Just For Fun Quiz / MDTI - ALL OF RHEUMATOLOGY

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Can you name the MDTI - ALL OF RHEUMATOLOGY?

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

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