MDTI - ALL OF RHEUMATOLOGY

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Can you name the MDTI - ALL OF RHEUMATOLOGY?

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

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