Rheumatoid Arthritis Flashcards
what is the definition of arthritis
inflammation of a joint
what are the funcitons oft he normal synovium
maintenance of intact tissue surface
lubrication of cartilage
control of synovial fluid
nutrition of chondrocytes within joints
name some aspect of a damaged joint
erosion in the corner of the bone
thinning of cartilage
inflamed synovium-the synovial fluid contains neutrophils which causes bone and cartilage destruction
what is the definition of rheumatoid arhritis
chronic symmetric polyarticular inflammatory joint disease which affects the small joints of the hands and feet
what antibodies are present in RA
rheumatoid factor
ACPA
ANAS-anti-nuclear antibodies
anti Cop test anything above 20 suggests RA
what environmental factors are suspected of leading of RA
smoking
infectious agents- virus, coli, mycoplasma
having a genetic susceptibility plus factors would lead to what
formation of immune complexes and RF
breakdown of tolerance
what is the development of RA
environmental factors/ genes/ epigenetic modification ===
loss of tolerance
transition to RA
describe what happens in synovitis
Villous hyperplasia Infiltration of T cells, B cells, macrophages and plasma cells Intimal cell proliferation (fibroblasts) Production of cytokines and proteases Increased vascularity Self-amplifying process
explain anti-inflammatory cytokines in RA
they are produced but an insufficient amount to stop the inflammation
explain angiogenesis
provides nutrients for the hyper-plastic synovium
hypoxic conditions enhance blood vessel proliferation
explain what happens to the bones and cartilage
proteases are produced by FLS fibroblast like synoviocytes
they invade the cartilage
bone destruction I mediated by osteoclasts which regulated by RANKL
what are some systemic consequences of RA
vasculitis nodes CV disease ILD sacropenia osteoporosis
what is the perecentage chance between monozygotic twins
15-20%
what is the percentage chance between sibilins
2-4%
