RHEUMATOLOGY REVIEW- short Flashcards Preview

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Flashcards in RHEUMATOLOGY REVIEW- short Deck (39)
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1
Q

Sports: in general, no increased risk; exercise may be _________ in OA

A

protective

2
Q

Cartilage in early Osteoarthritis MMPS

A

Increased metalloproteinases

3
Q

Osteoarthritis Factors

A
Interleukin-1
Nitric oxide
Prostaglandins
Complement activation
Adipokines
4
Q

Rheumatoid Arthritis (RA)– A systemic, inflammatory, autoimmune disorder of unknown etiology that results predominantly in a peripheral, ____________ which can result in cartilage and bone destruction

A

symmetric synovitis

5
Q

Rheumatoid Arthritis– Disease susceptibility and severity associated with shared epitope (QKRAA; in antigen binding groove) in subtypes of __________

A

HLA-DR4 and HLA-DR1;

6
Q

Rheumatoid Arthritis– RF-IgG immune complexes are _____________

A

pathogenic

7
Q

____________: modulation and amplification of local immune response through antigen recognition (query altered proteoglycans or collagen; citrullinated peptides)

A

CD4+ memory T cells- Rheumatoid Arthritis

8
Q

Gout– The result of tissue deposition of monosodium urate (MSU) crystals due to hyperuricemia (MSU ___________ of extracellular fluids)

A

supersaturation

9
Q

Hyperuricemia: over-production or under-excretion of uric acid; ______________ (90%)

A

underexcretors

10
Q

Uric acid is a product of ___________ metabolism:

A

purine

11
Q

Humans lack _________ which oxidizes uric acid into allantoin

A

uricase

12
Q

Overproduction of uric acid (X-linked):
PRPP synthetase ___________
HGPRT deficiency (complete: Lesch-Nyhan)

A

overactivity

13
Q

Crystal arthritis is diagnosed by arthrocentesis and crystal identification by polarized microscopy (MSU crystals: ______________)

A

needle-shaped, negatively birefringent

14
Q

_________ promotes phagocytosis by PMNs
IgG: not specific anti-crystal antibodies
Apolipoprotein B-coating inhibits phagocytosis

A

IgG-coating

15
Q

Overproduction of uric acid (X-linked):
PRPP synthetase overactivity
HGPRT __________ complete: Lesch-Nyhan)

A

deficiency

16
Q

Crystal arthritis is diagnosed by ___________ and crystal identification by polarized microscopy (MSU crystals: needle-shaped, negatively birefringent)

A

arthrocentesis

17
Q

IgG-coating promotes phagocytosis by PMNs
IgG: not specific anti-crystal antibodies
______________ inhibits phagocytosis

A

Apolipoprotein B-coating inhibits

18
Q

Seronegative Spondyloarthropathies- Axial arthritis: spine, SI joints (__________); morning (am) stiffness

A

sacroiliitis

19
Q

Seronegative Spondyloarthropathies

_______- ligamentous-, tendinous-, fibrous-osseous junctions

A

Enthesitis:

20
Q

Seronegative Spondyloarthropathies Synovium: increased expression of_________

A

TNFalpha

HLA-B27 genetic association; neg RF and ANA

21
Q

Chance of developing AS:
2% if HLA-B27 positive
20% if HLA-B27 positive with a ___________

A

first-degree relative with AS

22
Q

Asymmetric, oligoarticular, lower ext arthritis

A

Reactive Arthritis- Bacterial environmental triggers transported to the joints inside monocytes (Chlamydia can be latent):

23
Q

Systemic Lupus Erythematosus (SLE)- Fundamental defect is the _________________, resulting in an autoimmune process; T cell and B cell process

A

misdirected recognition of self as foreign

24
Q

Systemic Lupus Erythematosus (SLE)- Antibody responses toward autoantigens are antigen-driven and ___________

A

require CD4+ T cells

25
Q

Chance of developing AS:
2% if ____________
20% if HLA-B27 positive with a first-degree relative with AS

A

HLA-B27 positive

26
Q

Loss of T cell tolerance permitting autoreactive B cell stimulation: ? central or ________________ abnormality in self-reactive lymphocyte deletion or anergy

A

peripheral

27
Q

Systemic Lupus Erythematosus (SLE)- Association with HLA-DR3 and ___________ (greatest risk)

A

C4A null allele

28
Q

Systemic Lupus Erythematosus (SLE)- Fundamental defect is the misdirected recognition of self as foreign, resulting in an autoimmune process; _________________

A

T cell AND B cell process

29
Q

Loss of T cell tolerance permitting autoreactive B cell stimulation: ? central or peripheral abnormality in ____________ lymphocyte deletion or anergy

A

self-reactive

30
Q

SLE: > 95% patients have + ANAs
Not specific for SLE: can occur in other CTDs
Antibodies are directed to _____________

A

multiple nuclear antigens

Anti-dsDNA antibodies: renal disease
Anti-histone antibodies: SLE and drug-induced lupus
Antibodies to non-DNA, non-histone nuclear antigens:

31
Q

SLE- Anti-phospholipid antibodies: block prothrombin activation in the clotting cascade; associated with increased ___________;

A

clotting

32
Q

Vasculitis: Immune complexes: inflamm→ PAFs→ ↑vascular permeability→ IC deposition; ___________

A

palpable purpura

33
Q

Cytoplasmic ANCA (c-ANCA):

A

Proteinase-3 (PR3) in primary granules of PMNs

Associated with generalized GPA (Wegener’s)

34
Q

Perinuclear ANCA (p-ANCA):

A

Myeloperoxidase (MPO) in primary granules of PMNs

Associated with microscopic polyangiitis (MPA)

35
Q

ANCA Vasculitis

A

Antineutrophil Cytoplasmic Antibodies (ANCAs):

36
Q

Vasculitis: Immune complexes: inflamm→ PAFs→ ↑____________→ IC deposition; palpable purpura

A

vascular permeability

37
Q

Anti-synthetase Syndrome

A

PM or DM presenting with:
Interstitial lung disease (ILD): 60%

Anti-Jo-1 = anti-histadyl-tRNA synthetase
Not pathologic or myotoxic antibodies

38
Q

Endomysial distribution of inflammatory cells (CD8+ T cells) surrounding and invading muscle fibers

A

Polymyositis

39
Q

Perivascular (CD4+ T cells) and perifascicular inflammatory infiltrate

A

Dermatomyositis