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BRS > MSK 4: Rheumatology > Flashcards

MSK 4: Rheumatology Flashcards

1
Q

What are the functions of connective tissue?

A 
Binds together and supports other body tissues.
Protect and insulates internal organs.
Compartmentalises structures
Transport system
Reserve energy stores
Site of immune response
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2
Q

What are the three classes of components in connective tissue?

A

Cells
Fibres
Ground substance

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3
Q

What types of cells are present in connective tissue?

A 
Fibroblasts
Macrophages
Mast cells
Plasma cells
Lymphocytes
Leukocytes
Adipose cells
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4
Q

What are the three types of fibres in connective tissue?

A

Reticular
Elastic
Collagen

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5
Q

What two substances make up ground substance?

A

Macromolecules

Multiadhesive glycoproteins

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6
Q

Does connective tissue have nerve or blood supply?

A

Yes except cartilage, and tendons aren’t vascularised.

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7
Q

What is the purpose of collagen fibres in matrix?

A

Strong and flexible to resist forces

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8
Q

What is the purpose of elastic fibres in matrix?

A

Branch to form network

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9
Q

What is the purpose of reticular fibres in matrix?

A

Provide support for the walls of blood vessels

collagen covered in glycoprotein

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10
Q

What is an adipocyte?

A

Cells that store triglycerides

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11
Q

What is a fibroblast?

A

Large flat cell with branching processes that migrate throughout connective tissue secreting the fibres and ground substance.

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12
Q

What is a macrophage?

A

WBC that surround and engulf material by phagocytosis

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13
Q

What is a mast cell?

A

A white blood cell that secretes histamine.

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14
Q

What are the six types of connective tissue?

A 
Loose connective tissue
Adipose tissue
Blood
Fibrous connective tissue
Cartilage
Bone
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15
Q

How do connective tissues vary?

A

Very by fibres, ground substance and cells contained in it. Each has a specific structure and function.

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16
Q

What are the two types of connective tissue proper and examples of each?

A

Loose: Areolar, adipose, reticular
Dense: Regular, irregular, elastic

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17
Q

What is the function of connective tissue proper?

A

Binding tissue

Resists mechanical stress

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18
Q

What is the function and characteristics of hyaline cartilage?

A

Cushion joints

Weakest but most abundant

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19
Q

What is the function and characteristics of fibrocartilage?

A

Found in intervertebral discs.

Strongest with no perichondrium.

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20
Q

What is the function of elastic cartilage?

A

Provides strength, elasticity and maintains the shape of certain structures.

21
Q

What is housed in trabeculae in spongey bone?

A

Red bone marrow

22
Q

What is rheumatoid arthritis?

A

Autoimmune disorder primarily affecting joints resulting in warm swollen painful joints.

23
Q

When are symptoms of arthritis worst?

A

Following rest

24
Q

What is systemic lupus erythematosus?

A

Autoimmune disorder of connective tissues. Affects multiple organ systems and joints.

25
Q

What is vasculitis?

A

A group of disorders that destroy blood vessels by inflammation.

26
Q

What are the general macroscopic changes in rheumatoid arthritis?

A

Synovitis, bone, cartilage, erosion and angiogenesis.

27
Q

What are the general microscopic changes in rheumatoid arthritis?

A

Cells, interleukins, ANF, synoviocytes, osteoclasts, proteases, CD4 cells, plasma cells, neutrophils.

28
Q

What four things happens to a joint in rheumatoid arthritis?

A

Bone erosion
Swollen inflamed synovial membrane
Cartilage wears away
Reduced joint space

29
Q

Which cell produces IL-17?

A

Th17 (Thelper 17)

30
Q

What cells does IL-17 act on to cause inflammation in rheumatoid arthritis? What factors do they produce?

A

Synovial lining cell (IL-6 IL-8 MCP-1 GRO-α GM-CSF) and macrophages (IL-1β TNF-α IL-6)

31
Q

What cells does IL-17 act on to cause cartilage destruction in rheumatoid arthritis? What factors do they produce?

A

Macrophages (MMPs) and chondrocytes (NO)

32
Q

What cells does IL-17 act on to cause bone destruction in rheumatoid arthritis? What factors do they produce?

A

Osteoclasts (RANKL)

33
Q

How long does rheumatoid arthritis usually last?

A

The rest of the patients life.

34
Q

What joints does rheumatoid arthritis typically spare?

A

Thoracolumbar spine

DIPs of fingers and IP of the toes

35
Q

What is the difference between rheumatoid and osteoarthritis?

A

Rheumatoid is inflammatory not degenerative, involves antibodies and mainly affects small joints.

36
Q

What feature of RA may appear at pressure points?

A

Subcutaneous or periosteal nodules

37
Q

What clinical sign suggests RA?

A

Swelling around joints and synovial thickening that feels like a firm sponge.

38
Q

What are the four stages of treatment?

A

Diagnosis
Severity
Treatment
Moniter

39
Q

What is considered when assessing the disease?

A
  • Current activity: Morning stiffness, synovitis, fatigue, ESR.
  • Degree of damage: ROM and deformities, joint space narrowing and erosions on Xray, functional status.
  • Extra-articular manifestations: Nodules, pulmonary fibrosis, vasculitis.
  • Prior Rx and responses.
40
Q

What are the three key parts of treatment of RA?

A

Education
Exercise
Medications

41
Q

What is the effect of NSAIDs on RA?

A

Symptomatic relief and improved function but no change is disease progression.

42
Q

What should be considered if low dose prednisone is taken long term?

A

Prophylactic treatment for osteoporosis

43
Q

When are intra-articular steroids useful?

A

During flare ups of RA

44
Q

What are some examples of DMARDs?

A

Minocycline, sulfasalazine, hydroxychloroquine, intramuscular gold.

45
Q

What immunosuppressive drugs can be used as treatment for RA?

A

Methotrexate, azathioprine, cyclophosphamide, cyclosporine

46
Q

What is the function of etanercept?

A

New DMARD that is a soluble TNF recpetor so blocks TNF.

47
Q

What is the function of leflunomide?

A

Pyrimidine receptor

48
Q

Why do DMARDs need to be frequently monitored?

A

Adverse effects commonly occur in the blood, liver, lung and kidney.

BRS (5 decks)

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