MDTI - ALL OF RHEUMATOLOGY

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Can you name the MDTI - ALL OF RHEUMATOLOGY?

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

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