Connective Tissue Diseases (4) Flashcards
Types of Arthritis (deign, seropos, seroneg, crystal, vasculides)
Degen- OA
Seropos- RA, SLE, shortens
Seroneg- PA, AS, reactive
crystal- gout/pseudo gout`
General tests for inflammation
ESR
CRP (increases faster, better for monitoring)
RA tests
-IgM (IgG)- antibodies against the Fc frag of IgG
RF- not very specific (don’t use for screening)
Anti phospholipid antibodies (causes what and what is it pos in)
causes thrombosis, excessive coagulation
pos in 20-40% of SLE
What is anti neutrophil cytoplasmic antibodies (ANCA) seen in
seen in vasculitis
What are cryoglobulins and what are they seen in
immunoglobulins which forms precipitates or gels in the cold tat become soluble when warmed (reynauds phenom)
Seen in RA, SLE, polyarteritis nodosa
HLAs associated w
- RA
- AS
- reactive, RA, graves, celiac, goodpastures
- HLA DR4
- HLA B27
- HLA B27
What is the classical and alternate pathway of complement
classical- activated by antigen antibody complex
alternate- activated by microbes
steps when complement is activated
c3 converted to c3a and c3b
c5 converted to c5a and c5b
c3a and c5a stim neutrophils and mast cells to increase phase activity
c3b coat pathogens (opsonization follows)
c5b for membrane attack complex with c6-9
RA features + what may be pos b4 symptoms
systemic
bimodal (15-35, 55-65)
women>men
Anticitrullinated pro antibody may be positive 9 years before symptoms
SLE features, pop
young women
fever, rash, artritis
Antibodies in RA, SLE, Scleroderma, dermatomyotisis, MCD
RA- RF SLE- Anti-sm, anti-DNA, C3, C4, CH50 Scleroderma- Anti-Scl-70, anti centromere Dermatomyositis- CK increased anti jo-1 MCD- Anti RNP
tx of RA
treat with high dose methotrexate
AS age, gender, lab tests
men 15-40
m>w
HLA B27
Tests for Gout and pseudogout
gout- Urate, Kidney function tests, synovial fluid tests
psuedogout- synovial fluid microscopy
Key cause of gout
high concentration of urate may lead to kidney stones and/or deposition of uric acid crystals in synovial fluid of jts.
definitive test–> need to sample the fluid in swollen jt
needle shaped crystals
Polymyalgia rheumatica- age, gender, associated disease, lab tests
over 70 w
can lead to temporal arteritis
lab tests- none, dx by response to prednisone
What is infectious arthritis seen in
hep b/c rheumatic fever lyme disease septic arthritis STDs Rubella
rheumatic fever- s/s and cause
jts painful at first and heart perm damaged
group A haemolytic streptococci
Neisseria gonorrhoea arthritis and s/s
mono or polyarticular arthritis
tenosynovitis or wrist or dorsum of hand
conjunctivitis
lab- cucture organism in the jt
Reuters syndrome s/s
asymmetrical oligo arthritis
sacroilitis
extra articular inflammations
lab tests- culture, HLA B27
