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Jonathan's Exercise > Joint Pathology > Flashcards

Joint Pathology Flashcards

1
Q

What is bone congruence?

A

How well the bones fit each other, important for the distribution of pressure

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2
Q

What is the content of cartilage matrix?

A

Collagen, GAGs, hyaluronic acid

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3
Q

What is the function of GAG in the cartilage

A

attract water

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4
Q

Why isn’t the synovial membrane classified as an epithelium

A

It doesn’t have basement membrane or junctional complexes like desmosomes

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5
Q

What are the type A chondrocytes like?

A

Macrophage

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6
Q

What are the type B chondrocytes like?

A

Fibroblast

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7
Q

What is the function of type B chondrocyte?

A

produce ECM (hyaluronic acid production)

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8
Q

How can we tell between type A and type B chondrocytes on histology?

A

Type A cells are multi-nucleated giant cells

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9
Q

What are the treatments of osteoarthritis?

A

physiotherapy, pain relief and joint replacement

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10
Q

What are the main differences between RA and osteoarthritis?

A

RA tends to be diffused. It can affect skin, heart and lung

RA stiffness gets better through the day. OA gets worst with use

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11
Q

T/F RA usually starts in the major large joints of the body

A

False, they start in the small joints of hands and feet

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12
Q

T/F Gout is an acute form of osteoarthritis

A

True, inflammation is caused by crystalisation of uric acid

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13
Q

What are the treatments of gout?

A

anti-inflammatory medication, urate lowering therapy, lifestyle changes

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14
Q

What are the major enzymes and cytokines involved is OA?

A

collagenase, MMP

IL-1

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15
Q

What is the trigger of OA?

A

chondrocyte damage, leading to proliferation and enzyme/cytokine secretion

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16
Q

What are some bone changes that can occur with OA?

A

bone thickening, microfractures,

17
Q

What is fibrillation of cartilage

A

erosion of cartilage

18
Q

What is bone eburnation?

A

thickening, and bone appears white and shiny

19
Q

T/F OA is a diffused degenerative disease in the joint

A

False, it is focal. You get non-uniform loss of cartilage, subchondral thickening and osteophytes

20
Q

What are the signs of OA?

A

reduced RoM
Crepitus (grinding of joint)
Osteophytes

21
Q

What are the symptoms of OA?

A

insidious onset, deep achey pain that is worse with activity

no systemic symptoms

22
Q

What is the diagnosis of OA?

A

Mostly clinical

23
Q

What is the underlying pathological process of RA?

A

T helper cells activation, especially Th1 and Th17

TNF-a is central to RA inflammatory process, activating B plasma cells

24
Q

What kind of change do activated B cells do to the synovium?

A

they induce fibroblasts, macrophages and osteoclasts to make synovium hyperplastic, and deposit abnormal granulation tissue “pannus”

25
Q

What is the role of activated macrophage in RA?

A

secrete collagenases and MMPs to break down cartilage and bone

26
Q

What is the morphology of RA on histology?

A

villous hyperplasia
mononuclear infiltrate
germinal centres

27
Q

What is the presentation of late stage RA?

A

union of bones due to extensive fibrosis and destruction of capsule and ligaments

28
Q

What are the signs of RA?

A

warm, swollen joints
rheumatoid nodules
joint deformity in later stage

29
Q

T/F there are systemic symptoms from RA

A

True, patients can have fever, loss of weight, anaemia

30
Q

T/F RA is usually asymmetrical

A

False, the disease process is symmetrical

31
Q

Which joint is often sparred in RA?

A

distal interphalangeal joint

32
Q

T/F Granulomatous inflammation is typical of RA

A

True, there is central necrosis, epithelioid macrophages and surrounding lymphocytes

33
Q

What are the specific tests for RA?

A

Test for rheumatoid factor or anti-cyclic citrullinated peptided

34
Q

What is the effect of crystals on neutrophils in gout?

A

they are spiky and can pierce neutrophils, killing them and release internal inflammatory mediators

35
Q

T/F Pannus can occur in both OA and gout

A

True

36
Q

What is tophi?

A

urate deposition that can be seen superficially

37
Q

T/F Granuloma can be seen in RA, but not in gout

A

False, you can see granuloma in tophi

38
Q

T/F Serum urate is a good diagnostic technique for gout

A

False, acute gout attack lowers serum urate + most people with high urate don’t have gout

39
Q

What is the gold standard test for gout?

A

joint aspiration

Jonathan's Exercise (2 decks)

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