OA/RA/AD Flashcards
Osteoarthritis
The breakdown of joint cartilage and underlying bone.
AKA. wear and tear arthritis
OA is seen with ___
- Increasing age
- On one side or a single joint (but can be bilateral)
OA Signs & Symptoms
- Pain
- Joint stiffness
- loss of movement
- crepitus (crackling noise)
- Heberden’s nodules
OA Causes?
- Joint injury (mechanical stress)
- Abnormal limb development
- Hereditary factors
OA Risk Factors
- Overweight
- Repetitive Tasks
- legs of different length
OA secondary factors
- Alkaptonuria
- Congenital Joint Disorders
- Diabetes
- Ehlers-Danlos Syndrome
- Marfan’s Syndrome
- Hemochromatosis and Wilson’s disease
- Chronic inflammatory disease
- Joint infection
(OA) The articular cartilage is mainly composed of __?
Collagen, proteoglycans, and water
(OA)
In the cartilage the collagen matrix __?
Increased compressive force causes__
Decreased proteoglycan causes__
Reduced osmotic pressure causes __?
Is a balance of forces.
Decrease in proteoglycan
Reduced osmotic pressure and water content
Additional stress on collagen fiber (breakdown)
(OA)
The breakdown of collagen fiber __?
The collagen breakdown __?
Inflammation injures cartilage by__?
Weakens the cartilage.
initiate an inflammatory process in articular cartilage
Releasing proteolytic enzymes like metalloproteases
(OA)
Effects of Inflammation
- Ligaments and joint capsules may become fibrotic and thicken
- meniscus is worn away
- bone outgrowth, spurs form at the margin of the head of bone
- Bony growth
- Joint may disarticulate
Rheumatoid Arthritis
A chronic autoimmune disorder that presents as an inflammatory disorder
RA is seen__
- In the joints but may affect other tissues
- inflammation on both sides of the body
- primarily synovial joints
RA possible causes?
- May be Genetic
- environmental factor
(RA) Genetic Markers
- HLA-DR4
- HLA-DRBD1
(RA) Common components
- C-reactive Protein (CRP)
- Anticitrulline Antibody
- Rheumatoid factor (RF)
- Antinuclear Antibody
(RA) C-reactive Protein
- an acute phase reactant
- increases during inflammation in response to IL-6
- Binds to phosphocholine in the bacterial membrane and activates the complement system (phagocytosis)
(RA)
High CRP __?
CRP__?
are associated with RA
Influences Osteoclast activity
(RA)
Increased levels of CRP are associated with?
- CVD
- Metabolic syndrome
- Diabetes
- Interstitial Lung Disease
(RA)
Anticitrullinated Antibodies
Autoantibodies that target citrullinated peptides and proteins
A useful diagnostic tool
(RA)
Citrullinated Proteins
- May appear in their altered state
- Serves as antigens
- May initiate the production of antibodies when detected
Rheumatoid Factor
- Autoantibody found in RA
- is also a marker for RA
- directed against Fc portion of IgG antibody
RA may cause …?
- CVD
- Osteoporosis
- Interstitial Lung disease
RA starts as…?
The synovial ___?
Joint damage __?
Persistent cellular event
is the primary target
Loss of function
(RA)
3 Phases:
Initiation: __
Amplication: __
Chronic Inflammation: __
1) Non-specific Inflammation
2) T-lymphocyte Activation
3) Tissue is Injured
(RA)
Synovial Membranes are inflamed __
Mass on the synovial space, __
Synovial cells activated __
and infiltrated with inflammatory cells ( lympho, PMN, Plasma)
is called Pannus
which release enzymes to break down tissue, collagen and cartilage.
(RA) Tissue Injury
Progression leads to__
Persistent inflammation leads to__
May extend to__
cartilage loss and bone damage.
Joint and tendon destruction.
Bursae.
Rheumatoid nodules
- formed around a fibrinoid center
- the center is surrounded by a palisade (macrophage, fibroblasts)
Tisses/ Organs affected by RA
- Skin
- Lungs
- heart and blood vessels
- Blood
- Bone
(RA) Skin
- Subq rheumatoid nodules
- Vasculitis
(RA) Lungs
- Lung Fibrosis
- Caplan’s syndrome (coal dust)
(RA) Heart and Blood Vessels
- Risk of atherosclerosis
- Risk of heart attack + stroke
- others
(RA) Blood
- Anemia
- Normal RBC
- Low WBC
- Increase in Platelet
Atopic Dermatitis
-Eczema
- Inflammation of the skin
AD Symptoms
- itchy
- red
- swollen
- crack and dry
AD Lesions
- Epidermal intercellular edema
- Dermal inflammatory infiltration of lymphocytes
- Hypogranulation of mast cells
- Endothelial cell hypertrophy
- Basement membrane thickening of venules
- Increase of Langerhans cells
(AD) Possible Causes
- Genetics
- Immune system dysfunction
- Environment (+ S. Aureus)
- Altered Skin permeability
(AD)
S. aureus colonization leads__
to impairment of the barrier function and mutations in filaggrin
(AD)
Inherited mutation in __ has been associated with AD
Card11 gene
AD is driven by __
Resembles __ and __
Hypersensitivity
Type 1 and Type 4 hypersensitivity
IgE
- is driven when you’re first exposed to the antigen
- they bind together causing degranulation
