ALU 301: Chapter 3: Rheumatoid Arthritis Exam with Correct Answers

Rheumatoid Arthritis - correct answer A chronic inflammatory polyarthritis of unknown etiology that targets the synovial tissue of movable joints. Arthritis is the primary symptom but just one manifestation of a more extensive systemic inflammatory process. HLA-DR4 (a human leukocyte antigen) - correct answer A type of histocompatibility Class II antigen believed to be associated with an increased suspectibility to RA and is is found in the majority of people with RA. Also an indicator of a more severe form of the disease. Synovial joint - correct answer Also called a diarthrodial joint is composed of two bones held together by fibrous capsule that is lined with synovium. The two bones are capped with cartilage and are separated by a thin layer of synovial fluid. Together they permit frictionless movement of the joint Synovium - correct answer Provides nutrients to the avsacular cartilage. Produces hyalauonic acid that lubricates the joint. Produces collagen and fibronectin used for the synovial matrix Immunologic elements involved in the development of RA - correct answer T-Cells, macrophage/fibroblasts and B-Cells. Initially THelper 1 (TH1) CD4 cells are believed to be the key to the inflammatory process. Chronic Synovitis - correct answer A progressive process manifested by hypertroophy of the cells lining the synovium, neo-angiogenesis (the growth of new blood vessels)....An influx of TNFs into the synovium activates the production of other inflammtory cytokines and the fluid in the synovial cavity produces effusions (fluid in the joint cavity). Pannus Formation, the end product of this process Pannus Formation - correct answer The end product of the synovitis process. Pannus - correct answer An aggressive inflammatory tissue that spreads across the joint surface infiltrating and eroding adjacent bone and articular cartilage and producing enzymes that break down connective tissue.. Eventually it (_______) fills the joint, destroys articular cartilage and stretches (and at times ruptures) attached tendons. The end result is permanent joint deformity. Anti-inflammatory Cytokines - correct answer Soluble tumor necrosis factor receptor Interleukin-1 receptor antagonist (IL-1ra) Transforming growth fact B (TBF-B) Interleukin 10 (IL-10 Pro-Inflammatory Cytokines - correct answer Tumor necorsis factor alpha (TNF-a) Interleukin 1, 2, 4 , 6, or 8 IFN-y, Granulocyte macrophage colony stimulating factor (GM-CSF) TNF-a and IL-1 - correct answer Play a significant role in the development of RA by producing substances that degrade tissues and activate other inflammatory mediators. They also trigger the production of IL-6, IL-8 and GM-CSF as well a s prostaglandins, osteoclasts and metalloproteinases at the cartilage/pannnus junction Most Common Symptoms of RA - correct answer Pain, stiffness and swelling of the diarthrodial joints (moveable joints lined with synovium) Most common joints affected by RA - correct answer PIP and MCP of the hands. MTP of the feet, wrists , elbows, shoulders, ankles and knees PIP--proximal interphalangeal MCP--metacrpophalangeal MTP--metatarsophalangeal