Draw it
Act it
Describe it
Drug it
SOAP it
100
CD4+ T cell with all its components
TCR (alpha&beta), CD3 (gamma&epsilon), delta&epsilon, zeta&zeta
100
swan-neck deformity and boutonniere deformity
nice work :)
100
genetic component
HLA-DR4
100
MOA of Tylenol and Aleeve
COX1 and 2 inhibitors
100
list the clinical presentation for RA patients
- Persistent symmetric polyarthritis of hands and feet
- joint pain, morning stiffness, tenderness
- decreased ROM
- fever, myalgia, malaise
- weakness
200
interaction between a B cell and CD4+ T cell
I trust that we made the right answer
200
ulnar deviation and volar subluxation
well done :)
200
....environmental factors
infection
smoking
trauma
viruses
200
Role/MOA of Metformin
-decreases blood glucose levels by decreasing hepatic glucose production, decreases the intestinal absorption of glucose, and increases insulin sensitivity by increasing peripheral glucose uptake and utilization
-inhibiting mitochondrial complex I activity
200
common joint affected in RA
SYMMETRIC
- Upper extremities: MCP, PIP, wrists, elbows, shoulders
- Lower extremities: MTP, ankles, knees, hips
- Cervical spine
300
the timeline and progression of RA
the onset is gradual, often beginning with fever, malaise, arthralgias, and weakness before progressing to joint inflammation and swelling.
300
+/- selection
now take a bow
300
the comorbidities of systemic glucocorticoids
-weight gain
-diabetes/hyperglycemia
-osteoporosis
-ocular complications like cataracts
-infection
-GI
-HPA axis depression
300
MOA of prednisone and importance of the taper?
Binds to the glucocorticoid receptor and induces translocation, activated GR binds to short DNA. inactivation of NFKB-->decreased pro-inflammatory cytokine production and release as well as COX2, PLA2 and lipooxygenase
abrupt discontinuation can lead to adrenal insufficiency
300
predict the following labs and explain the clinical utility for an RA patient
- Erythrocyte sedimentation rate
- C-reactive protein level
- Rheumatoid factor assay
- Anti−cyclic citrullinated peptide
- Creatinine
- WBC
- Hgb
- Hct
- platlets
- Erythrocyte sedimentation rate: high
- C-reactive protein level: high
- Rheumatoid factor assay: high
- Anti−cyclic citrullinated peptide:high
- Creatinine: nl
- WBC:nl
- Hgb
- Hct
- platlets
400
morphological changes in the joint
... see robbins pg 1210/1211
400
instruct your peers to act out the immune response taking place in RA
super!!
400
importance of influenza vaccine and pneumococcal conjugate vaccine
:)
400
MOA of methotrexate and the importance of folic acid?
mimics folic acid, it inhibits dihydrofolic acid reductase, which ultimately interferes with DNA synthesis, repair, and cellular replication.
400
common complications in RA patients?
- Anemia
- Infections
- cancer
- osteoporosis
- heart disease
- vasculitis
500
outline the pathogenesis of RA starting with the non-self antigen all the way to antibodies being produced
in short.... DC-->T cells--> secrete cytokines that stimulate the immune response and also activate B cells. TNF-a is specifically involved.
The synovial has germinal center with plasma cells that can secrete Abs. Autoantibodies IgM are made against the Fc portion
500
patient/physician encounter... no this is not broadway... just do your best!
*clapping*
500
the citrulline and the importance in RA
argine-->citruilline is done by peptidylargine deaminase (PAD) enzyme that is on the HLA-DR4 receptor
Immune cells no longer see this as "self"
500
goal of DMARDs, importance of screening for chronic infections and liver disease?
slow or prevent disease progression and, thus, joint destruction and subsequent loss of function. DMARD therapy may eliminate the need for other anti-inflammatory or analgesic medications
500
What are the differentials for our patient and what rules them out?
Fibromyalgia
Lyme Disease
Myelodysplastic Syndrome
Osteoarthritis
Paraneoplastic Syndromes
Relapsing Polychondritis
Polymyalgia Rheumatica
Psoriatic Arthritis