Rheumatoid Arthritis Flashcards
Rheumatoid arthritis affects mostly who
females from mid 30’s to mid 50s
Genetic predisposition in RA
Yeah
Rheumatoid arthritis has to be present for how long?
More than 6 weeks…..this is because Parvo virus looks just like RA but it resolves in about 6 weeks
Symmetrical or asymetrical synovitis
Symmetrical
What joints does RA typically spare
The spine and the DIP joints of the fingers and IP joints of the feet
Morning stiffness is present in RA but not in
Osteoarthritis
What is the most important gene to be aware of in RA pathogenesis
HLA-DR4….this codes for a class II MHC molecule
Very new genes involved in RA diagnosis
PTPN22 and PAD14
Heritability of RA is estimated to be at about 60%
ok
Genetic risk for RA is most strongly associated with shared epitope alleles of HLA-DRB1
KNOW THAT
Hving the HLA-DR4 mutation increases what
Your chances of getting RA by 4 as well as the severity of RA
Where does RA autoimmunity start>?
POtentially the gums? Apparently there is a link between peridontitis and the gums. I can’t tell though because his lecture is dog shit.
Evidence of autoimmunity can be present many years before teh onset of RA
ok
What do autoantibodies in RA recognize?
Potentially joint antigens (type II collagen) or systemic antigens such as glucose phosphate isomerase
The synovium in RA is characterized how
intimal lining hyperplasia
- infiltration with CD4 T cells, macs, B cells
RA synovial effusions contain
Neutrophils and mononuclear cells
Prostaglanbdins and leukotrioenes
What T cell cytokines are present in the synovium of RA pts
interferon gamma and IL-17
Regulatory T cell function in RA is
Low
Reactive oxygen and nitrogen species exist in RA joints and may damage cells and increase inflammation
ok
Abnormalities of key regulatory genes such as the p53 tumor suppre3ssor may also enhance cell accumulation in the joints
ok
Several classes of proteases including metalloproteinases, serine ptroeases, cathepsins, aggrecanases are produced by intimal lining cells
ok
Systemic features of RA
fatigue, anorexia, weight loss, weakness, generalized aching, low grade fever
Systemic features of RA often appear as a ……… to disease onset and are worse with flare-ups
PRODROME. (appear before the disease onset)
What does a synovial fluid analysis show in an RA pt
color: yellow
WBC count: High
VIscosity: Low (very watery so its not a good lubricant)
