Lecture 16 - Inflammatory Arthropathies

Question 1

Which body part does Osteoarthritis (OA) typically present in and in which joints within this body part? How does this compare to Rheumatoid Arthritis (RA)?

Which of the two has systemic symptoms such as fever. malaise, weight loss, and fatigue?

Answer 1

OA is most commonly in the hand, specifically in the DIP/PIP joints more so than MCP joints, but can also be seen in the hips and knees.

RA is common in the hand as well, but it SPARES THE DIP joints. It is also LESS common in the hips and knees, and it is a Polyarthritis.

RA has systemic symptoms

Question 2

_____ Syndrome is a result of untreated RA characterized by neutropenia, infections, splenomegaly, and leg ulcers.

Answer 2

Felty’s Syndrome

Question 3

Rheumatoid Factor is an Ig___ Ab that targets the Fc region of Ig___. This is present in 80% of patients, and it binds complement. In these patients, the disease is _____ (more or less?) severe.

Answer 3

IgM

IgG

More severe

Question 4

Anti-_____ Protein Antibodies (ACPA) are also characteristic of RA, and is more specific for RA than Rheumatoid Factor. It is also indicative that the patient will have more severe disease.

Answer 4

Anti-Citrulline Protein Antibodies

Question 5

Clinical Diagnosis of RA requires a score greater than or equal to _____ using Classification Criteria.

Answer 5

6

Question 6

_______-like Synoviocytes are important for maintaining cytoskeleton in the synovium.

Answer 6

Fibroblast-like synoviocytes

Question 7

In OA, the articular cartilage dries out and becomes _____ and eroded/split.

Answer 7

Fibrilated

Question 8

In RA, there’s characteristic ______ formation, which is the overgrowth of the synovium and Fibroblast-like Synoviocytes. So in RA, the synovium is what’s disrupted primarily, whereas in OA it’s the articular cartilage.

Answer 8

Pannus

Question 9

Unlike with OA, RA causes angiogenesis and adipose is replaced with stromal ________.

Answer 9

Macrophages

Question 10

The most important genetic risk factor for RA is expression of MHC class 2 ____-DR4 –> increases binding to Citrullinated proteins. Furthermore, patients with the _____ epitope in the 3rd variable region of the DR Beta-chain tend to have more severe disease.

Answer 10

HLA-DR4

Shared Epitope

Question 11

PADI4 is a peptidyl arginine deaminase type IV that increases peptide _______. So, patients who express this allele experience more severe RA.

Answer 11

Citrulination

Question 12

What is the most important environmental risk factor for RA?

Answer 12

Cigarette smoking

Question 13

The cytokines IL-___ and IL-___ induce matrix degrading enzymes that degrade cartilage in OA and RA patients. There’s a “second hit” in RA, which is when synovial fibroblasts invade the cartilage once being activated by ____-alpha.

Answer 13

IL-17 and IL-1

TNF-alpha