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► Med - Pathology > Osteoarthritis and Chronic Inflammatory Arthritis > Flashcards

Osteoarthritis and Chronic Inflammatory Arthritis Flashcards

1
Q

Osteoarthritis

A

Also known as degenerative arthritis - characterized by degeneration of articular cartilage

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2
Q

What is the most common type of osteoarthritis?

A

Primary

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3
Q

What are the causes of secondary osteoarthritis?

A
  • Trauma
  • Inflammatory Arthritis
  • Hereditary Conditions
  • Kashin-Bek Disease: Joint hypermobility
  • Bone and Endocrine Disorders
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4
Q

What is the main population for osteoarthritis?

A

Elderly - more than 65 yrs

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5
Q

What are the risk factors of osteoarthritis?

A
  • Age
  • Obesity
  • Repetitive Impact
  • Genetics
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6
Q

What are the clinical characteristics of osteoarthritis?

A 
 Localized joint pain
 Stiffness
 Worse with weight bearing
 Better with rest
 Very little morning stiffness
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7
Q

What happens to the joints of the hand with osteoarthritis?

A

Distal & Proximal interphalangeal joints

- Heberdens & Bouchards nodes

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8
Q

What are some large joints affected by osteoarthritis?

A
  • Knees
  • Hips
  • Cervical Spine
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9
Q

What will the x-ray of osteoarthritis show?

A
  • Decreased joint space
  • Osteophytes
  • Subchondral Sclerosis
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10
Q

What is the treatment for osteoarthritis?

A
  • Weight loss/Physical therapy
  • NSAIDs
  • Joint Replacement
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11
Q

Rheumatoid Arthritis

A

 Systemic
 Chronic
 Inflammatory
 Autoimmune

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12
Q

What can rheumatoid arthritis also affect?

A

Primarily involves joints but can affect extra-articular organs - lungs, blood, eyes, skin, heart, etc.

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13
Q

What gender is rheumatoid arthritis more common in?

A

Women

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14
Q

What gene is associated with rheumatoid arthritis?

A

HLA-DRB1

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15
Q

Does OA have swelling?

A

No

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16
Q

Which type of arthritis has morning stiffness?

A

RA

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17
Q

What type of arthritis involves the lumbar spine?

A

OA

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18
Q

What is the pathogenesis of rheumatoid arthritis?

A

Activation of CD4+ helper T cells that leads to the generation of a pro-inflammatory milieu with destructive enzymes and increased osteoclast activation that can cause bone erosions.

19
Q

Pannus

A

Pannus is an abnormal layer of fibrovascular tissue or granulation tissue. In RA it can be vascular, dense and layered.

20
Q

What are some lab indications of RA?

A
  • Anti-CCP antibody

- Elevated inflammatory markers

21
Q

Rheumatoid Nodule

A

Area of fibrinoid necrosis (center) surrounded by palisading histiocytes

22
Q

What is the treatment for rheumatoid arthritis?

A
  • NSAIDs
  • Corticosteroids
  • DMARDS
23
Q

Anakinra MOA

A

Anti-IL1

24
Q

Etanercept, Adalimumab, Infliximab MOA

A

Anti-TNF alpha

25
Q

Tocilizumab MOA

A

Anti-IL 6

26
Q

Abatacept MOA

A

CTLA4 agonist

- Blocks CD28 co-stimulation of T cells

27
Q

Rituximab MOA

A

Anti-CD20

- Causes destruction of B cells

28
Q

Tofacitinib MOA

A

JAK1 and 3 inhibitor

- Blocks signaling for inflammatory cytokines

29
Q

Seronegative Spondyloarthropathy

A

Group of inflammatory arthritides which primarily involve ankylosing of the spine that improves with exercise but NOT with rest

30
Q

What extra-articular manifestations can seronegative spondyloarthropathy have?

A
  • Uveitis
  • GU Tract
  • Skin
31
Q

What is the typical patient of seronegative spondyloarthropathy?

A

Caucasian between 16 and 30 yrs

32
Q

What are some pathogenesis theories of seronegative spondyloarthropathy?

A
  • Molecular mimicry following an infection

- Misfolding and dimerization leads to inappropriate stimuli and inflammation

33
Q

What are the important molecules in the pathogenesis of seronegative spondyloarthropathy?

A
  • TNF
  • IL-17 - important in defense against bacteria but dysregulation leads to joint destruction
  • IL-23
34
Q

What are some of the effects of IL-17?

A

 Increase in proinflammatory cytokines
 Increase in metalloproteinase
 Increase in RANKL activity

35
Q

Sacroiliitis

A
  • Granulation tissue erodes through bone and cartilage into joint cavity
  • Infiltration of subsynovium: macrophages, lymphocytes, plasma cells
  • Osteoblasts eventually replace cartilage with new bone which is called ankylosis
36
Q

Spinal Ankylosis

A

 Spinal inflammation

 Spinal ankylosis

37
Q

Syndesmorphytes

A

Sclerosising and squaring of the vertebral corners - can lead to complete bridging ossification

38
Q

What GI disease is seronegative spondyloarthropathy associated with?

A
  • Crohn’s Disease

- Ulcerative Colitis

39
Q

What type of arthrtitis will have pain increase throughout the day after weight bearing?

A

OA

40
Q

What arthritis does smoking have a lot of correlation with?

A

RA

41
Q

What are the main differences between RA and OA?

A

RA will often be symmetrical and will affect many joints as well as have extra-articular involvement and inflammatory cells

42
Q

What is the first line biologic for RA?

A

Anti-TNF alpha drugs

43
Q

What are the only biologics that work in spondyloarthropathy?

A

Anti-TNF alpha drugs

► Med - Pathology (203 decks)

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