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15 Cards in this Set

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RA and T cells
- HLA DRB1 is the HLA II molecule that makes it genetic
- T cells recognize this and this is key in RA path
- most lymophcyets you see in imfalmed RA synovial membrane are T cells
RA and B cells
- 70% of pts produce RF, and IgM that goes agaist the IgG
- there is an IgG RF, and that gets arterial lumen and causes vasculitis
RA pathology
- synovial membrane has macros, lymphos, plasma cells, and granulocytes
- rheumatoid nodule ahs palisaides of epi ce3lls in a mantle of lymphos
- if bad, hypertrophy of synovial membrane and AC erosion
- can even erode bone
RA clinical
- ulnar deviaiton
- swan neck and boutineer
- like wrists and hands (MCPs)
- can get heart, eyes, NS, kidneys (amyloid), blood
Sjogren syndrome
- 15% of RA pts
- infiltration of exocrine gland w/ lymophcytes
- keratoconjuctivitis sicca, xerostomia, lymph infiltration of parencymal orgain
- increased risk of lymphoid malignancy
RA labs
- RF common, doesn't dx or exclude
- Ab's to CCP, more specific
- sed rate up
- normochromic, normocytic anemia
- minority have ANA
RA tx (overview)
- NSAIDs
- corticosteroids
- DMARDs
- therapy
- surgery
Infliximab
TNF-a inhibitor for RA
Enteracept
TNF-a inhibitor for RA
Adlimumab
TNF-a inhibitor for RA
anakinra
IL-1 antagoinst for RA
rituximab
B cell therapy for RA
Ankylosing Spondylitis
- young to middle aged men
- pain and stiffness in lower back
- somtimes infommation of large joints, uveal tract, or aotra intima too
- progressive movement up the spine, spinal fusion, especially SI joints
- associated w/ HLA-B27 gene
Reiter's syndrome
- arthiritis of large joints (knees and ankles), uvitis, skin lesions, and urethritis
- linked to chlamydia, but may be shigella, yersinia, and salmonella
- peristosis of heel
- may be 1 attack or many
- can get chronic and look just like ankylosing spondylitis
Psoriatic arthritis
- pencil cup x-rays
- ASx oligoarthritis
- like DIPs
- some may get spondylitis associated w/ HLA-B27 gene