MDTI - ALL OF RHEUMATOLOGY

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Can you name the MDTI - ALL OF RHEUMATOLOGY?

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PromptsDiseases
Schirmer's test
African Americans have particularly high anti-SCL70, bad prognosis
environmental influence of vinyl plastics, hair dyes
Can be caused by increase in enzyme APRT
interferon signature connects viral infection to lymphocyte invasion
6% concordance among MZ twins
IFN signal induced by DNA/RNA containing complexes
polymorphisms in HLA DR2/DR3
slow progression over time
HLA DQ7/DR5 associated
Mainly affects DIP, Knee, and 1st MCP joints
fibrillations
cytokines: TGFb, CTGF, PDGF(r)
Can be caused by increase in enzyme XO
IFNalpha upregulates TLR7/IRF7 to help uptake of DNA/RNA containing complexes
cytoplasmic and perinuclear antibodies
monoarthritic arthritis, usually 1st MTP/Knee/Ankle
cholinesterase
2000-100,000 white cells in joint fluid
IFN-g/TNFa both inhibit SMAD activity
Tophi in olecranon bursa
problems in the WNT pathway
anti-M3
CXCL 13 - B-cells
Belimumab (2)
Raynaud's Phenomenon precedes it
4:1 female to male ratio
subchondral sclerosis
Vital Dye test
two causal reasons: highly vascularized synovium, no basement membrane
associated with previous damage (RA, OA), diabetes mellitus, immunosuppression
Allopurinol
Genetic defect in COL1A2, TGFb, Fibrillin 1
75% of people get this
antibiotic resistant arthritis possibly due to mimcry between OspA and LFA
Interferon Signature (1)
sialadenitis
Characterized by immune dysregulation/vascular dysfunction/fibrosis
Inflammasomes
3 stages, last one develops B cell Lymphoma
PromptsDiseases
Possible mimicry between retroviruses and anti-SCL70
focus
Belimumab (1)
karryohexis
anti-ANA are first important sign
Blys
estrogen and prolactin cause activation/proliferation of lymphocytes
HLADRB1 association
CREST
malar rash
Uric Acid Kidney Stones
osteophytes
Febuxostat
Defect in clearance of apoptosis
Anti-SCl-70 (Topoisomerase 1)
Anti-centromere antibodies seen in limited version
fibroblasts upregulate PDGFr in response to TGFb
Comes in both diffuse/limited versions
Heberden's Node
ANA test involves permeabilizing cells
cppd
polymorphisms in C2/C4 genes
lack of DHEA
Anti-Smith, Anti-dsDNA, Anti-SSB
Cytokines: IL-6, IL-17, IFN-alpha
Probenecid
lymphepithelial lesion
NALP3
crescentic glomerulonephritis
early, early disseminated, late disseminated spread
Pyrazinamide, Nicotinate, Lactate all stimulate URAT1
Can be caused by deficiency of HGPRT
30% associated with HepB infection
Can be caused by increase in enzyme PRPP
A20 mutation leads to too much NfKb
Type I/III collagen production
Pathway: Nalp3 -> IL-1b -> NfkB -> attracting of neutrophils
spares lung/kidneys
Alcohol increases conversion of ATP to AMP; produces lactate that acts on URAT1
Cytokines Involved: IL-1, IL-6, IL-17, TNFalpha
PromptsDiseases
cartilage fragments mediate inflammation
20-200 white cells in joint fluid
fibroblasts turn to myofibroblasts
>50,000 cells, >95% PMN's
Vascular injury may be initiating factor
cells inappropriately express both MHC1 and 2
Acute Uric Acid nephropathy (especially in cancer patients with chemo drugs)
Defect in Complement Receptor 1, FCyR
Fibrosis leading to ischemia and organ damage
increase vascularization of cartilage which allows cytokine spread
sicca
Interferon Signature (2)
hypertrophy of chondrocytes, but decrease in collagen production
Occurrence linked to ingestion of purine/pyrimidines, endogenous production of urate, and breakdown of tissues
Bouchard's Node
fibrinoid kidney necrosis causes hypertension
treat acute flair up with NSAIDs, colchicine, corticosteroids
anti-ssa/ssb (not lupus)
Oxypurinol
CXCL 12 - T-cells
cast nephritis
URAT1
cells express Bax, lymphocytes express BCLxl
renal hypertension due to medium vessel closure
discoid rash
treat with physical therapy, braces, NSAIDs
40% twin concordance
transmural inflammation
TGFb/SMAD signaling
TGFb/CTGF sensitize fibroblasts and increases collagen production
environmental triggers are UV exposure/DNA or RNA viruses/Medication
msu crystals
90% male, correlated with obesity and alcohol use
Sex hormones/chromosomes are important
Cytokines Involved: IL-1, IL-6, IL-17, TNFalpha, with TNF-alpha being the boss
ectopic lymphoid follicles in salivary glands
TGFb downregulated metalloproteinase release
200-2000 white cells in joint fluid
BAFF

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