Rheumatoid Flashcards Preview

Pathophysiology II - MSK > Rheumatoid > Flashcards

Flashcards in Rheumatoid Deck (62)
Loading flashcards...
1

T/F: Acute Rheumatic diseases are often spontaneously initiated

False

They are typically onset from an outside force like infection, medications, or exposure

2

Are acute rheumatic diseases typically self-limiting?

Yes

3

Chronic rheumatic disease typically occurs as a result of what?

An autoimmune response

4

Once a disease establishes flares of chronic rheumatic disease, those flares become _________ (less frequent/more frequent)

What is this a result of?

More Frequent

Likely the result of immune system memory

5

How is the endothelium involved in the initiation of a rheumatic response?

What happens to neutrophils and monocytes during this time?

Regional Blood vessel endothelium is activation by pro-inflammatory cytokines

The endothelium expresses ligands (attachment sites) for inflamatory cell markers (integrins) which allow neutrophils and monocytes to preform diapedesis into the underlying tissues

6

Antibody-antigen complexes are _________ (activators/deactivators) of the complement cascade

Activators

7

When the complement cascade is activated......

It ________ (attracts/repels) additional imflammatory cells

It ________ (Increases/Decreases) cell permeability which ________ (Increases/Decreases) inflammation

Attracts

Increases
Increases

8

Helper T1 cells activate _________ which increase __________

Macrophages

Phagocytosis

9

Helper T2 cells activate ________ which increases what?

B-Cells

Increases Antibody Production

10

Helper T-17 cells activate __________ and ________ ________

Granulocytes

Autoimmune Mechanisms

11

T/F: In some tissues, cells that ordinarily are unrelated to the immune response can alter their form and function to become part of a chronic inflammatory response.

True

12

What condition involves crystal induced inflammation in synovial joints?

Gout

13

What crystals are typically responsible for gout?

Monosodium urate

14

What joints does gout primarily effect?

Great Toe
Midfoot
Ankle
Knee

15

What is the name for the collections of urate crystals that collect in joint spaces in gout?

Tophi

16

What are TWO common ways people develop gout and hyperuricemia?

Under Excretion (90%)
Over Production (10%)

17

Only about ___% of people with hyperuricemia will develop gout

10%

18

What increases your risk for developing gout?

Metabolic Syndrome
High-Purine Diet
Obesity
Renal Disease
Heart Disease

19

How does a patient develop a gout 'flare'?

1. Uric acid crystals precipitate in a joint

2. IL-1 and TNF activate the endothelium and inflammatory mediator come into the joint

3. Complement gets activated leading to more inflammation

4. Inflammation builds even more with phagocytosis, degranulation, free radical release/damage, and protein destruction with proteinases

20

What medications can reduce joint inflammation in gout flares?

NSAIDs
Steroids
Colchicine

21

What are THREE 'lifestyle' changes that can prevent future gout attacks?

Loss Weight
Decrease Protein in diet
Control Co-morbid conditions (HTN, BP, Met-S)

22

How does colchicine work in gout?

It is a microtubule poison, so WBC can not squeeze through the small endothelial spaces into joints and produce inflammation

23

Which rheumatic disease is characterized by joint inflammation, pain, and swelling, with a prevalence for joint destruction, a higher mortality, and an unknown trigger?

Women are more effected by this than men by a 3:1 ratio

Rheumatic Arthritis

24

What are the THREE most common joints effected by RA?

Wrist
MCP
MTP

25

A _________ is a membrane of granulation tissue made of mesenchyme and bone-marrow derived cells that forms in the joints during chronic RA.

This stimulates the release of what?

Pannus

This stimulates the release of cytokines (ex: IL-1, Prostagladins, Substance P) by macrophages leading to cartalige destruction and bone erosion

26

What is the most sensitive antibody test for RA?

Anti-CCP

27

Which antibody is present in about 50% of RA patients?

Rheumatoid Factor (RF)

28

Which gene is associated with Anti-CCP and RA?

What lifestyle habit is also associated with the above two things?

HLA-DRB1

Smoking

29

T/F: There is a foolproof blood test to diagnosis RA

False

There is not

30

What are extra-articular manifestations of RA?

Sicca Syndrome (Sjogren's)
Pericarditis
Pleuritis
Pulmonary Fibrosis
Ocular Inflammation
Neuropathies
Vasculitis