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BRS > Rheumatology > Flashcards

Rheumatology Flashcards

1
Q

What are the 6 main functions of connective tissue?

A

Binds together, supports, and strengthens other body tissues
Protects and insulates internal organs
Compartmentalises structures (skeletal muscle)
Transport system within the body
Site of stored energy reserves
Main site for immune response

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2
Q

Which embryological tissue does cartilage derive from?

A

Mesoderm

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3
Q

Describe the vascularity of cartilage?

A

Avascular

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4
Q

What are the 3 class components of the structure of connective tissue?

A

Cells
Fibres
Ground substance

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5
Q

What 7 cells comprise connective tissue?

A 
Fibroblasts
Macrophages
Mast cells
plasma cells
Lymphocytes
leukocytes
Adipose cells
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6
Q

What are the 3 main fibres of connective tissue?

A

Reticular
Elastic
Collagen

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7
Q

What are the 2 main ground substance molecules that comprise connective tissue?

A

Macromolecules

Multi-adhesive glycoproteins

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8
Q

What is ground substance of extracellular matrix in terms of connective tissue?

A

Amorphous gelatinous material, occupies space between fibres sand cells

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9
Q

What are the large molecules that comprise connective tissue ground substance?

A

Glycosaminoglycans linked together to form proteoglycans

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10
Q

Where does connective tissue not occur?

A

Does not occur on free surfaces

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11
Q

Which connective tissue is not supplied by nerves?

A

Cartilage

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12
Q

Which connective tissue types are not highly vascular?

A

Cartilage and tendons

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13
Q

What is the main function of extracellular matrix?

A

Resides as an intermediary between cells & fibres, facilitating a supportive role towards binding cells together
Provides medium through which substances are exchanged

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14
Q

What is the principal fibres of fibres within connective tissue?

A

Support & strengthen connective tissue

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15
Q

What are the main properties of collagen fibres?

A

Strong, resist force, and flexible

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16
Q

In terms of diameter compare elastic fibres with collagen?

A

The diameter of elastic fibre is comparatively smaller than that of collagen fibres.

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17
Q

Which proteins are associated with elastic fibres?

A

Elastin proteins

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18
Q

Describe the structure of elastic fibres?

A

Elastic fibres are essential extracellular matrix macromolecules comprising of an elastin core surrounded by a mantle of fibrillar rich microfibrils.

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19
Q

What properties are endowed by elastic fibres to blood vessels, lungs and skin?

A

Properties of elasticity and resilience

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20
Q

What are the main functions of reticular fibres?

A

Provide support for walls of blood vessels

Comprise of collagen with a glycoprotein covering

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21
Q

What is the main function of fibroblasts in connective tissue?

A

Fibroblasts function as accessory cells in immune & inflammatory responses, cytokine release, mediators enable fibroblast leukocyte interactions
Modifies extracellular matrix components , secretes collagen

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22
Q

Describe the structure and appearance of fibroblasts?

A

Large flat cells with branching processes, migrates through connective tissues secreting the fibres & ground substance

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23
Q

What are macrophages?

A

Perform immunological function and engulf material by phagocytosis

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24
Q

Which cells are macrophages derived from?

A

Monocytes within the bone marrow

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25
Q

Which tissue resident cells within connective tissue residing proximal to blood vessels, release histamine ?

A

Mast cells

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26
Q

How do mast cells release histamine?

A

Through mast-cell degranulation

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27
Q

What is the main function of histamine?

A

Vasodilator,

Enables diapedesis of neutrophils to exhibit an inflammatory response

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28
Q

Where are adipocytes located?

A

Located within adipose tissue

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29
Q

What is the main function of adipocytes?

A

Storage of triglycerides, site of lipolysis, and lipogenesis

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30
Q

What are the four main types of connective tissue?

A

Connective tissue proper
Cartilage
Bone tissue
Blood

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31
Q

What are the three main types of cartilage?

A

Hyaline cartilage
Elastic cartilage
Fibrocartilage

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32
Q

What are the 2 main categories of connective tissue proper?

A

Loose connective tissue

Dense connective tissue

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33
Q

What are the two main types of bone?

A

Compact cortical

Spongy cancellous

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34
Q

What is the main function performed by connective tissue proper?

A

Binding tissue, and resisting mechanical stress (tension)

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35
Q

Which 4 main cells are located within connective tissue proper?

A

Fibroblasts
Fibrocytes
Defence cells
adipocytes

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36
Q

What are the 3 main categories of loose connective tissue proper?

A

Areolar
Adipose
Reticular

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37
Q

What is the function of areolar tissue?

A

Lines organs
Provides structural support, holds organs in place, attaching epithelial tissue to underlying tissues
Serves as a reservoir of water and salts for surrounding tissues (Tissues absorb nutrients and release water into areolar connective tissue)

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38
Q

Which type of loose connective tissue proper serves as a water reservoir?

A

Areolar connective tissue proper

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39
Q

What is the main function of adipose tissue?

A

Adipose tissue contains adipocytes, a triglyceride storage cell, in addition to providing insulating and force absorbing properties.

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40
Q

What type of support is provided by reticular connective tissue?

A

Fibres provide stromal support to lymphoid organs (lymph nodes, stromal cells, red bone marrow and spleen(

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41
Q

What type of collagen forms reticular loose connective tissue?

A

Type III collagen

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42
Q

What are the three main types of dense connective tissue?

A

Regular
Irregular
Elastic

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43
Q

What is dense connective tissue proper?

A

Dense regular connective tissue provide connection between different tissues; collagen fibres are bundled in a parallel fashion (Tendons & ligaments)

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44
Q

What is the structure of irregular connective tissue proper?

A

Irregular unparalleled fashion (skin, dermis)

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45
Q

What is elastic connective tissue proper?

A

Contains elastin fibrils, accommodating stretch

46
Q

How is the cartilage supplied with nutrients?

A

The perichondrium contains periosteal blood vessels supplying cartilage with nutrients and oxygen

47
Q

What are the three main functions of cartilage?

A

Strengthens and supports connective tissue
Resists compression
Cushions and supports body structures

48
Q

Which cells actively side within the perichondrium and produce components of extracellular cartilage matrix?

A

Chondroblasts

49
Q

What are mature chondroblasts that reside within lacunae?

A

Chondrocytes

50
Q

What is the main function of hyaline cartilage?

A

Provides support and flexibility

51
Q

What is hyaline cartilage surrounded by?

A

Perichondrium or synovial membrane on articular surfaces

52
Q

What type of collagen forms hyaline cartilage?

A

Type II collagen

53
Q

Which 2 main molecules form hyaline cartilage?

A

Type II collagen

Chondroitin sulphate

54
Q

Where is hyaline cartilage typically found?

A

Reside at terminal ends of long bone to cushion joints, and at epiphyseal plates

55
Q

Which is the weakest cartilage type?

A

Hyaline cartilage

56
Q

Which type of cartilage is the strongest?

A

Fibrocartilage

57
Q

Which type of collagen is present within fibrocartilage?

A

Type I & II collagen

58
Q

What is the main function fibrocartilage?

A

Behaves as a shock absorber , and involved in reparation process

59
Q

Where is fibrocartilage mainly found?

A

Found in intervertebral discs

60
Q

What is absent in fibrocartilage?

A

Perichondrium

61
Q

Which cells are mainly found in elastic cartilage?

A

Chondrocytes located in elastic fibre network, providing strength, elasticity and maintain the shape of specific structure (auricles)

62
Q

Which three main cell classes form bone tissue?

A

Osteoclasts
Osteoblasts
Osteocytes

63
Q

What does the bone matrix comprise of?

A

Ground substance calcified with inorganic calcium-hydroxyapatite crystals, encapsulated with organic type 1 collagen.

64
Q

Which structure within compact bone comprises of a central canal?

65
Q

What term is used to describe the concentric rings of the bone matrix?

66
Q

Which cells reside within lacunae of compact bone?

A

Osteocytes

67
Q

How is extracellular fluid transported to the Haversian canal in bone?

A

Canaliculi radiate from lacunae to provide passageways through the hard matrix

68
Q

How do blood vessels interconnect within compact bone?

A

Volkmann’s canal

69
Q

What is the function of cortical bone?

A

Supports body weight, protects organs, and provides levers for movement, store & release calcium.

70
Q

Where does haemopoesis occur within cancellous bone?

A

Within red bone marrow

71
Q

What is the main function of blood?

A

Transport of oxygen, carbon dioxide, nutrients, waste and hormones
Heat distribution
Immune cells

72
Q

Which are the main cell types found within blood?

A

Erythrocytes - oxygen transport
Leukocytes - function in immunity
Platelets - blood clotting

73
Q

What is found within the blood matrix?

A

Liquid
Plasma
No fibres

74
Q

What type of disorder is rheumatoid arthritis?

A

Autoimmune disorder

75
Q

When are joints most painful with patients experiencing rheumatoid arthritis?

A

Exacerbates during rest

Resulting in a heat swollen painful joint

76
Q

What is the mechanism of action of rheumatoid disorders in terms of synovial joints?

A

Inflammation of the synovium occurs. Erosion of hyaline cartilage reduces protective barrier, thus stimulating inflammation of synovial membrane

77
Q

Which fibroblast and macrophage derived cytokines are released in rheumatoid arthritis?

A

IL-1 & TNF-alpha

78
Q

What effect arises from IL-1 and TNF-alpha?

A

Stimulates cell to secrete proteases (serine proteases, and matrix metalloproteinases), hydrolyses the joint.

79
Q

What are the 3 main mechanisms of action of rheumatoid disorders?

A

1) Erosion of hyaline cartilage
2) Inflammation of synovial membrane
3) Reduced joint space

80
Q

What are the predominant cytokines in terms of RA inflammation?

A

TNF-alpha

IL-1/6/17

81
Q

What are the main 3 symptoms of rheumatoid arthritis?

A

Joint pain
Stiffness
Swelling

82
Q

Which joints are mainly affected in rheumatoid disorders?

A

Mainly small joints are affected
BOTH small and large joints
Radio-ulnar joint, carpal-metacarpal

83
Q

Early morning stiffness is associated with which type of arthritis?

A

Rheumatoid arthritis

84
Q

What are the main cells in rheumatoid disorders?

A

Cells, IL, ANF, synoviocytes, osteoclasts, proteases, CD4 cells, plasma cells & neutrophils

85
Q

Which autoimmune disorder of connective tissue affects multiple organ systems & joints?

A

Systemic lupus erythematosus (SLE)

86
Q

What is vasculitis?

A

Collection of disorders that destroy blood vessels by inflammation

87
Q

What are the key features of rheumatoid arthritis in terms of symptom duration?

A

Symptoms peristalsis longer than 6 weeks, chronic

88
Q

What is mono arthritis?

A

1 joint is affected

89
Q

What is oligoarthritis?

A

2-4 joints affected

90
Q

What are nodules in rheumatoid arthritis?

A

Nodules are attributed with subcutaneous or periosteal pressure points.These nodules are considered to be extra-articular projections.
Demarcated by marginal erosion sand joint space narrowing

91
Q

Which factor is typically present in rheumatoid nodules?

A

Rheumatoid factor
anti-CCP
Antibodies

92
Q

How long does morning stiffness typically last for?

A

Longer than an hour

93
Q

What is the pattern and distribution of rheumatoid arthritis and swelling?

A

Swelling is symmetrical

94
Q

Which arthritis is mainly associated with metacarpal and proximal interphalangeal joints?

A

Rheumatoid arthritis

95
Q

Which joints are spared for rheumatoid arthritis?

A

Thoracolumbar spine, DIPs on fingers

IPs on toes

96
Q

What is the main difference between Rheumatoid and osteoarthritis in terms of inflammation?

A

Rheumatoid is inflammatory

Osteo has no inflammation or auto-antibodies

97
Q

Which arthritis type as no antibody affiliation?

A

Osteoarthritis

98
Q

Which types of joints are mainly affected with osteoarthritis?

A

Large, weight bearing joints

99
Q

Sclerosis of osteophytes and subchondral bone cysts are associated with which type of arthritis?

100
Q

What is primary osteoarthritis mainly associated with?

A

Advancing age
Females
occupation and obesity

101
Q

What are the main causes of secondary osteoarthritis?

A

Trauma
Surgery/removal of fibrocartilage
Infection

102
Q

ESR is elevated in which type of arthritis?

A

Rheumatoid arthritis

103
Q

What are the main radiographic changes due to arthritis?

A

Subluxation (partial dislocation)
Loss of joint space
juxta-articular bone erosions
soft tissue swelling

104
Q

What is the first treatment principle for arthritis?

A

Diagnosis

Assess current activity: Morning stiffness, synovitis, fatigue, erythrocyte sedimentation rate (ESR).

105
Q

How is arthritis severity measured?

A

Determine where the patient stands in the spectrum of disease. Document the degree of damage: ROM, deformities, joint space narrowing, X-ray erosions; and functional status.

106
Q

What is the main treatment for arthritis?

A

Education: Build a cooperative long-term relationship and personalised medical plan. Use materials from the Arthritis foundation and the ACR; use assistive devices.
Exercise: ROM, conditioning, and strengthening exercises.
Medications: Analgesic/anti-inflammatory; immunosuppressive, cytotoxic, and biologic
Balance efficacy and safety with activity.

107
Q

What are NSAIDs in terms of their use in arthritic treatment?

A

Symptomatic relief, improved function
No change in disease progression
Prednisone may substitute .

108
Q

Which types of steroids are mainly used for rheumatoid disorders?

A

Intra-articular steroids, useful for flares

109
Q

What are DMARDs?

A

Disease modifying drugs

110
Q

What are the main 5 DMARds?

A 
Minocycline
Sulfasalazine hydroxychloroquione
Intramuscular gold
Leflunomide
Etanercept

BRS (38 decks)

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