Arthritis

Question 0

Pathology and pathogenesis of OA

Answer 0

1. IL-1, TNF-1,PG,NO,Matrix Degradation Products
2. Synovial Inflammation => Dediffererentiation of Chondrocytes (Inc in 1 and 2 type of collagen,shorter proteoglycans,dec. proteinases,inc. proteinases) => Inc collagen breakdown => Carillage loss => Fibrillations => subchondral bone remodelling =>osteophytosis

Question 1

Gross Features of ARthritis

Answer 1

• End Stage bone disease

- Bone spurs,Exposed bone,Eroded cartillage and Meniscus

Question 2

Consequence of Shorter proteoglycans

Answer 2

Cartillage are less hydrophillic, stiffer, and more to cracking/fracturing

Question 3

Morphologic changes in OA

Answer 3

1 Shift to chondrocyte catabolic phenotype
2 mechanical stress as a relevant inducer of downstream inflammatory and catabolic events in cartillage
3 TLR2, TLR4 upregulation
4 Complement dysregulation

Question 4

Classification OA

Answer 4

Idiopathic (localized and Primary) and Secondary (Trauma 40%)

Question 5

Primary Non-modifiable Risk Factors for OA

Answer 5

Age
Race
Female Gender
GEnetic Factors (col 1 gene)

Question 6

Responsible for Low-grade inflammatory State of obesity

Answer 6

adipokines

Question 7

Secondary OA

Answer 7

ACl tear, repetitive stress, inflamamtory joint disease, Metabolic.endocrine disorders, congenital and dev defects, proprioceptive defects, Vitamin D and C deficiency

Question 8

clinical features of oa

Answer 8

no systemic mx, slow evolution, age,one or few joints,non-inflamatory

Question 9

Sx of OA (different from sign)

Answer 9

*Use related pain, relief with rest, gelling, loss of movement

Question 10

Signs of OA

Answer 10

Coarse crepitus, Bony swelling, Mild inflammation, deformities, Tenderness around joint

Question 11

First symptom of OA

Answer 11

first symptom is pain

Question 12

Pip Swellings

Answer 12

bouchard’s nodes

Question 13

DIP nodes

Answer 13

heberden’s nodes

Question 14

PAthology of RA

Answer 14

Microvascular endothelial cell activation /injury => Synovial hyperplasia > Synovial hypertrophy and edema => Tissue ischemia and infarction = Pannus => Erosion of subchondral bone

Question 15

PAthology: RAdiology of Knee OA
1 Focal loss of articular cartillage
2 Inc activity of Subchondral bone
3 Marginal lipping and outgrowths of bone
4 REmodeling oj joint surface and alterations in joint shape

Answer 15

1 joint space narrowing
2schondral bone sclerosis and cyts
3 osteophytosis
4 altered long contour

Question 16

Strengthening of this muscle decreases cx of OA

Answer 16

Quadriceps

Question 17

CLincal features of RA

Answer 17

1 Insidous onset
2 Chronic Course
3 MArked constitutional symptoms (feverm cachexia fatigue anotexia malaise
4 synovial inflammation 
5 Polyarticular arthritis
6 Systenic involvement

Question 18

Classification of HAnd OA includes HAnd pain, Aching, stiffness with….

Answer 18

HArd tissue enlargement of >2 of 10 selected joints
1 of 10 selected joints
*DIP 2-3, PIP 2-3, 1st CMC

Question 19

ACR/EULAR 2010 Classification’s Target population

Answer 19

patients with at least 1 DEFINITE clinical synovitis of NO OTHER CAUSES

Question 20

Components of ACR/EULAR 2010 Classification Criteria

Answer 20

Joint involvement, Duration of SX, SErology, ACute Reactants

Question 21

Systemic involvement of RA

Answer 21

Anemia, Hypoalbuminemia, ILD, FEity’s sybdrome, Myopathy, NErve entrapment, osteoporosis, High titer RF, Rheumatoid nodules, Rheumatoid vasculitis, SCleromalacia perforans

Question 22

ERoded sclera and choroid plexus seeps out

Answer 22

Scleromalacia perforans

Question 23

Felty’s syndrome

Answer 23

RA,splenomegaly, Neutropenia

Question 24

TX: Gold standard for RA

Answer 24

MEthotrexate