenerative disease in the joint

False, it is focal. You get non-uniform loss of cartilage, subchondral thickening and osteophytes

20

What are the signs of OA?

reduced RoM
Crepitus (grinding of joint)
Osteophytes

21

What are the symptoms of OA?

insidious onset, deep achey pain that is worse with activity

no systemic symptoms

22

What is the diagnosis of OA?

Mostly clinical

23

What is the underlying pathological process of RA?

T helper cells activation, especially Th1 and Th17

TNF-a is central to RA inflammatory process, activating B plasma cells

24

What kind of change do activated B cells do to the synovium?

they induce fibroblasts, macrophages and osteoclasts to make synovium hyperplastic, and deposit abnormal granulation tissue "pannus"

25

What is the role of activated macrophage in RA?

secrete collagenases and MMPs to break down cartilage and bone

26

What is the morphology of RA on histology?

villous hyperplasia
mononuclear infiltrate
germinal centres

27

What is the presentation of late stage RA?

union of bones due to extensive fibrosis and destruction of capsule and ligaments

28

What are the signs of RA?

warm, swollen joints
rheumatoid nodules
joint deformity in later stage

29

T/F there are systemic symptoms from RA

True, patients can have fever, loss of weight, anaemia

30

T/F RA is usually asymmetrical

False, the disease process is symmetrical