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*MSK > Science of Rheumatoid Arthritis > Flashcards

Science of Rheumatoid Arthritis Flashcards

1
Q

What are the functions of synovium?

A

Maintenance of intact tissue
Lubrication of cartilage
Control synovial fluid volume
Nutrition of chondrocytes

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2
Q

RA typically affects which joints?

A

Small joints of hand + feet

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3
Q

Rheumatoid synovitis is characterised by what?

A

Inflammatory cell infiltration
Synoviocyte proliferation
Neoangiogenesis

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4
Q

What does synovial fluid contain during acute flares of RA?

A

Neutrophils

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5
Q

How does Seropositive RA present?

A

Rheumatoid factor
ACPA
Diagnostic anti-CPP

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6
Q

How does ACPA+ve diagnosis effect the prognosis?

A

Less favourable prognosis

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7
Q

Anto-antibodies attack what in RA?

A

self IgG Fc

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8
Q

What genes are associated with RA?

A

HLA-DRB1
PTPN22
CTLA4

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9
Q

What are the environmental factors associated with RA?

A

Infectious agents
Smoking
Exposure to silica
Repeated insults in the genetically susceptibly

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10
Q

What infectious agents are associated with RA?

A 
EBV, CMV
E. coli 
Mycoplasma
Periodontal disease
Microbiome disruption
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11
Q

What is Citrullination?

A 
Conversion of arginine in a protein into citrulline 
Effects enzymes (peptidylarginine)
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12
Q

What is synovitis in RA?

A

Neutrophils in synovial fluid with neoangiogenesis due to cytokines

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13
Q

What is the pathogenesis of RA?

A 
Inflammation of the synovium
Villous hyperplasia 
Infiltration of T cells, B cells 
Fibroblast proliferation 
Increased vascularity
Increased cytokines
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14
Q

What are the roles of B-cells in rheumatoid arthritis?

A

CD20+ B cells produce autoantibodies

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15
Q

What cytokines are involved in RA?

A

TNF-a

IL-6, 1, 15, 18

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16
Q

What are the role of inflammatory cytokines in RA?

A

Endothelial-cell adhesion molecules
Activate fibroblasts, chondrocytes, osteoclasts
Angiogenesis
(IL-6)

17
Q

What is the role of neoangiogenesis in RA?

A

Provides nutrients to the hyperplastic synovium

18
Q

What are the triggers for neoangiogenesis?

A

Hypoxic conditions

Angiogenic factors - IL-8, VEGF

19
Q

What are the systemic consequences of rheumatoid arthritis?

A 
Cardiovascular disease 
Vasculitis, Scleritis 
Fatigue 
Reduced cognitive function
Liver (anaemia)
Interstitial lung disease
Muscle/bone weakness
Sjogrens
20
Q

What cells mediate bone and cartilage destruction?

A

Osteoclasts

Fibroblast-like synoviocytes

*MSK (25 decks)

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