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Can you name the MDTI - ALL OF RHEUMATOLOGY?

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

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Created Feb 5, 2012ReportNominate
Tags:disease, prompt