Week 8 Flashcards
5 antibody classes
Ig M, A, D, E, G
secondary immune response is characterized by __
rapid increase in IgG and remains elevated after second exposure
major cell type in synovial fluid
neutrophils
major cell type in pannus
T lymphocyte & macrophages
minor cell type in pannus
fibroblast, plasma cells, endothelium, dendritic cells
primary site of rheumatoid arthritis is __
synovium
primary site of spondyloarthropathies is __
enthesis
spondyloarthropathies process
mechanical injury > vasodilation > entheseal inflammation > new bone formation
gout involves the deposition of __
mono sodium urate crystals
MSU crystals activate __ pathway
inflammasome
osteoarthritis is caused by __
aging, obesity, lifestyle choices
what is the lead up to osteoarthritis
chondrosenescence
articular pain symptoms
- over joint line
- global decrease in ROM
- pain at rest
periarticular symptoms
- away from joint line
- decreased ROM in 1 plane
- pain upon initiating movement
how to differentiate mechanical from inflammatory pain
mechanical has no morning stiffness & night pain; only gets worse with activity
early stiffness in inflammatory arthritis is caused by __
IL-6
monoarticular
1
oligoarticular
2 - 4
polyarticular
> 4
ankylosing spondylitis affects __
spine, SI joint, hip, shoulder
rheumatoid arthritis affects __
proximal joint of digits, symmetric, TMJ & C-spine involved
reiter’s syndrome affects __
lower extremity, lumbosacral spine, SI joints, asymmetric
psoriatic arthritis affects __
distal hands & feet, lumbosacral spine, SI joint, asymmetric
osteoarthritis affects ___
neck, lumbosacral spine, hip, knee, 1st MTP of foot, DIP, PIP, 1st CMC of hand
what is rheumatoid arthritis
autoimmune disease where joints attacked leading to chronic swelling & bone destruction
psoriatic arthritis clinical features
- dactylitis
- pencil in cup deformity
- Achilles tendinitis
- hairline psoriasis
- DIPJ synovitis, onycholysis
Arthritis mutilans in psoriatic arthritis are ___
telescoped digits
ankylosing spondylitis clinical features
question mark posture, hyperextended neck, kyphotic, loss of lumbar lordosis, bamboo spine (used SI joints)
stages of gout
asymptomatic hyperuricaemia > acute intermittent gout > chronic tophaceous gout
x-ray images indicating gout
rat bite at edges, hydroxyapatite crystals leading to milwaukee shoulder & calcific tendinitis
between RA, PsA, Gout, OA, which are inflammatory / mechanical arthritis
inflammatory = RA, PsA, Gout
mechanical = OA
most patients with OA will have __ knees
genu varus / bow legged
patients with secondary OA will have __ knees
valgus
arachidonic acid oxidation leads to __
eicosanoids
eicosanoids are synthesized as needed when ___
activated by trauma or cytokines which activate phospholipase A2
prostanoids include
prostaglandins, prostacyclin, thromboxane
thromboxane A2 is used for __
platelet aggregation
prostacyclin is used for __
vasodilation & inhibit platelet aggregation
prostaglandins used for __
gastroprotection
inflammation, pain, fever
PGG2 converted to PGH2 by __
peroxidase
DMARDs
disease modifying anti-rheumatic drugs for RA
types of DMARDs
conventional synthetic, biological, targeted synthetic
tofacitinib
janus kinase inhibitor for RA
