revision

Question 1

key features of RA

Answer 1

morning stiffness of joints- symmetrical polyrthritis of small joints of hand- subcutaenous nodules- rheumatoid factors- joint erosions at late stages

Question 2

what is rheumatoid factor

Answer 2

antibodies that recognise FC portion of IgG as antigen- they are usually IgM

Question 3

what makes synovial fluid viscous

Answer 3

hyaluronic acid

Question 4

what is reactive arthritis

Answer 4

STERILE inflammatory synovitis after infection

Question 5

extra-articular features of reactive arthritis

Answer 5

enthesopathy, skin and eye inflammation

Question 6

infections associated with reactive arthritis

Answer 6

HIV/hep C, but also urogenital/gut infections

Question 7

2 examples of enthesopathy

Answer 7

achiles tendonitis, dactylitis

Question 8

DIAGRAM what is OA

Answer 8

irreversible loss of articular cartilage- leads new bone formation, and greater density (sclerosis= whiter)

Question 9

define proteoglycan+ example

Answer 9

glycoproteins contain sulphates GAG’s eg aggrecan

Question 10

define GAG+ example

Answer 10

repeating polymer of disaccharides eg hyaluronic acid

Question 11

major collagen and proteoglycan in articular cartilage

Answer 11

type 11 collagen+ aggrecan

Question 12

major collagen in bone

Answer 12

type 1- the word bone has ‘one’ in it

Question 13

effect of articular cartilage loss in OA

Answer 13

leads to joint space narrowing

Question 14

HLA associated in AS reactive A, SLE, and RA

Answer 14

AS and react A= HLA B27- SLE= HLA DR3- RA= HLA DR4

Question 15

composition of bone

Answer 15

protein matrix (osteoid) and mineral (hydroxyapatite)

Question 16

define osteoporosis

Answer 16

loss of bone mass= increased risk of skeletal fractures

Question 17

bone chemistry in osteporosis

Answer 17

NORMAL ie calcium/phosphate etc

Question 18

define osteomalacia

Answer 18

defective minerilsation in MATURE bones ie not rickets= soft bone

Question 19

causes of osteomalacia

Answer 19

vit D deficiency/defective vit D metabolism eg CDK, or low phosphate

Question 20

biochemsistry of ostemalacia

Answer 20

low Ca2+, low phosphate (due to high PTH), and high PTH+ alkaline phosphatase ie secondary hyperparathyroidism

Question 21

define pagets

Answer 21

disorder of bone remodelling of unknwon cause- high bone resorption followed by high formation= disorganised pattern of woven and lamellar bone

Question 22

biochemistry in pagets

Answer 22

high alkaline phosphatase (coming from bone, not liver)

Question 23

xray in pagets

Answer 23

higher cortical bone thickness+ SLECROSIS