Gen Path Exam 3 - Autoimmune Disease - RA Flashcards
Chronic systemic autoimmune inflammatory disease of unknown cause, chiefly affecting synovial membranes of multiple joints
Rheumatoid arthritis
This disease has a wide clinical spectrum with considerable variability in joint and extra-articular manifestations
RA
T/F: The etiology of RA involves a complex, and still poorly understood, interactions of genetic risk factors, environment, and the immune system
True
T/F: RA is 3-5x more common in men than in women
FALSE, it is 3-5x more common in women than in men
When is the usual age at onset of RA?
20-40
Approximately 50% of the risk of developing RA is related to which genetic factors?
HLA-DRB1 locus
Polymorphism in PTPN22 gene
Which gene encodes a tyrosine phosphatase that is postulated to inhibit T cell activation?
PTPN22 gene
Usually gradual onset; common prodromal symptoms of weakness, fatigue, and anorexia
RA
What is the initial presentation of RA?
Symmetric joint involvement in hands and feet
Joint effusions, tenderness, and restricted motion are usually present early in the disease
RA
What are the 3 eventual characteristic deformities in RA?
Subluxations
Dislocations
Joint contractures
What do the following describe?
-Tendon sheaths and bursae frequently affected by chronic inflammation
-Possible tendon rupture
-Rheumatoid nodules over bony prominences such as the elbow and shaft of the ulna
-Splenomegaly, pericarditis, and vasculitis
-Carpal tunnel syndrome resulting from flexor tenosynovitis
Extra-articular findings in RA
The pathologic findings in the joint include chronic ________ with ________ formation
synovitis; pannus
What does the pannus erode?
Cartilage
Bone
Ligaments
Tendons
Acute, late, or chronic phase?
Effusion and other manifestations of inflammation are common
Acute
Acute, late, or chronic phase?
Organization may result in fibrous ankylosis; true bony ankylosis is rare
Late
Acute, late, or chronic phase?
Inflammation of soft tissues around the joints may be prominent and is a significant factor in joint damage
Acute and chronic
What microscopic finding is most characteristic of RA?
Subcutaneous (rheumatoid) nodule
Granuloma with a central zone of fibrinoid necrosis surrounding a palisade of radially arranged elongated CT cells, and a margin of
chronic granulation tissue
Subcutaneous (rheumatoid) nodule
Pathologic alterations indistinguishable from those of the ______________ ___________ are occasionally seen in the myocardium, pericardium, endocardium, heart valves, visceral pleura, lungs, sclera, dura mater, spleen, larynx, and other tissues
subcutaneous nodule
In the era of more effective treatment, secondary
____________ is now very rare
amyloidosis
RA has features of which type of hypersensitivity reaction directed against articular cartilage, bone, and other joint tissues?
Type IV hypersensitivity rxn
What does the synovium of RA-affected joints contain?
Germinal centers w/ secondary follicles + plasma cells
What do plasma cells produce in the synovium of RA-affected joints?
Autoantibodies
