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Pathophysiology > Unit 3 - CVD Pt 1 > Flashcards

Unit 3 - CVD Pt 1 Flashcards

1
Q

Common features of Collagen Vascular Disease

A
  • all affect blood vessels via collagen
  • all chronic diseases
  • all autoimmune diseases caused by formation of autoantibodies
  • affect more females than males (except CVD polyarteritis nodosa)
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2
Q

common s/s of CVD

A
  • weight loss
  • anemia
  • fatigue, fever, malaise
  • joint and musculoskeletal pain
  • joint deformities (swan neck and boutonniere)
  • elevated ESR
  • raynaud’s
  • rash
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3
Q

rheumatoid arthritis facts

A

Inflammatory Joint Disease
Likely has Systemic Effects
Female: Male = 5:2
Peak 40-60 years of age

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4
Q

RA info

A 
Affects Joints
Inflammation:
Joint Capsule
Synovium
Destroys Articular Cartilage 
Bone Destruction (Erosion) with pannus formation 
Nodules/granulomas
Extra-artocular manifestations
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5
Q

juvenile RA and 2 types

A

RA in Children
Joint swelling and pain
Polyarticular: 4 or more joints*** - small joints
Pauciarticular: less than 4 joints - large joints

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6
Q

JRA clinical feutres and prognosis

A

Asymmetrical Pattern of joint involvement
Some children “age out” and go into remission
Others do not “age out”
More joints affected, the more likely the disease will be chronic in nature

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7
Q

systemic JRA (still’s disease) triad

A
  1. Joint swelling and pain
  2. Spiking fever (>102 degrees F)
  3. Rash (Salmond colored, bumpy)
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8
Q

adult onset still’s disease

A 
(rare)
Systemic Inflammation:
Joint swelling and pain
Spiking fever
Rash (Salmond colored, bumpy)
Pericarditis
Pleuritis
Gastroenteritis and Nausea
Pharyngitis
Enlarged Lymph Nodes
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9
Q

rheumatoid pannus

A

inflammatory exudate which collects around and over the synovial lining of affected joints
Highly vascularized granulation tissue
Derived from the synovial membrane

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10
Q

extra-articular manifestations of RA - skin

A

subcutaneous nodules
vasculitis - brown spots
ecchymosis - bruising

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11
Q

extra-articular manifestations of RA - heart

A 
Myocarditis
Valvulitis
Pericarditis
tamponade (rare)
all can lead to CHF
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12
Q

extra-articular manifestations of RA - lungs

A

Pleuritis with/out pleural effusion (fluid in pleural space)

pulmonary inflammatory lesions - causing interstitial lung disease

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13
Q

extra-articular manifestations of RA - eyes

A

Scleritis or Conjunctivitis

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14
Q

extra-articular manifestations of RA - nervous system

A

Peripheral neuropathy
Sensory nerves: Stinging and burning
peripheral compression syndromes (carpal tunnel, ulnar nerve, peroneal palsy, cervical spine)
Mx weakness and decreased DTRs

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15
Q

extra-articular manifestations of RA -systemic

A 
anemia (60% - common)
osteoporosis
Felty's syndrome
Sjogren's syndrome
Amyloidosis (rare)
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16
Q

felty’s syndrome

A

RA, splenomegaly, leukocytopenia (dec WBCs)

17
Q

Sjogren’s syndrome and blood marker

A

Dryness of Mucous Membranes
Mouth, Skin, Vagina
Parotid and Lacrimal gland Enlargement
Telangiectasias-small dilated capillary spots

*Anti Ro/SS-A is a blood marker present in about 70% cases

18
Q

Amyloidosis

A

Accumulation of proteins in the form of abnormal, insoluble fibers
Known as Amyloid fibrils
Accumulate within the extracellular space in the tissues of the body

19
Q

RA assessment criteria

A
  • 3+ joints in adults
  • usually in a symmetrical pattern (monoarthropathies in kids)
  • subcutaneous nodules
  • morning stiffness and pain for 1+ hour
  • ulnar drift and other deformities
  • bony erosion and loss of joint space shown on xray
20
Q

most specific criteria suggesting presence of RA

A

Rheumatoid factor measured in blood (IgM and IgG)

80-90%

21
Q

another blood marker associated with RA

A

Anti-CCP
acts as an autoantibody
blood test measures levels of antibodies that bind citrulline and CCP

inflammatory indicators will also be elevated - CRP and ESR

22
Q

Is OA a CVD

A

No!

it is a degenerative joint disease (DJD)

23
Q

OA etiology

A
  • genetic: 12th chromosome mutation
  • trauma to a joint
  • 45+ yrs
  • females more
24
Q

OA info

A 
Progressive Joint Disease 
Chronic Non-inflammatory joint disease**
OA is not a systemic disease
Destruction of articular cartilage
Formation of osteophytes (bone spurs)
Articular cartilage worn away and loses compressibility, decrease bone space
25
Q

OA mainly affects which joints

A

weight bearing joints

- hips, knees, ankles, feet, spine

26
Q

Nodes and finger joints RA vs OA

A

OA - DIPs affected - Heberden’s nodes

RA - PIPs affected - Bouchard’s nodes when OA

27
Q

Dx of OA

A
  • morning stiffness shorter duration than RA, but pain progresses throughout the day
  • no diagnostic markers in the blood
  • possible C-telopeptid marker
28
Q

composition of normal articular cartilage

A

Chondrocytes-cells that make cartilage
Collagen fibers-most abundant substance
Proteoglycans-macromolecules with high water content
Normal cartilage composed of Type II collagen
Coded by the COL2A1 Gene
Located on the long term of chromosome 12

29
Q

Type II collagen traits

A

Normal remodeling

Normal compressibility

30
Q

Mutation in the COL2A1 Gene

A

Increased degradation of proteoglycans and Type II collagen-net loss over time –> Type I collagen replaces Type II
Proteoglycan loss
Loss of compressibility causes cartilage to wear down

31
Q

other types of OA

A

Erosive inflammatory osteoarthritis
Ankylosing hyperostosis
Secondary osteoarthritis

32
Q

Erosive inflammatory osteoarthritis

A
  • Affects MCP/IP joints of the hand

- Cartilage particles cause inflammation

33
Q

Ankylosing hyperostosis

A

Affects the lumbar spine
Elderly patients
Note the osteophytes (bone spurs)
Note loss of the intervertebral joint spaces (vertebral bodies)

34
Q

Secondary osteoarthritis

A

interarticular fracture, trauma

sports injury

Pathophysiology (27 decks)

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