Rheumatoid Arthritis Flashcards

1
Q

rheumatoid arthritis

A
  • joint disease affecting 1-2% of the population
  • 80% of people with RA are women (autoimmune?)
  • systemic and affects CT all throughout the body
  • affects non-wt bearing joints (distal joints like fingers, toes, ankles)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

etiology

A
  • complex trait -> genetic and environmental triggers
  • bacterial or viral triggers (ex. EBV)
  • autoimmune (HLA and MHC gene mutations)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

patho

A
  • combination of B cells and T cells
  • T helper cells are activated (by interacting with Ag-presenting cells when infected with the bacterial or viral trigger) and release mediators/cytokines (eg. TNF, IL-1) that induce inflmtn and communicate damage within the joint
  • T helper cells activate T cells -> target synovial membrane -> inflmtry damage within joint cavity
  • T helper cells activate B cells (now plasma cells) that prod. a specific Ab that targets the joint, known as RF (rheumatoid factor) -> not all pts w/ RA are (+) for this Ab
  • immune complex HS (Type III)
  • repeated autoimmunity and hypersensitivity -> ongoing inflmtn -> complement activated (increased inflmtn and WBC attraction) -> continuous damage = obvious joint damage
  • T cells and Abs target synovial membrane, but inflmtry damage that follows affects the membrane, cartilage and underlying bone once cartilage is damaged
  • calcification -> damaged bone will release Ca+ which deposits within the joint
  • joint fusion -> difficult to mobilize joint d/t extensive damage (aka fused)
  • as disease progresses, ligaments change their alignment -> alters how bones are attached to bones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

TNF

A
  • tumor necrosis factor

- cytokine that can cause cell death, cachexia (muscle wasting) and fever by stimulating IL-1 secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Interleukin-1

A

a pro-inflammatory cytokine that increases WBC migration to the site, induces fever (endogenous pyrogen) and causes hyperalgesia (increased sensitivity to pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pannus

A

granulation tissue that develops within the joints

  • angiogenesis in synovium
  • contains inflmtry cells which release proteases that further tissue damage
  • proteases target articular cartilage
  • space-occupying within small joints ->less room = decreased mobility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

manifestations

A
  • early-age onset (20s-30s)
  • non-specific mnftns at beginning of disease: fatigue, generalized pain, malaise (subtle onset)
  • later on, fatigue intensifies, stiffness after inactivity,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly