Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Blood and Lymph > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What is arthralgia?

A

When a joint hurts but there is no sign of inflammation

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

when is monoarticular arthritis typically seen?

A

infections, crystal-induced arthritis, or trauma, septic arthritis, gout, pseudogout, traumatic arthritis, mechanical derangement of joint, osteochondritis dissecans

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

What is oligoarticular arthritis and when is it typically seen?

A

seen in several joints (2-4)

often associated with the axial arthropathies such as ankylosing spondylitis, psoriatic arthritis, or reactive arthritis.

often asymmetrical and involves the large joints (although not invariably).

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

what is polyarticular arthritis and when is it typically seen?

A

Involves multiple joints, often SYMETRICALLY, and usually
affects both the small and large joints.

** rheumatoid arthritis, systemic lupus erythematosus, and certain viral syndromes.

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

What is hyaline cartilage composed of?

A

type II collagen, proteoglycans and chondrocytes which produces collagen and proteoglycans

matrix proteins: metalloproteinases (MMP)

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

what are polyarticular diseases which can present as a Monoarticular disease?

A

juvenile rheumatoid arthritis, Reactive arthritis, Sarcoid arthritis, psoriatic arthritis, pseudogout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are joints involved in osteoarthritis?

A

-distal interphalangeal joints (DIP), proximal interphalangeal joints (PIP), first carpometacarpal joint (CMC), cervical spine,
lumbosacral spine, hips, knees, first metatarsophalangeal joint (MTP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which arthritis is worse with rest or in the morning?

A

rheumatoid arthritis or axial arthropathies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what arthritis is worse with use?

A

osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What genetic factor is associated with rheumatoid arthritis?

A

HLA-DR4 & 1

**QKRAA sequence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does PRPP synthetase contribute to Gout?

A

overactivity of PRPP leads to increase uric acid

PhosphoRibosyl-PyrophosPhate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does HGPRT contribute to gout?

A

deficiency in HGPRT leads to increase uric acid

Hypoxanthine Guanine PhosphoRibosylTransferase used to convert hypoxanthine –>guanine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which type of arthritis is noninflammatory?

A

Osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What cytokines are associated with osteoarthritis?

A

Interleukin 1 –> MMP, prostaglandins, nitric oxide
nitric oxide –> increases MMP production and chondrocyte apoptosis
Prostaglandins: increase production and activation of MMP
complement activation
adipokines–> cytokines released from fat cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does rheumatoid factor contribute to rheumatoid arthritis?

A

IgM Rheumatoid factor attacks Fc portion of IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What other antibodies are associated with rheumatoid arthritis other than RF?

A

anti citrulline antibodies

These citrulline peptides should not be made and are specifically present in patients with rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of cells are present in RA synovium?

A

CD4+ Tcells, Th17 cells, B cells, and plasma cells
B cells produce antibodies to RF and CCP
macrophages induced to release MMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the joints involved in gout?

A

1st MTP

cool, peripheral joints of lower and upper extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Are majority of gout patients underexcreters of uric acid or overproducers?

A

UNDEREXCETERS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What treatment would you use to inhibit the conversion of xanthine to uric acid?

A

allopurinol and febuxostat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does MSU trigger immune response?

A

binds to TLR2 and 4

also engages in caspase 1 that activates NLRP3 inflammasome –> production of IL-1beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the self limiting process of gout?

A

IgG coats the MSU and triggers phagocytosis by PMNs –> immune response

eventually apolipoprotein B coats it, now inhibiting phagocytosis and the immune response in suppressed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe calcium pyrophosphate dihydrate deposition disease?

A

You have an abnormal production of pyrophosphate (PPi) due to the over productions of nucleoside triphosphates –> PPi

Nucleoside triphosphate (NTP) is hydrolyzed by NTPPPH generating NMP and PPi

24
Q

Describe the genetic component with CPPD

A

there is an ANK GENE mutation that results in a transmembrane PPi transporter protein that allows excess PPi to leave the chondrocyte

25
What are the important characteristics of CPPD?
rhomboid shape | POSITIVELY birefringent
26
What is the genetic component of seronegative sponyloarthropathies?
HLA-B27
27
Which important cytokine would be found in the synovium for seronegative spondyloarthropathies?
tumor necrosis factor
28
What arthritis has a 20% chance of developing if you have a family history with one first degree relative?
seronegative spondyloarthropathy
29
Which arthritis is asymmetric, oligoarticular, and affects lower extremities?
reactive arthritis
30
What is Reiter's syndrome?
can't see, pee, or climb a tree conjunctivitis, urethritis, arthritis
31
What are some of the hypotheses for reactive arthritis?
molecular mimicry arthriogenic peptide hat is uniquely presented by HLA-B27 HLA-B27 heavy chains combine and activate NK cells **unfolded protein hypothesis: ER stress response
32
Which arthritis is most likely explained by a misfolded protein (ERAP-1) in the ER that stimulates production of IL-23?
seronegative spondyloarthropathy
33
What is the fundamental defect in systemic lupus erythematosus (SLE)?
misdirected recognition of self as foreign. A T cell AND B cell process
34
What is the strongest genetic association with lupus?
HLA-DR3 and C4A null allele
35
What is the hallmark of systemic lupus erythmatosus?
positive ANA
36
What type of antibodies are produced in lupus/
anti-dsDNA anti histone anti-smith, SSA, SSB
37
What is the significance of anti-phospholipid antibodies in lupus?
it blocks the prothrombin activation in clotting but INCREASES CLOTTING (counterintuitive) probably neutralizes the anti-coagulating effect of beta 2 GP1
38
What is the major target organ in SLE?
The kidneys
39
What is the classic clinical presentation of Vasculitis?
palpable purpura
40
What is the presentation of giant cell vascultitis?
temporal : temporal arteries, vessels originating from the aortic arch, other arteries less common; temporal headache, jaw claudication, scalp tenderness, visual loss (ophthalmic artery) **carotid artery
41
What is Takayasu's arteritis?
giant cell vasculitis affecting vessels branching from the aortic arch claudication of upper > lower extremities, CNS events; granulomatous panarteritis
42
medium vessel vasculitis affects which arteries?
muscle arteries
43
Polyarteritis nodosa
medium vessel vasculitis that affects small and medium-sized arteries; may affect any organ, but skin, joints, peripheral nerves, gut, and kidney are most commonly involved; focal but panmural necrotizing arteritis with a predilection for involvement at the vessel bifurcation
44
Kawasakis disease
medium vessel vasculitis - fever, conjunctivitis, erymatous rash of palms and soles, lymphadenopathy
45
What are ANCAs?
Antineutrophil cytoplasmic antibodies
46
What vasculitis is associated with cytoplasmic ANCA?
granulomatosis with polyangiitis
47
What does c-ANCA stain positive for?
proteinase - 3
48
What vasculitis is associated with perinuclear ANCA?
microscopic polyangiitis
49
What does perinuclear ANCA stain positive for?
myeloperoxidase (MPO)
50
What are signs of polymyositis/dermatomyositis?
muscle weakness that is proximal | low endurance
51
What skin rashes seen with dermatomyositis?
``` gottron's papules Heliotrope rash V-sign and shawl sign mechnic's hands periungual changes/erythema ```
52
What disease does PM or DM typically present with?
interstitial lung disease 60%
53
What antibodies are associated with PM or DM?
anti-synthetase antibodies "ANTI-JO-1" which is an ANTI-HISTADYL TRNA SYNTHETASE
54
What t cell is associated with polymyositis?
CD 8 + T cells
55
What t cells is associated with dermatomyositis?
CD4+ T cells

Blood and Lymph (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions