Term
|
Definition
| synovial membranes of diarthrodial joints |
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Term
|
Definition
1% population
2.5x more in women
ages 30-50 peak, but can occur any age |
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Term
|
Definition
the synovium
-space within capsule that nourishes cells of joint |
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Term
|
Definition
infiltration of inflammatory mediators
-lymphocytes, macrophages, cytokines |
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Term
|
Definition
forms in the joint with RA
a fibroblast hyperplasia
leads to structural damage |
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Term
| which parts of spine are NOT affected by RA |
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Definition
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Term
|
Definition
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Term
| earliest treatment for RA |
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Definition
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Term
|
Definition
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Term
| initial drug given to someone suspected to have arthritis |
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Definition
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Term
| pros of NSAIDS- in regard to arthritis |
|
Definition
anti-inflammatory
increased flexibility
analgesia |
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Term
| cons of nsaids with arthritis |
|
Definition
don't affect disease progression
long term: GI effects, ulcerations
fluid/Na retention --> HTN |
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Term
|
Definition
respiratory alkalosis
metabolic acidosis |
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Term
| corticosteroids are more/less potent than NSAIDS |
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Definition
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|
Term
| a common use of corticosteroids in RA |
|
Definition
| as a bridge to another treatment form |
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Term
|
Definition
enters cell, binds steroid receptor
alters transcription ~20%
-less IL-2, T-cell prolif, PGE and leukotriene synthesis |
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Term
| short/medium side effects of corticosteroids |
|
Definition
increased appetite
nervousness, insomnia
*delayed wound healing |
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Term
|
Definition
osteonecrosis
osteoporosis, bone demin.
increased infection
adrenal insufficiency (bc exogenous steroid) |
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Term
| secondary adrenal insufficiency |
|
Definition
exogenous steroid means less ACTH produced
inability to synthesize cortisol levels
need MORE steroid prior to surgery
may lead to hypotension, shock, fever, nausea, vomiting, fatigue, hypoglycemia |
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Term
|
Definition
prednisone
cortison
hydrocortisone
dexamethasone |
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Term
|
Definition
| disease modifying anti-RA drugs |
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|
Term
antimalarial drug used for RA
not as potent as other drugs |
|
Definition
hydroxychloroquine
-used to be first drug
-takes 3 months to kick in |
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Term
| first-line treatment for systemic lupus |
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Definition
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|
Term
| methotrexate toxicity caused by |
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Definition
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Term
|
Definition
increases adenosine (at low doses, like for RA)
inhibits DNA synthesis and repair |
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Term
| key factor in DMARD function |
|
Definition
| inhibit DNA synthesis and repair |
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Term
| 2nd choice to methotrexate |
|
Definition
leflunamide (arava)
-PO, 20mg per day
-long half-life (can be there for 2 yrs) |
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|
Term
| drug used in organ transplatation, also used in RA |
|
Definition
azathioprine
-active metabolite decreases synthesis of purine nucleotides |
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Term
| cyclosporine...uses and MOA |
|
Definition
RA drug
inhibits T-helper cell release of IL-2 |
|
|
Term
| gingival hyperplasia can result from long term use of |
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Definition
|
|
Term
| severe extra-articular RA treated with |
|
Definition
cyclophosphamide (cytoxan)
-decreases DNA synthesis |
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Term
| first class of RA biologic DMARD |
|
Definition
TNF antagonists
-tumor necrosis factor alpha |
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Term
|
Definition
a TNF antagonist
-binds tnf to prevent it from binding receptor |
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|
Term
| infliximab and adalimumab MOA |
|
Definition
anti-TNF antibody
binds TNF-alpha (thinks its an antigen)
-can be rejected by patient's immune |
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Term
| adalimumab or infliximab is more likely to produce immune reaction? |
|
Definition
infliximab is...
adalimumab is a fully-human antibody, whereas infliximab is from a mouse |
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|
Term
abatacept MOA
and should be avoided with what drug class |
|
Definition
blocks T-cell activation
avoid with TNF-alpha antagonists |
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Term
|
Definition
binds IL-6 receptors, inhibits signalling
-decrease pannus formation
-decrease joint destruction
-less Ab production |
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Term
|
Definition
initial corticosteroids
put on DMARD |
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Term
| upon initial exam, OA is... |
|
Definition
non-inflammatory
as this occurs in response, and is secondary
(i.e. doesn't cause the OA) |
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Term
|
Definition
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|
Term
RA is a problem in the ____
OA is a problem in the ____ |
|
Definition
RA: SYNOVIUM
OA: ARTICULAR CARTILAGE |
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Term
| in a joint, the decrease in cartilage leads to... |
|
Definition
| an increase in sclerosis (stiffening of) |
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Term
|
Definition
physical therapy
weight loss
orthotics/prosthetics
pain relief |
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Term
|
Definition
corticosteroids
hyaluronic acid derivs (knee only) |
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Term
|
Definition
| develop crystals of monosodium urate in joints |
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Term
|
Definition
| False, it is not autoimmune |
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|
Term
| organ most heavily associated with gout |
|
Definition
|
|
Term
|
Definition
men (19:1)
over 40
in women, late 50-60s |
|
|
Term
| most common inflammatory disorder in males over 40 |
|
Definition
|
|
Term
| gout affects many/few joint |
|
Definition
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Term
|
Definition
spine
hips
shoulders
(thought b/c they're warm joints) |
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Term
|
Definition
nsaids
AVOID aspirin (b/c of acid)
colchicine |
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Term
|
Definition
| inhibits neutrophile engulfment of crystals |
|
|
Term
| treatment of hyperuricemia |
|
Definition
allupurinol
febuxostat
probenacid |
|
|
Term
| allupurinol and febuxostat block ___ in the ___ pathway |
|
Definition
| they block xanthine production in the purine metabolism pathway |
|
|
Term
| inhibits the reabsorption of uric acid at kidney |
|
Definition
probenacid
works at proximal convulted tubule |
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