RA

Question 1

Rheumatoid Arthritis

Answer 1

A chronic inflammatory condition effecting diarthrodial joints. Effects up to 1% worldwide. Presents in 4th decade.
Linked to smoking.

Question 2

Autoantibodies in RA

Answer 2

70% of cases are associated with autoantibodies.

Question 3

Rheumatoid Factor

Answer 3

Autoantibodies that react with other antibody’s Fc portions. Activate inflammatory pathways.

Question 4

Enzymatic conversion of Arginine to Citrulline

Answer 4

Deamination of arginine can change charge of r group, causing it to fit into different binding sites. Presents as a different antigen, basically.

Question 5

IgM rheumatoid factor

Answer 5

Can be found in patients years prior to their symptoms (as far as 14 years). Mothers can not pass any signs for RA on to their infants.

Question 6

Citrulline Formation

Answer 6

Occurs normally in the body. This can occur in the lungs of smokers. However, it is only the RA people that have a reaction against citrulline.

Question 7

HLA DR4

Answer 7

The most significant susceptibility gene in ACPA-positive patients.

Question 8

Phases of RA

Answer 8

1. Genetic and environmental risks.
2. Asymptomatic autimmunity and infalmmation
3. Clinically apparent RA develops
4. Long term behavior of disease.

Question 9

Disease Modifying Anti-Rheumatic Drugs (Adaptive)

Answer 9

DMARDs. Drugs that interfre with adaptive immunity: T-cells blocked by Cyclosporine, abatacept
B-Cells are blocked by rituximab.

Question 10

Disease Modifying Anti-Rheumatic Drugs (Innate)

Answer 10

TNF-a is blocked by etanercept

Il-6R is blocked by tocilzumab