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BRS Term 2 > Introduction to Rheumatology (23) > Flashcards

Introduction to Rheumatology (23) Flashcards

1
Q

What are the 4 types of tissue?

A
  • nervous tissue
  • epithelial tissue
  • muscle tissue
  • connective tissue
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2
Q

What are the 4 subtypes of connective tissue and what unites them?

A

bone, cartilage, blood, and proper

- all come from mesoderm

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3
Q

What are the different functions of connective tissue?

A
  • binds together, supports and strengthens body tissues
  • protects and insulates internal organs
  • compartmentalises structures e.g. skeletal muscle
  • major transport system within body
  • site of stored energy reserves
  • main site of immune responses
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4
Q

What are the components that make up the structure of connective tissue?

A
  • cells

- and extracellular matrix (largest component: ground substance + fibres)

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5
Q

What is ground substance?

A
  • component of connective tissue
  • between cells and fibres
  • structurally supports cells and binds them together
  • jelly-like, made of starch, proteins and water
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6
Q

What are the 3 types of connective tissue matrix fibres?

A
  • collagen: strong, resists forces, flexible
  • elastic: more flexible, branch to form network, made of elastin, smaller diameter
  • reticular: made of collagen w/glycoprotein coat, smaller diameter
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7
Q

What are the different types of cells in connective tissue?

A
  • fibroblasts: large flat cells w/ branches, migrate through connective tissue secreting fibres and ground substance
  • macrophages: develop from WBCs, surround and engulf material by phagocytosis
  • mast cells: produce histamine–> dilates blood vessels
  • adipocytes: store triglycerides
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8
Q

What is the most abundant protein in the body?

A

collagen

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9
Q

What is the main function of connective tissue matrix fibres (collagen, reticular and elastic)?

A

provide strength and support to connective tissue

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10
Q

What are the 2 categories of proper connective tissue?

A

loose connective tissue: more ground substance

dense connective tissue: more collagen (more tightly packed)

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11
Q

What are the types of loose (proper) connective tissue?

A
  • areolar: most common form, lots of ground substance, lines organs
  • adipose: composed of adipocytes, energy reserve
  • reticular: composed of reticular fibres, mesh structural support e.g. spleen
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12
Q

What are the types of dense (proper) connective tissue?

A
  • regular: tight collagen fibres, tendons and ligaments
  • irregular: skin dermis, irregular formation of collagen
  • elastic: in vertebrae, composed of elastic fibres
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13
Q

What are general features of cartilage?

A
  • avascular and no nerve supply
  • strengthens and supports connective tissue
  • resists compression
  • cushions and supports body structures
  • collagen fibres, sometimes elastic fibres
  • chondroblasts in growing cartilage–> mature into chondrocytes
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14
Q

What are the features of hyaline cartilage?

A
  • weakest, but most abundant of 3 types of cartilage
  • in synovial joints
  • gel-like ground substance
  • found at end of long bones to cushion joints and at epiphyseal plates
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15
Q

What are the features of fibrocartilage?

A
  • has thick collagen fibres in matrix
  • strongest of 3 types
  • found in intervertebral discs bc good shock absorber
  • chondrocytes scattered in matrix
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16
Q

What are the features of elastic cartilage?

A
  • strength, elasticity and maintains shape of certain structures e.g. external ear
  • similar to hyaline, but more elastic fibres in extracellular matrix
  • chondrocytes in a threadlike network of elastic fibres
17
Q

What are the general features of blood (connective tissue)?

A
  • no fibres
  • plasma
  • erythrocytes: transport oxygen
  • leukocytes: immune function
  • platelets: blood clotting
18
Q

What is rheumatoid arthritis?

A
  • autoimmune disorder
  • inflammatory
  • warm, swollen and painful joints
  • genetic and environmental factors
19
Q

What is arthritis?

A
  • disorder that affects the joints

- 2 types: rheumatoid and osteoarthritis

20
Q

What are the joint changes in rheumatoid arthritis?

A
  • swollen, inflamed synovial membrane
  • bone erosion
  • cartilage wears away
  • reduced joint space
21
Q

What are some key pathophysiological mechanisms involved in developing rheumatoid arthritis?

A
  • cytokines: TNF-alpha, IL-1, IL-6 and IL-17–> inflammation
  • proteinase enzymes (MMPs) and NO–> cartilage destruction
  • osteoblasts- RANKL–> bone destruction
22
Q

What are 3 key symptoms that people present with rheumatoid arthritis?

A
  • joint pain, stiffness and swelling for >6wks
  • morning stiffness
  • symmetrical and polyarticular (>3 joints)
    (N.B. mainly affects small joints e.g. fingers and wrists)
23
Q

What are the key differences between rheumatoid vs osteoarthritis?

A
  • inflammatory vs degenerative
  • autoantibodies (RF/rheumatoid factor and anti-CCP) vs no antibodies
  • symmetrical vs asymmetrical
  • morning stiffness vs no
  • 30-50yrs vs >50 yrs
  • rapid vs slow
  • AM stiffness in rheumatoid, not osteo
  • small joints vs large, weight bearing joints
24
Q

How do we investigate rheumatoid arthritis?

A
  • blood tests
  • inflammatory markers
  • x-rays
  • ultrasounds
25
Q

How do we manage rheumatoid arthritis?

A
  • MDT
  • patient education
  • physiotherapy
  • mild pain killers and/or steroids
  • longterm: disease modifying anti-rheumatic drugs (DMARDs) e.g. methotrexate, leflunomide, sulfasalazine, hydroxychloroquine
    ^effectively immunosuppressants
26
Q

What are some extraarticular manifestations of rheumatoid arthritis?

A
  • fibrosis of lungs
  • fluid in lungs
  • dry eyes
  • kidney damage
  • nodules at elbows or hands
27
Q

What is lupus/SLE?

A
  • connective tissue disorder, so v. variable symptoms
  • autoimmune condition w/ inflammation
  • arthritis, skin rash, joint pain, photosensitivity etc.
28
Q

What is vasculitis?

A

a group of disorders that destroy blood vessels by inflammation

29
Q

What are the key X-ray changes found in rheumatoid arthritis?

A
  • loss of joint space
  • juxta-articular bone erosions
  • soft tissue swelling
  • osteopenia (weak)
  • subluxations

BRS Term 2 (36 decks)

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