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

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