Serology 3 Flashcards
define RA
a chronic inflammatory disease that affects most joints, especially MCPs, PIPs and wrists, however any synovial joint can be involved
what do abnormal IgG antibodies get produced by?
lymphocytes in the synovial membranes
act as antigens
RF measures
IgM antibodies against IgG
if someone has decreased joint space bilaterally and symmetrically, what labs would be appropriate?
RF
SED rate
CBC (if anemia was suggested)
if there is one joint that is decreased, what must be a ddx? what labs would be appropriate?
infection
CBC
RF
HLAs test for?
the presence of leukocyte antigens present on human cell surfaces
HLAs are useful in?
organ and tissue transplants to identify histocompatibility between donor an recipient
diagnostic adjunct in certain rheumatoid disorders (AS)
what HLA is found in myasthenia gravis?
HLA-B8 and DR 3
AS
chronic inflammatory disorder, predominantly affecting young adults males
primarily involves axial skeleton
s/s of AS
ligamentous ossification and enthesopathic changes
chronic LBP in young men
aching stiffness typically originates in the low back, espeically noted about the SI joints
what is the most common seronegative arthropathy?
AS
initial changes in AS
synovial proliferation, inflammatory cellular infiltrate producing pannus
clinical features of AS
males 15-35 years 3 months of physcian observed pain and stiffness limited spinal motion sacriliitis limited chest expansion presents as spinal pain and stiffness iritis, conjunctivitis usually no disability, sometimes severe aortic insuffieciency pulmonary fibrosis
AS lab results
+HLA B27
+ESR
-RA
-ANA
management of AS patients
long term plan to prevent, decrease or delay joint and postural deformities
NSAIDS to limit joint inflammation and pain
suggest a rheumatological consultation with any of the inflammatory joint diseases
difference between inflammatory enthesopathy and degenerative spur
enthesopathies are cloud like in appearance
degenerative spurs have a good cortical outline
characteristics of sacroiliitis
bilateral and symmetrical
loss of subchondral bone
osteitis (sclerosis)
joint widening
if sacroiliitis is unilateral, what are the ddx? what labs would you order?
infection
AS
CBC
HLA B27
squared vertebral bodies slightly sclerotic irregular SI joints decreased disc height asymmetrical facets slight curve DDX, labs?
most likely AS, enteropathic arthritis, psoriatic arthritis and Reiter’s
HLA B27
if negative, BCP
factors that can influence host resistance are?
general health subluxations patient defense previous contact ability to produce antibodies past clinical hisotry age stress sleep deprivation exposure to antiboitics type of treatments received type of tissue involved, etc
