Intro to Rheum Flashcards
Mechanisms of self tolerance? (3)
Clonal deletion
Clonal anergy
Peripheral Suppression by T-cells
Induction of Anti-Self Responses? (3)
Loss of Suppression
Modification by external agent
Alteration of self-antigen
Gene most frequently implicated in autoimmunity problems?
PTPN-22, results in excessive lymphocyte activation via defective protein tyrosin phosphatase
What causes Chron’s disease?
NOD-2 cytoplasmic sensor of microbes in epithelial cells
RA associated with what genetic markers?
HLA DR4 and DR1
Cell mediated immunity to what can cause RA?
Type 2 collagen
Key features of RA?
Pannus
Joint Space loss
Juxta-Articular bone erosion
What is Rheumatoid factor?
Antibodies to autologous IgG immunoglobulin
RF critical cause of RA?
No
What is Felty’s syndrome?
Rheumatoid arthritis
Splenomegaly
Neutropenia
In RA what joints are most often affected?
Symmetrical Disease
Lumbosacral spine, hips usually spared
In what tissue layer are rheumatoid nodules found?
Subcutaneous tissues
How do you measure Rheumatoid factor?
Measured by agglutination of latex particles coated with IgG
What differentiates Juvenile RA from regular RA? (3)
Oligoarthritis more common
Systemic onset more frequent
RF, nodules usually absent
What is Ankylosing Spondylitis?
Chronic inflammatory joint disease involving axial joints especially sacroiliac joints. Marie-Stumpell disease
What genetic component is Ankylosing spondylitis associated with?
HLA B27
Diagnostic features of Ankylosing spondylitis?
RF -
Joint distribution
What is a specific pathology associated with Ankylosing spondylitis?
Loss of spinal mobility
Ossification
What is Reiter’s syndrome?
Arthritis following nongonococcal urethritis, cervicitis, conjunctivitis, or following GI disorder.
Diagnostic features of Reiter’s syndrome?
RF -
Joint distribution
What joints does Reiter’s syndrome go to?
Ankles, knees, and feet
Enteropathic Arthritis associated with what?
Inflammatory bowel disease
Patients with Ulcerative colitis or Crohn’s disease can experience what with Enteropathic Arthritis?
Migratory oligoarthritis of large joints and spine
Clinical features of Psoriatic arthritis?
DIP of hands, and feet Asymmetrically
Diagnostic features of Psoriatic arthritis?
Psoriasis
RF -
Specific Pathologic features of psoriatic arthritis?
Sausage finger, inflammation of tendon sheaths
What is infectious Arthritis?
Acute infectious suppurative inflammation of a joint
Problem associated with TB and weight bearing joints?
Potts disease
In gout what are deposition of masses of rates in joints and other sites called?
Tophi
Predisposing factors for Gout?
Heavy alcohol
Obesity
Drugs (thiazides)
What kills people with gout?
Progressive renal disease
What is psuedogout?
Calcium pyrophosphate crystal deposition disease
Most common type of joint disease?
Osteoarthritis
What do you see in Osteoarthritis as the main clinical feature?
Heberden’s nodes
Specific pathologic feature of osteoarthritis?
Cysts in bone
