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zFoundations of Pathophysiology > Topic 5: Joint Disease > Flashcards

Topic 5: Joint Disease Flashcards

1
Q

What are some functions of synoviocytes?

A
  • phagocytose dead/dying tissue
  • secrete synovial fluid
  • maintain homeostasis within joint
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2
Q

What are some functions of the synovial membrane?

A
  • produce lubricin and hyaluronic acid (maintains integrity of AC)
  • nutrient exchange
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3
Q

What are the functions of AC?

A
  • frictionless motion
  • even distribution of joint load
  • disperse energy from loading
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4
Q

What are the properties of AC?

A
  • avascular –> no inflammatory response
  • aneural –> no source of pain
  • alymphatic
  • hypocellular –> low density of chondrocytes
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5
Q

What type of inflammation is OA?

A

dysregulated para-inflammation

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6
Q

What is the onset age of OA?

A

50-60yrs

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7
Q

What types of problems occur as a result of OA?

A

synovitis, alterations of joint capsule, degeneration of menisci and ligaments, AC breakdown, osteophyte formation, subchondral bone oedema + swelling

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8
Q

Role of synovium in OA

A
  • decreased levels of HA and lubricin
  • decreased cartilage protecting factors and increased degradation factors
  • synovial inflammation precedes structural changes
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9
Q

Role of AC in OA

A
  • over-expression of degradation enzymes

- fibrillation

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10
Q

Role of biomechanical influences in OA

A
  • mal-alignment: abnormal load distribution
  • loss of mensical tissue: alterations in load transmission, increased peak load stresses
  • cartilage lesions: exposure of sub-chondral bone
  • joint instability and ligament laxity: increased translation
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11
Q

Role of obesity in OA

A

adipokines - pro-inflammatory

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12
Q

Role of age-related changes in OA

A
  • increased SASP secretion
  • oxidative stress/damage
  • decreased growth factors
  • increased AGE formation (advanced glycation end-product)
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13
Q

Inducers of OA

A

Endogenous

  • cell-derived alarmins
  • tissue-derived metabolites
  • ECM-derived
  • AGEs
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14
Q

Sensors of OA

A

PRRs

  • osteocytes and chondrocytes in sub-chondral bone
  • tissue-resident macrophages
  • synoviocytes
  • chondrocytes
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15
Q

Effectors of OA

A
  • AC chondrocytes
  • tissue-resident macrophages and mast cells
  • fibroblasts in ligament capsule
  • osteocytes and chondrocytes in sub-chondral bone
  • synoviocytes
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16
Q

Clinical features of OA

A
  • crepitus
  • decreased muscle strength
  • joint instability
  • deformities - genu varus/valgum
  • pain in joint
  • loss of ROM
  • joint enlargement
17
Q

Pathology of OA

A
  • cartilage loss - decreased matrix material produced
  • cartilage softening –> cracking, flaking, fibrillation, fissuring –> exposure of subchondral bone –> eburnation
  • sunchondral cysts
  • local muscle weakness
18
Q

What is the onset age of RA?

A

25-50 years

19
Q

What is the gender bias of RA?

A

females 2.5:1

20
Q

What is an antigen?

A

cause immune response to produce antibodies

21
Q

What is an antibody?

A

immunoglobulins, specific, adaptive immune system

22
Q

What is an auto-antigen?

A

endogenous, body attacks self

23
Q

Aetiology of RA

A
  • Rh factors produce (auto-antibodies that react with immunoglobulins)
  • immune complexes lodge in walls of synovial joints and blood vessels and attract immune cells
24
Q

Inducers of RA

A
  • endogenous - genetic factors
  • PAMPs and DAMPs - cell-derived alarmins (Rh factors), tissue-derived inducers, pathogen-derived alarmins
  • exogenous: microbial (PAMPs, virulence factors), non-microbial (allergens, irritants)
25
Q

Sensors of RA

A

PRRs

  • chondrocytes
  • synoviocytes
  • B + T cells
  • osteocytes + condrocytes in sub-chondral bone
  • tissue-resident macrophages
26
Q

Effectors in RA

A
  • AC chondrocytes
  • tissue-resident macrophages
  • synoviocytes
  • osteocytes and chondrocytes in sub-chondral bone
  • T + B cells
  • antigen-antibody complexes
27
Q

What is pannus?

A
  • collection of fibroblasts, T + B lymphocytes
  • fills joint space and contributes to fibrillation of AC
  • releases cytokines and enzymes
28
Q

What is the onset age of RA?

A

25-50yrs

29
Q

What are some potential causes of RA?

A

stress, genetics

30
Q

Does Rh trigger RA?

A

no, because not everyone with RA has Rh factors

31
Q

Clinical features of RA?

A
  • joint pain + tenderness
  • swelling
  • flu-like symptoms
  • decreased ROM
  • joint deformities
32
Q

What are whole body features of RA?

A

-subcutaneous nodules, vasculitis, pericarditis, nodules in sclera, renal sclerosis, sleep disturbances

33
Q

What is the pattern of joint involvement in RA?

A

bilateral, polyarticular

34
Q

What is the pattern of joint involvement in OA?

A

weight-bearing synovial joints usually

zFoundations of Pathophysiology (10 decks)

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