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

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