Rheumatoid Arthritis

Question 1

Rheumatoid arthritis affects mostly who

Answer 1

females from mid 30’s to mid 50s

Question 2

Genetic predisposition in RA

Answer 2

Yeah

Question 3

Rheumatoid arthritis has to be present for how long?

Answer 3

More than 6 weeks…..this is because Parvo virus looks just like RA but it resolves in about 6 weeks

Question 4

Symmetrical or asymetrical synovitis

Answer 4

Symmetrical

Question 5

What joints does RA typically spare

Answer 5

The spine and the DIP joints of the fingers and IP joints of the feet

Question 6

Morning stiffness is present in RA but not in

Answer 6

Osteoarthritis

Question 7

What is the most important gene to be aware of in RA pathogenesis

Answer 7

HLA-DR4….this codes for a class II MHC molecule

Question 8

Very new genes involved in RA diagnosis

Answer 8

PTPN22 and PAD14

Question 9

Heritability of RA is estimated to be at about 60%

Answer 9

ok

Question 10

Genetic risk for RA is most strongly associated with shared epitope alleles of HLA-DRB1

Answer 10

KNOW THAT

Question 11

Hving the HLA-DR4 mutation increases what

Answer 11

Your chances of getting RA by 4 as well as the severity of RA

Question 12

Where does RA autoimmunity start>?

Answer 12

POtentially the gums? Apparently there is a link between peridontitis and the gums. I can’t tell though because his lecture is dog shit.

Question 13

Evidence of autoimmunity can be present many years before teh onset of RA

Answer 13

ok

Question 14

What do autoantibodies in RA recognize?

Answer 14

Potentially joint antigens (type II collagen) or systemic antigens such as glucose phosphate isomerase

Question 15

The synovium in RA is characterized how

Answer 15

intimal lining hyperplasia

- infiltration with CD4 T cells, macs, B cells

Question 16

RA synovial effusions contain

Answer 16

Neutrophils and mononuclear cells

Prostaglanbdins and leukotrioenes

Question 17

What T cell cytokines are present in the synovium of RA pts

Answer 17

interferon gamma and IL-17

Question 18

Regulatory T cell function in RA is

Answer 18

Low

Question 19

Reactive oxygen and nitrogen species exist in RA joints and may damage cells and increase inflammation

Answer 19

ok

Question 20

Abnormalities of key regulatory genes such as the p53 tumor suppre3ssor may also enhance cell accumulation in the joints

Answer 20

ok

Question 21

Several classes of proteases including metalloproteinases, serine ptroeases, cathepsins, aggrecanases are produced by intimal lining cells

Answer 21

ok

Question 22

Systemic features of RA

Answer 22

fatigue, anorexia, weight loss, weakness, generalized aching, low grade fever

Question 23

Systemic features of RA often appear as a ……… to disease onset and are worse with flare-ups

Answer 23

PRODROME. (appear before the disease onset)

Question 24

What does a synovial fluid analysis show in an RA pt

Answer 24

color: yellow
WBC count: High
VIscosity: Low (very watery so its not a good lubricant)

Question 25

Typical pattern of joint involvement in RA

Answer 25

Symmetrical

• starts in wrist and PIP/ MCP joints
• moves to knees, hips, ankles, elbows, shoulders
• spares the spine

Question 26

CERVICAL SPINE INVOLVEMENT IN RA

Answer 26

Usually doesnt occur until after several years of disease progression. Carries teh risk of spinal ord compression.

Question 27

RHeumatoid nodules occur in what % of pts

Answer 27

30

Question 28

R nodules most often occur where

Answer 28

olecronon process or proximal ulna

Question 29

Vasculitis is manifested by

Answer 29

inflammation of small blood vessesl