MDTI - ALL OF RHEUMATOLOGY

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Can you name the MDTI - ALL OF RHEUMATOLOGY?

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

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Created Feb 5, 2012ReportNominate
Tags:disease, prompt