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

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