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CABS - MSK > pathophysiology of rheumatologic and joint disorders > Flashcards

pathophysiology of rheumatologic and joint disorders Flashcards

1
Q

what is SLE

A

autoimmune disease hallmarked by large number of autoantibodies against erythrocytes, coagulation cascade proteins, lymphocytes, platelets

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2
Q

what does SLE result in

A

chronic, multisystem, inflammatory process

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3
Q

when are autoimmune disorders worse

A

when there is a time of trauma/illness - more DNA in circulation

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4
Q

what causes SLE

A

thought to be interaction of random events, genetics, hormonal trigger and environmental triggers

-estrogen, infection, smoking, UV light

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5
Q

what organ is most effected in SLE

A

kidneys

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6
Q

what organs does SLE have affinity for

A

*glomerular basement membrane
choroid plexus (brain)
heart
spleen
lungs
GI tract
skin

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7
Q

what is the classic presentation of SLE symptoms

A

malar rash
oral or nasopharyngeal ulcers
non-erosive arthritis
pericarditis, pleurisy
lupus nephritis
hematologic disorders

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8
Q

what is an ANA

A

anti-nuclear antibodies
looks for antibodies that are targeted against the host cells

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9
Q

when will ANA increase

A

SLE, RA, scleroderma

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10
Q

what is systemic sclerosis known as

A

scleroderma

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11
Q

what is systemic sclerosis

A

disease process that leads to cutaneous and visceral fibrosis that is rare

skin is the main tissue affected

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12
Q

what is the pathophysiology of systemic sclerosis

A

vascular injury or destruction (reynauds early sign)
tissue fibrosis with increased collagen and CT matrix
immune system activation

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13
Q

what is CREST syndrome

A

Raynaud phenomenon, esophageal dysmotiility, sclerodactlyly, telangectasias

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14
Q

what is sjogrens syndrome

A

autoimmune disease that affects exocrine syndrome

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15
Q

what is usually affected with sjogrens syndrome

A

salivary and lacrimal glands
(dry eyes and xerostomia)

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16
Q

what is the most common organism of infectious arthritis

A

Staph aureus

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17
Q

what is septic arthritis

A

infection within the joint space

18
Q

what is the most common joint affected by septic arthritis

A

knee is the most common affected joint

19
Q

what is a ganglion cyst

A

benign lesion, typically asymptomatic but may present with pain, sensory changes, difficulty with functionality

20
Q

what is damaged in an osteoarthritis joint

A

damage to the articular cartilage

21
Q

what part of the bone is remodeled during osteoarthritis

A

subchondral bone

22
Q

what may be involved as OA worsens

A

joint capsule
ligaments
synovial membrane
periarticular muscles

23
Q

what are the causes of OA

A

multifactorial:
biomechanics forces
inflammatory processes
congenital deformities
genetic predisposition
joint instability
neuronal sensation (parasthesias)

24
Q

what is RA

A

systemic autoimmune disease that classically affects small joints with inflammatory polyarthritis

25
Q

what is the main epigenetic cause of RA

A

HLA group is affected but over 100+ genetic risk factors have been identified

26
Q

what do HLA genes code for

A

proteins that help with immune response and distinguishing self from non-self

27
Q

what does the synovium line

A

joint capsule (not along the bony articular surface)

28
Q

what is spondylarthritis

A

disease process that causes inflammation within the spine and joints

29
Q

what is reiters syndrome

A

reactive arthritis

30
Q

what gene mutations associated with reactive arthritis

A

HLA gene

31
Q

what are the typical triggers of reactive arthritis

A

chlamydia, ureoplasma, salmonella, shingella, yersinia (all gram -) which triggers immune response

32
Q

when do reactive arthritis symptoms begin

A

2-3 weeks after infection

33
Q

where does ankylosing spondylitis usually begin

A

lumbar spine and works its way up

34
Q

what gene is affected in ankylosing spondylitis

A

HLA B27 gene usually affected

35
Q

do ankylosing spondylitis have circulating rheumatoid factor

A

no

36
Q

what is a product of the breakdown of purines

A

uric acid

37
Q

what foods increase uric acid

A

alcohol, purine rich foods, seafood, soft drinks and liver

38
Q

when is gout most often symptomatic

A

at night or when it is cold due to decrease blood supply and fluid

39
Q

what shape crystals are associated with gout

A

needle-shaped, negatively birefringent cyrstals

40
Q

what shape crystals are associated with psuedogout/CPPD

A

positively bifringent rhomboid crystals

CABS - MSK (12 decks)

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