Rheumatoid Arthritis Flashcards
Pattern of RA?
Symmetric
Etiology of RA?
Unknown, thought to be genetic
What is associated with increased incidence of rheumatoid and lupus
STAT4 haplotypes chromosome 2
What is associated with increased risk of CCP positive RA?
TRAF1-C5 on chromosome 9
What does TRAF1-C5 code for?
Intracellular protein that mediates signal transduction through TNF receptors 1 and 2
Primary orchestrator of the cell mediated immune response in rheumatoid arthritis?
CD4 helper T-cells
What do patients with RA express at much greater rate than patients w/o RA?
HLA DR4 haplotypes
TNF, IL-1, IL-6 cause what?
Erosion of bone and cartilage
IL-1 and TNF do what?
Stimulate adhesion molecules
Increase recruitment of polymorphonuclear cells into the joints
What do polymorphonuclear cells release that degrades cartilage?
Elastase and proteases
Function of rheumatoid factor?
Unknown
How is rheumatoid factor released?
Stimulated CD4 stimulates B cells to produce immunoglobulins including rheumatoid factor
Function of IL-4 and IL-10?
Down regulate the inflammatory response
What happens to the synovial membrane in early RA?
Membrane becomes thickened due to hyperplasia and hypertrophy of synovial lining cells
When RA is established what does synovial membrane become?
Inflammtory tissue (pannus)
What is Pannus made up of?
Type A (macrophage like), type B (fibroblast like), and plasma cells
Constitutional features of RA?
Morning stiffness lasting for hours
Malaise, fatigue
Men or women more likely to get RA?
Womean 3:1 ratio
Peak onset of RA?
30-55
How do the joints feel in RA?
Joints have a warm boggy feel (soft and squishy)
What joint does RA never infect?
DIP
What does infection of DIP joints indicate?
OA or psoriatic arthritis
Does RA get to the lower back?
NO!
Finding between cardiac and RA?
Fourfold increase in cardiovascular events in rheumatoid population
