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Flashcards in Rheumatoid Arthritis Deck (29)
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1

Rheumatoid arthritis affects mostly who

females from mid 30's to mid 50s

2

Genetic predisposition in RA

Yeah

3

Rheumatoid arthritis has to be present for how long?

More than 6 weeks.....this is because Parvo virus looks just like RA but it resolves in about 6 weeks

4

Symmetrical or asymetrical synovitis

Symmetrical

5

What joints does RA typically spare

The spine and the DIP joints of the fingers and IP joints of the feet

6

Morning stiffness is present in RA but not in

Osteoarthritis

7

What is the most important gene to be aware of in RA pathogenesis

HLA-DR4....this codes for a class II MHC molecule

8

Very new genes involved in RA diagnosis

PTPN22 and PAD14

9

Heritability of RA is estimated to be at about 60%

ok

10

Genetic risk for RA is most strongly associated with shared epitope alleles of HLA-DRB1

KNOW THAT

11

Hving the HLA-DR4 mutation increases what

Your chances of getting RA by 4 as well as the severity of RA

12

Where does RA autoimmunity start>?

POtentially the gums? Apparently there is a link between peridontitis and the gums. I can't tell though because his lecture is dog shit.

13

Evidence of autoimmunity can be present many years before teh onset of RA

ok

14

What do autoantibodies in RA recognize?

Potentially joint antigens (type II collagen) or systemic antigens such as glucose phosphate isomerase

15

The synovium in RA is characterized how

intimal lining hyperplasia
- infiltration with CD4 T cells, macs, B cells

16

RA synovial effusions contain

Neutrophils and mononuclear cells
Prostaglanbdins and leukotrioenes

17

What T cell cytokines are present in the synovium of RA pts

interferon gamma and IL-17

18

Regulatory T cell function in RA is

Low

19

Reactive oxygen and nitrogen species exist in RA joints and may damage cells and increase inflammation

ok

20

Abnormalities of key regulatory genes such as the p53 tumor suppre3ssor may also enhance cell accumulation in the joints

ok

21

Several classes of proteases including metalloproteinases, serine ptroeases, cathepsins, aggrecanases are produced by intimal lining cells

ok

22

Systemic features of RA

fatigue, anorexia, weight loss, weakness, generalized aching, low grade fever

23

Systemic features of RA often appear as a ......... to disease onset and are worse with flare-ups

PRODROME. (appear before the disease onset)

24

What does a synovial fluid analysis show in an RA pt

color: yellow
WBC count: High
VIscosity: Low (very watery so its not a good lubricant)

25

Typical pattern of joint involvement in RA

Symmetrical
- starts in wrist and PIP/ MCP joints
- moves to knees, hips, ankles, elbows, shoulders
- spares the spine

26

CERVICAL SPINE INVOLVEMENT IN RA

Usually doesnt occur until after several years of disease progression. Carries teh risk of spinal ord compression.

27

RHeumatoid nodules occur in what % of pts

30

28

R nodules most often occur where

olecronon process or proximal ulna

29

Vasculitis is manifested by

inflammation of small blood vessesl