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Unit 4: D & D > Path. of Arthritis and Autoimmune Disease > Flashcards

Path. of Arthritis and Autoimmune Disease Flashcards

1
Q

_____ is the most common disease causing morbidity in the elderly.

A

Arthritis

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2
Q

What is joint pain without evidence of inflammation called?

A

arthralgia

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3
Q

What is periarticular pain?

A

pain arising from structures around the joint, like tendons or bursae

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4
Q

How are periarticular pain and true arthritis distinguished?

A

periarticular pain does not have effusion or point tenderness and is not worse with active motion compared to passive

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5
Q

What is soft tissue pain?

A

pain from muscle, nerves, or referred from a distant site that may be interpreted as joint pain

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6
Q

What are the findings in true arthritis?

A

joint effusion, active and passive joint pain

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7
Q

What is arthralgia?

A

joint pain w/o evidence of inflammation

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8
Q

Pain arising from structures around the joint, like tendons or bursae, is called?

A

periarticular pain

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9
Q

What is monoarticular arthritis? When does it arise?

A

arthritis of one joint; most often due to infections, crystal-induced arthritis, or trauma

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10
Q

What is oligoarticular arthritis? What diseases are assoc. with it?

A

arthritis seen in 2-4 joints, usually asymmetrical and involving the large joints; assoc. with ankylosing spondylitis, psoriatic arthritis, or reactive arthritis

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11
Q

What is polyarticular arthritis? What diseases are assoc. with it?

A

multiple joints, symmetric, both small and large. RA, SLE, and viral syndromes

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12
Q

What is a synarthrosis? Example?

A

joint where bones come together and interlock; skull

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13
Q

What is an amphiarthrosis? Example?

A

bones are joined by a segment of flexible fibrocartilage;; ribs to sternum

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14
Q

What is a diarthrosis?

A

most common joint- articulation cushioned with hyaline cartilage, stabilized by ligaments, actively moved by muscles, and nourished/lubricated by synovial tissues

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15
Q

What is an uniaxial or hinge joint? Example?

A

moves along one plane; knee or elbow

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16
Q

This arthritis is seen in 2-4 joints, usually asymmetrical and involving the large joints; assoc. with ankylosing spondylitis, psoriatic arthritis, or reactive arthritis.

A

oligoarticular arthritis

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17
Q

What is a polyaxial joint? Example?

A

movement along multiple axes, such as the ball and socket joint of the shoulder

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18
Q

This arthritis involves multiple joints, is symmetric, inn both small joints and large, and is found in RA, SLE, and viral syndromes.

A

Polyarticular arthritis

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19
Q

What are ligaments composed of?

A

bundles of parallel type 1 collagen

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20
Q

What is the most common joint- an articulation cushioned with hyaline cartilage, stabilized by ligaments, actively moved by muscles, and nourished/lubricated by synovial tissues?

A

a diarthrosis

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21
Q

____ are active drivers of joint motion whereas ____ are passive restraints.

A

Tendons; ligaments

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22
Q

What is an enthesis?

A

where tendons and ligaments insert into the bone

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23
Q

Why are entheses important in the spondylo-arthropathies?

A

they can become inflamed, cause erosions, and calcify in these diseases

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24
Q

What are bursae?

A

synovial-lined sacs supported by dense regular CT designed to slide and cushion tissues

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25
Q

Where do bursae occur? Example?

A

between tendon and bone, tendons and ligaments, or between tendons; subacromial bursa over the shoulder

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26
Q

What is Axial Arthropathy?

A

arthritis involving the spine

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27
Q

What is Ankylosis?

A

Fixation of a joint as the result of a disease process, with fibrous or bony union across the joint

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28
Q

What is Sacroiliitis?

A

Inflammation of the sacroiliac joint

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29
Q

What is Spondylitis?

A

Inflammation of one or more vertebrae of the spine

30
Q

What is an Osteophyte?

A

A bony outgrowth of bone

31
Q

What is a Syndesmophyte?

A

Calcification of a ligament or tendon at site of bony insertion

32
Q

What is a Synchondrosis?

A

A union between two bones formed by cartilage

33
Q

Give an example of a synchondrosis.

A

pubic symphysis, manubrosternal joints, costosternal joints

34
Q

What is inflammation of the sacroiliac joint called?

A

sacroiliitis

35
Q

What is inflammation of one or more vertebrae of the spine called?

A

spondylitis

36
Q

What is a bony outgrowth of bone?

A

osteophyte

37
Q

What is a calcification of a ligament or tendon at the site of bony insertion called?

A

a syndesmophyte

38
Q

What is a union between two bones formed by cartilage called?

A

Synchondrosis

39
Q

In a diarthrodial joint, the articular surface of the bone is covered by _____.

A

hyaline cartilage

40
Q

What is hyaline cartilage made of?

A

type II collagen, proteoglycans (chondroitin and keratin sulfate), hyaluronic acid, water

41
Q

_____ is a thin layer of cells and a capsule that covers all intra-articular surfaces other than the articular areas of cartilage.

A

Synovium

42
Q

What is synovium made of?

A

a well ordered matrix of microfibrils and proteoglycan aggregates with synovial cells

43
Q

Synovial cells are divided into 2 types: Type A cells are _____ and derived from the _____; Type B cells are _____.

A

macrophage-like, bone marrow; fibroblast-like

44
Q

What is inflamed synovium called?

A

synovitis

45
Q

What is pannus? What disease is this assoc. with?

A

diffusely inflamed and thickened synovium; RA

46
Q

The area under the cartilage is called the _____.

A

subchondral bone

47
Q

This area commonly becomes dense or sclerotic in osteoarthritis.

A

the subchondral bone

48
Q

Which joints are involved in OA?

A

DIPs, PIPs, first carpometacarpal joint (CMC), cervical spine, lumbosacral spine, hips, knees, first metatarsophalangeal joint (MTP)

49
Q

Which joint pathologies have an acute onset?

A

septic joints, crystal diseases

50
Q

Which allele is assoc. with RA?

A

HLA-DR4

51
Q

Synovial cells are divided into 2 types: _____ are macrophage-like and derived from the bone marrow; _____ are fibroblast-like.

A

Type A cells; Type B cells

52
Q

Which allele is assoc. with axial arthropathies?

A

HLA-B27

53
Q

Which alleles are assoc. with SLE?

A

HLA-DR2, HLA-DR3, C4A null allele

54
Q

When inflammation occurs in the body, a large number of systemic and metabolic changes occur which are collectively referred to as the _____.

A

acute-phase response (APR)

55
Q

Cytokines stimulate the ____ to produce ____, and during this time it decreases _____ production.

A

liver; acute phase proteins; albumin

56
Q

General measurements of the acute phase inflammatory response are the ____ and the ______.

A

erythrocyte sedimentation rate (ESR); C-reactive protein (CRP)

57
Q

What does ANA stand for?

A

antinuclear antibody

58
Q

What is vasculitis?

A

inflammation of blood vessels

59
Q

How are the vasculitides categorized?

A

size of the BVs involved

60
Q

What does ANCA stand for?

A

antineutrophil cytoplasmic antibodies

61
Q

What does CRP stand for?

A

C-reactive protein

62
Q

The ESR is an indirect way of screening for elevated
concentrations of acute phase proteins made by the liver that result in increased ______ (rouleaux formation), causing them to fall more rapidly.

A

aggregation of erythrocytes

63
Q

CRP is a pentameric protein that behaves as a primitive _____. It can activate the classic complement pathway and bind to the Fc gamma receptor. It rapidly
rises in 2 to 3 days after an acute inflammatory stimulus.

A

immunoglobulin

64
Q

What are ANCAs?

A

antibodies to cytoplasmic antigens found in neutrophils

65
Q

The ANCAs may be directly involved in the patho-genesis of _____.

A

pauci-immune types of vasculitis

66
Q

The ____ is a set of closely-linked genes whose products regulate the recognition of foreign antigens by T cells.

A

MHC

67
Q

The ESR is an indirect way of screening for elevated
concentrations of acute phase proteins made by the liver that result in increased aggregation of erythrocytes (______), causing them to fall more rapidly.

A

rouleaux formation

68
Q

____ may be directly involved in the pathogenesis of pauci-immune types of vasculitis.

A

ANCAs

69
Q

CRP is a pentameric protein that behaves as a primitive immunoglobulin. It can activate the _____ and bind to the _____ receptor. It rapidly rises in 2 to 3 days after an acute inflammatory stimulus.

A

classic complement pathway; Fc gamma

70
Q

The MHC is a set of closely-linked genes whose products regulate the recognition of foreign antigens by ___.

A

T cells

Unit 4: D & D (22 decks)

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