Intro to Rheum

Question 1

Mechanisms of self tolerance? (3)

Answer 1

Clonal deletion
Clonal anergy
Peripheral Suppression by T-cells

Question 2

Induction of Anti-Self Responses? (3)

Answer 2

Loss of Suppression
Modification by external agent
Alteration of self-antigen

Question 3

Gene most frequently implicated in autoimmunity problems?

Answer 3

PTPN-22, results in excessive lymphocyte activation via defective protein tyrosin phosphatase

Question 4

What causes Chron’s disease?

Answer 4

NOD-2 cytoplasmic sensor of microbes in epithelial cells

Question 5

RA associated with what genetic markers?

Answer 5

HLA DR4 and DR1

Question 6

Cell mediated immunity to what can cause RA?

Answer 6

Type 2 collagen

Question 7

Key features of RA?

Answer 7

Pannus
Joint Space loss
Juxta-Articular bone erosion

Question 8

What is Rheumatoid factor?

Answer 8

Antibodies to autologous IgG immunoglobulin

Question 9

RF critical cause of RA?

Answer 9

No

Question 10

What is Felty’s syndrome?

Answer 10

Rheumatoid arthritis
Splenomegaly
Neutropenia

Question 11

In RA what joints are most often affected?

Answer 11

Symmetrical Disease

Lumbosacral spine, hips usually spared

Question 12

In what tissue layer are rheumatoid nodules found?

Answer 12

Subcutaneous tissues

Question 13

How do you measure Rheumatoid factor?

Answer 13

Measured by agglutination of latex particles coated with IgG

Question 14

What differentiates Juvenile RA from regular RA? (3)

Answer 14

Oligoarthritis more common
Systemic onset more frequent
RF, nodules usually absent

Question 15

What is Ankylosing Spondylitis?

Answer 15

Chronic inflammatory joint disease involving axial joints especially sacroiliac joints. Marie-Stumpell disease

Question 16

What genetic component is Ankylosing spondylitis associated with?

Answer 16

HLA B27

Question 17

Diagnostic features of Ankylosing spondylitis?

Answer 17

RF -

Joint distribution

Question 18

What is a specific pathology associated with Ankylosing spondylitis?

Answer 18

Loss of spinal mobility

Ossification

Question 19

What is Reiter’s syndrome?

Answer 19

Arthritis following nongonococcal urethritis, cervicitis, conjunctivitis, or following GI disorder.

Question 20

Diagnostic features of Reiter’s syndrome?

Answer 20

RF -

Joint distribution

Question 21

What joints does Reiter’s syndrome go to?

Answer 21

Ankles, knees, and feet

Question 22

Enteropathic Arthritis associated with what?

Answer 22

Inflammatory bowel disease

Question 23

Patients with Ulcerative colitis or Crohn’s disease can experience what with Enteropathic Arthritis?

Answer 23

Migratory oligoarthritis of large joints and spine

Question 24

Clinical features of Psoriatic arthritis?

Answer 24

DIP of hands, and feet Asymmetrically

Question 25

Diagnostic features of Psoriatic arthritis?

Answer 25

Psoriasis

RF -

Question 26

Specific Pathologic features of psoriatic arthritis?

Answer 26

Sausage finger, inflammation of tendon sheaths

Question 27

What is infectious Arthritis?

Answer 27

Acute infectious suppurative inflammation of a joint

Question 28

Problem associated with TB and weight bearing joints?

Answer 28

Potts disease

Question 29

In gout what are deposition of masses of rates in joints and other sites called?

Answer 29

Tophi

Question 30

Predisposing factors for Gout?

Answer 30

Heavy alcohol
Obesity
Drugs (thiazides)

Question 31

What kills people with gout?

Answer 31

Progressive renal disease

Question 32

What is psuedogout?

Answer 32

Calcium pyrophosphate crystal deposition disease

Question 33

Most common type of joint disease?

Answer 33

Osteoarthritis

Question 34

What do you see in Osteoarthritis as the main clinical feature?

Answer 34

Heberden’s nodes

Question 35

Specific pathologic feature of osteoarthritis?

Answer 35

Cysts in bone