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pathology mesodermal


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Osteoarthritis what occurs in osteoarthritis?
mechanical wear and tear of the joints, leads to destruction of the articular cartilage, subchondral bone formation, sclerosis, osteophytes, eburnation, Herberden's nodes (DIP), and Bouchard's nodes (PIP)
Osteoarthritis classical presentation of osteoarthritis?
pain in weight bearing joints after use (worse at the end of the day0 improves w/ rest. No systemic symptoms
Rheumatoid Arthritis : what happens in in RA?
autoimmune inflammatory proccess which affects synovial joints, w/ pannus formation in joints (MCP, PIP), S-Q rheumatoid nodules, ulnar deviation,subluxation
Rheumatoid Arthritis : classical presentation of RA?
female, 80% pts Rf positive (anti-IgG Ab) morning stiffness improving w/ use, symmetrical joint involvement, and systemic symptoms (fever, fatigue, pleurtis, pericarditis)
What is the classic triad of Sjogren’s syndrome?
dry eyes (conjunctivitis, xeropthalmia), dry mouth (dysphagia, xerostomia), arthritis
What is SICCA syndrome?
dry eyes, dry mouth, nasal and vaginal dryness, chronic bronchitis, reflux esophagitis
T/F Sjogren’s syndrome predominantly affects males between 40 and 60 years of age.
False. Females between 40 and 60 y.o are predominantly affected in Sjogren’s syndrome.
T/F Gout is the precipitation of monosodium urate crystals into joints due to hyperuricemia.
What is the favored manifestation of gout?
Podagra. (painful MTP joint)
The crystals of gout are:
needle shaped and negatively bifringent
T/F Pseudogout is the precipitation of calcium pyrophosphate crystals within the joint space.
The crystals of psuedogout are:
basophilic, weakly positively birefringent, rhomboid crystals
Psudogout usually affects:
Large joints (classically the knee)
T/F Both gout and psuedogout predominantly affect men.
False. Gout is more common in men. Pseudogout affects both sexes equally, most pts are >50 years old.
T/F The treatment for both pseudogout and gout is allopurinol, probenecid, colchicines, and NSAIDS.
False. That is the tx for gout. However, there is no tx for pseudogout.
Celiac sprue is the autoimmune-mediated intolerance of what substance, leading to steatorrhea?
gliadin (wheat)
T/F Findings in Celiac sprue include blunting of villi, neutrophils in the lamina propria, and abnormal D-xylose test.
False. lymphocytes, not neutrophils are found in the lamina propria.
What drugs can produce a SLE-like syndrome that is commonly reversible?
HIPP: Hydralazine, INH, Phenytoin, Procainamide
SLE causes LSE. What is LSE?
Libman Sacks Endocarditis. Valvular vegetations found on both sides of valve (Mitral Valve Stenosis) and do not embolize.
T/F 90% Systemic lupus erythematousus pts are female between ages 14 and 45. SLE is most common and severe in black females.
Both statements are true
What are 4 lab tests in SLE? Which test, when positive is predictive of a poor prognosis?
1. ANA (antinuclear antibodies)- sensitive, not specific for SLE 2. anti-ds DNA (antibodies to double stranded DNA)- very specific, poor prognosis 3. Anti-Smith antibodies (anti-Sm)- very specific, but not prognostic 4. Antihistone antibodies- drug induced lupus
In what organ are wire loop lesions found in SLE?
kidney (with immune complex deposition and nephrotic syndrome)
What causes death commonly in SLE?
Renal failures and infections
What are symptoms of SLE?
fever, fatigue, wt loss, joint pain, malar rash, photosensitivity. Also: pleuritis, pericarditis, nonbacterial verrucous endocarditis, Raynaud’s phenomenon
What disease is characterized by gamaglobulinemia, rheumatoid arthritis, ace increase, interstitial fibrosis, and noncaseating granulomas?
Name 2 seronegative spondyloarthropathies.
ankylosing spondylitis, reiters’ syndrome
What is a seronegative spondyloarthropathy?
Arthritis without rheumatoid factor (no anti-IgG Ab). Strong association with HLA-B27 (gene that codes for HLA MHC1)
T/F seronegative spondyloarthropahties occur more often in males
What is the classic triad for Reiter’s syndrome?
Urethritis, conjunctivitis and anterior uveitis, arthritis. “Can’t see, can’t pee, can’t climb a tree”
T/F reiter’s syndrome occurs commonly post respiratory or chlamydia infections.
False. Post-GI or chlamydia infections
Describe ankylosing spondylitis
Chronic inflammatory disease of spine and sacroiliac joints. Ankylosis (stiff spine), uveitis and aortic regurg.
T/F Crest syndrome is wider-spread than diffuse scleroderma.
False. Diffuse scleroderma has widespread skin involvement, rapid progression, early visceral involvement. CREST syndrome has limited skin involvement, often confined to fingers and face. More benign clinical course.
what does CREST stand for?
False. CREST= calcinosis, raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia.
What antibodies are associated with scleroderma (progressive systemic sclerosis- PSS)?
"diffuse scleroderma- anti-Scl-70 antibody; CREST--anticentromere
T/F Pemphigus vulgaris is described as an autoimmune disorder with IgG antibody against epidural basement membrane (linear immunofluorescence). Affects skin but spares oral mucosa.
False. That description is for Bullous pemphigoid (less severe disease than Pemphigus vulgaris). Pemphigus vulgaris is a potentially fatal autoimmune skin disorder. Intradermal bullae involve the oral mucosa and skin. Findings include acantholysis, IgG ab against epidermal cell surface.
T/F Dermatitis is a group of inflammatory pruritic skin disorders. The etiology is allergy (usually type IV hypersensitivity), chemical injury, or infection.
What HLA groups are associated with psoriasis?
HLA-B27, HLA-13, HLA-17
What is psoriasis? Where is it most commonly found?
Psoriasis is nonpruritic chronic inflammation of the skin, particularly on the knees and elbows.
T/F Goodpasture’s syndrome affects the lungs and liver.
False. Lungs and Kidneys. (Pulmonary hemorrhagesà hemoptysis, renal lesionsà hematuria, anemia, crescentic glomerulonephritis)
What type of Abs are associated with Goodpastures?
anti-glomerular basement membrane abs produce linear staining on immunofluorescence.
Who commonly gets Goodpastures?
Men between 20-40 years.

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