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SP18: Pharm MT2 > Arthritis > Flashcards

Arthritis Flashcards

1
Q

What is the most common type of joint disease?

A

Osteoarthritis

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2
Q

What is the etiology of osteoarthritis?

A

Biochemical breakdown of articular (hyaline) cartilage

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3
Q

What is the difference between articular cartilage and meniscus?

A

Articular cartilage lines the heads of bones - meniscus is a shock absorber

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4
Q

T/F: Catabolic activities of chondrocytes dominate in inflamed cartilage.

A

True

Leads to an unhealthy extracellular matrix

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5
Q

What inflammatory mediators are important in producing change in chondrocytes activity in inflamed cartilage?

A

IL-1B and TNFa

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6
Q

T/F: There will be an increased production of collagen in inflamed cartilage.

A

False

Decrease in collagen, increase in MMPs

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7
Q

T/F: Osteoarthritis is related to periodontal disease.

A

False

Rheumatoid arthritis

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8
Q

T/F: Rheumatoid arthritis is much more common in males.

A

False

Females

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9
Q

What is rheumatoid arthritis?

A

Immunologically mediated joint inflammation

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10
Q

The ___________ is the site of initial inflammatory process.

A

Synovium

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11
Q

What is the pannus?

A

Eventually synovitis leads to growth of inflammatory mass called the pannus

Commonly seen over cornea, joint surface, or on a prosthetic valve

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12
Q

T/F: Chondrocytes are involved in both production and breakdown of cartilage.

A

True

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13
Q

What are three of the main destructive things produced by osteoclasts and chondrocytes that lead to the breakdown of bone and cartilage?

A

MMPs, cathepsins, and ROS

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14
Q

What happens in RA after the pannus is formed?

A

Joint invaded by fibrous connective tissue and eventually the bones will fuse

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15
Q

T/F: RA is triggered by a T cell mediated response to an infection.

A

True

People with certain MHC alleles are predisposed

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16
Q

__________ are heavily implicated in autoimmune disorders.

A

T helper 17

Defined by production of IL-17

17
Q

Which antibody is an important diagnostic marker for RA?

A

Rheumatoid factor (RF)

18
Q

_______ is defined as an antibody against the Fc portion of IgG.

A

Rheumatoid factor

19
Q

Antibodies directed against _____________ are frequently discovered in patients with RA.

A

Citrullinated proteins

20
Q

When are the antibodies directed against cyclic citrullinated peptide presented?

A

Often years before the joints are affected

21
Q

What are the four possible drugs that can treat RA?

A
  1. NSAID
  2. DMARDS
  3. Glucocorticoids
  4. Opioids/capsaisin cream
22
Q

What are DMARDS (disease-modifying antirheumatic drugs)?

A

Categorized by their use to slow down progression of RA

NSAIDs and glucocorticoids do not actually slow down disease progression

23
Q

What is a standard first treatment for RA?

A

NSAID and methotrexate

NSAID: treats pain and inflammation

methotrexate: DMARD acts as immunosuppressant

24
Q

___________ is an enzyme inhibitor of dihydrofolate reductase, and works as a ____________ agent.

A

Methotrexate; chemotherapeutic

25
Q

What is the end goal of methotrexate?

A

Inhibit nucleic acid and amino acid synthesis via inhibiting DHFR

26
Q

Why are the doses of methotrexate so low for RA, and why do we give folate supplements to RA patients when methotrexate is inhibiting folate production?

A

Because it is likely that inhibition of DHFR is not the mechanism by which methotrexate treats RA

27
Q

What is the most likely reason methotrexate works for RA treatment?

A

Potentiation of adenosine signaling as an immune modulator

28
Q

T/F: High dose methotrexate treatment produces immune-suppressive and anti-inflammatory effects, making it good for RA treatment.

A

False

LOW DOSE

29
Q

What is cyclosporin?

A

Another DMARD that inhibits cytokine gene expression

30
Q

What is Azathioprine?

A

DMARD that inhibits DNA replication

31
Q

Which DMARD inhibits the JAK Kinase pathway?

A

Tofacitinib

32
Q

What is the next option for patients who do not respond to methotrexate?

A

Biologics that interfere with TNFa signaling

33
Q

IgG is a tetrameric quaternary structure that has a ___________ the recognizes antigens.

A

Fab region

34
Q

What is the effect of humira?

A

It mimics human IgG to inhibit TNFa and therefor inhibit inflammation

SP18: Pharm MT2 (7 decks)

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