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15 Cards in this Set
- Front
- Back
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RA and T cells
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- 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 |
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RA and B cells
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- 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 |
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RA pathology
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- 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 |
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RA clinical
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- ulnar deviaiton
- swan neck and boutineer - like wrists and hands (MCPs) - can get heart, eyes, NS, kidneys (amyloid), blood |
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Sjogren syndrome
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- 15% of RA pts
- infiltration of exocrine gland w/ lymophcytes - keratoconjuctivitis sicca, xerostomia, lymph infiltration of parencymal orgain - increased risk of lymphoid malignancy |
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RA labs
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- RF common, doesn't dx or exclude
- Ab's to CCP, more specific - sed rate up - normochromic, normocytic anemia - minority have ANA |
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RA tx (overview)
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- NSAIDs
- corticosteroids - DMARDs - therapy - surgery |
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Infliximab
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TNF-a inhibitor for RA
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Enteracept
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TNF-a inhibitor for RA
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Adlimumab
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TNF-a inhibitor for RA
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anakinra
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IL-1 antagoinst for RA
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rituximab
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B cell therapy for RA
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Ankylosing Spondylitis
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- 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 |
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Reiter's syndrome
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- 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 |
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Psoriatic arthritis
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- pencil cup x-rays
- ASx oligoarthritis - like DIPs - some may get spondylitis associated w/ HLA-B27 gene |
