Rheumatoid Arthritis and Cancer Quiz
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Questions and Answers

What is the primary cause of rickets in children?

  • Vitamin D deficiency (correct)
  • Injury or trauma
  • Autoimmune response
  • Genetic predisposition

    • What is a common characteristic of rheumatoid arthritis?

  • Is usually a result of external injury
  • Affects only one joint
  • Primarily affects men
  • Involves an autoimmune mechanism (correct)

    • Which treatment is commonly used for managing rheumatoid arthritis?

  • Methotrexate (correct)
  • Acupuncture
  • Physical therapy exclusively
  • Chiropractic adjustments

    • Which group is most commonly affected by osteoarthritis?

    <p>Individuals in their seventies</p> Signup and view all the answers

    What pathological change occurs in rheumatoid arthritis's disease process?

    <p>Synovial cells proliferate in response to triggers</p> Signup and view all the answers

    How does osteoarthritis typically manifest?

    <p>As a slowly progressive condition</p> Signup and view all the answers

    What aspect of osteoarthritis contributes to its classification?

    <p>It has both degenerative and inflammatory components</p> Signup and view all the answers

    Which of the following is NOT a treatment goal for rheumatoid arthritis?

    <p>Increasing stiffness in joints</p> Signup and view all the answers

    What is the process by which cells detach from a solid tumor and spread to distant sites?

    <p>Metastasis</p> Signup and view all the answers

    What term describes the loss of differentiation in cancerous cells?

    <p>Anaplasia</p> Signup and view all the answers

    Which of the following is NOT a category of malignant neoplasms?

    <p>Epithelial tumors</p> Signup and view all the answers

    Which risk factor is linked to an increased risk of cancer due to genetic predisposition?

    <p>Heredity</p> Signup and view all the answers

    What are hematologic cancers primarily characterized by?

    <p>Cancers of bone-forming tissues or immune cells</p> Signup and view all the answers

    Which subcategory of hematologic cancer is characterized by the uncontrolled growth of white blood cells?

    <p>Leukemia</p> Signup and view all the answers

    Which environmental agent is associated with increased cancer risk due to its carcinogenic effects?

    <p>Alcohol</p> Signup and view all the answers

    What is the relationship between smoking and alcohol consumption in terms of cancer risk?

    <p>They can enhance each other's carcinogenic effects.</p> Signup and view all the answers

    What are the common causes of anemia in cancer patients?

    <p>Blood loss, hemolysis, impaired red blood cell production, treatment effects</p> Signup and view all the answers

    What are the primary goals of cancer treatment?

    <p>Curative, control, palliative</p> Signup and view all the answers

    Which symptom is initially common in Ankylosing Spondylitis?

    <p>Lower back pain</p> Signup and view all the answers

    Which of the following treatment modalities is NOT commonly used for cancer?

    <p>Hypnotherapy</p> Signup and view all the answers

    What is one of the diagnostic criteria for gout?

    <p>High serum uric acid levels above 6.8 mg/dL</p> Signup and view all the answers

    Which type of cancer develops in the glands that line organs?

    <p>Adenocarcinoma</p> Signup and view all the answers

    What type of medications is primarily used to treat Osteoarthritis?

    <p>NSAIDs</p> Signup and view all the answers

    Which hormone is uniquely known for lowering blood glucose levels?

    <p>Insulin</p> Signup and view all the answers

    In which phase of gout is a person likely to be asymptomatic?

    <p>Asymptomatic hyperuricemia</p> Signup and view all the answers

    What type of cells within the islets of Langerhans secrete insulin?

    <p>Beta cells</p> Signup and view all the answers

    What typically worsens lower back pain in a person with Ankylosing Spondylitis?

    <p>Resting</p> Signup and view all the answers

    Which organ is primarily responsible for regulating blood glucose levels?

    <p>Pancreas</p> Signup and view all the answers

    What is one of the actions of insulin besides promoting glucose uptake?

    <p>Inhibits gluconeogenesis</p> Signup and view all the answers

    What is the known cause of Systemic Lupus Erythematosus (SLE)?

    <p>The cause is unknown</p> Signup and view all the answers

    Which gender is typically less severely affected by Ankylosing Spondylitis?

    <p>Women</p> Signup and view all the answers

    What type of therapy is recommended for Osteoarthritis management?

    <p>Physical and exercise therapy</p> Signup and view all the answers

    What is a characteristic feature of Type 1 Diabetes Mellitus?

    <p>Destruction of pancreatic beta cells</p> Signup and view all the answers

    Which statement accurately describes Type 2 Diabetes Mellitus?

    <p>Is more frequently diagnosed in adolescents</p> Signup and view all the answers

    What condition is classified as Gestational Diabetes Mellitus (GDM)?

    <p>Diabetes lasting only through pregnancy</p> Signup and view all the answers

    Which of the following is not a metabolic abnormality associated with Type 2 Diabetes?

    <p>Autoimmune destruction of pancreatic beta cells</p> Signup and view all the answers

    What is a key risk factor in the metabolic syndrome that is associated with diabetes?

    <p>High blood sugar levels</p> Signup and view all the answers

    What is the primary hormonal issue in Type 1 Diabetes Mellitus?

    <p>Absolute lack of insulin</p> Signup and view all the answers

    Which of these best describes Type 1B Diabetes?

    <p>Less common with no autoimmune component</p> Signup and view all the answers

    Which factor is not part of the five risk factors for metabolic syndrome?

    <p>Decreased waist circumference</p> Signup and view all the answers

    What is the primary process by which the number of cells increases in the body?

    <p>Cell proliferation</p> Signup and view all the answers

    Which type of cell is least likely to divide and reproduce?

    <p>Skeletal muscle cells</p> Signup and view all the answers

    What characterizes benign tumors?

    <p>They develop a fibrous capsule.</p> Signup and view all the answers

    What is the main difference between malignant and benign neoplasms regarding growth?

    <p>Malignant tumors tend to grow rapidly.</p> Signup and view all the answers

    What is hyperplasia?

    <p>An increase in cell numbers.</p> Signup and view all the answers

    What defines undifferentiated stem cells?

    <p>They can give rise to various cell types.</p> Signup and view all the answers

    Which of the following statements about malignant tumors is true?

    <p>They can cause ischemia and tissue injury.</p> Signup and view all the answers

    What term describes abnormal cellular changes leading up to cancer?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Lecture 7: Metabolic & Rheumatic Disorders of Skeletal System, Neoplasia and Diabetes Mellitus

    • Objectives:
      • Study different disorders affecting musculoskeletal function.
      • Define, examine the pathogenesis, and categorize neoplasia.
      • Study diabetes and its complications.

    1- Metabolic & Rheumatic Disorders of Skeletal System

    • During childhood, skeletal structures grow in length and diameter, increasing bone mass.
    • Skeletal disorders can arise from abnormal growth and developmental processes, potentially due to hereditary or congenital factors.
    • Other contributing factors include metabolic disorders, hormonal influences, aging, and nutritional deficiencies.

    Osteoporosis and Osteomalacia

    • Osteoporosis: Characterized by the loss of mineralized bone mass, increasing porosity, and causing fragile bones prone to fractures.
    • Osteomalacia: Results from inadequate bone mineralization (lack of vitamin D), leading to soft bones prone to fractures.
    • Symptoms of osteomalacia include muscle pain and weakness, difficulty walking, muscle cramps, painful bones and joints.
    • Symptoms of osteoporosis include painful bones & joints
    • Diagnosis of both relies on X-ray studies, laboratory testing, bone scans, and bone biopsies.

    Etiology of Osteoporosis

    • Hormonal imbalance: Postmenopausal osteoporosis is a result of estrogen deficiency.
    • Age: Risk increases with age.
    • Gender: Women are more susceptible.
    • Genetic predisposition:
    • Activity level: Sedentary lifestyles are a contributing factor.
    • Nutritional status: Nutritional deficiencies negatively affect bone health.

    Etiology of Osteomalacia

    • Vitamin D deficiency: Common causes include reduced Vitamin D absorption (due to biliary or intestinal diseases) and kidney failure.
    • Calcium deficiency.
    • Phosphate deficiency.

    Rickets

    • Rickets is the softening and weakening of bones in children.
    • Rickets is caused by vitamin D deficiency.
    • It is linked to kidney failures and malabsorptive syndromes, as in osteomalacia.

    Rheumatoid Arthritis

    • Rheumatoid arthritis (RA) is an autoimmune, inflammatory disease, primarily targeting joints.
    • Women are affected more frequently than men (approximately three times).
    • The etiology and pathogenesis are speculated to involve genetic predisposition combined with a cell-mediated response to a microbial agent.
    • The disease process involves synovial cell proliferation, plasma cell production, mast cell interaction, neovascularization, and edema, eventually leading to synovial hyperplasia and lymphoid nodules.
    • The synovium spreads, resorbs cartilage, and spreads to the joint space, causing further damage.

    Diagnosis and Treatment of RA

    • Diagnosis involves history, physical examinations, and laboratory tests.
    • Treatment aims at preventing and reducing pain, minimizing stiffness and swelling, maximizing mobility, and potentially halting the pathological process.
    • Treatment involves drugs such as Methotrexate, Steroids, and NSAIDs.

    Osteoarthritis (OA)

    • Osteoarthritis (OA) is a slowly progressive destruction of cartilage in weight-bearing joints (including fingers) in older adults and those who have suffered trauma earlier in life.
    • OA's prevalence increases with age.
    • OA is sometimes called degenerative joint disease.
    • It's a leading cause of disability and pain in older adults
    • Diagnosis involves detailed history, physical examinations, X-ray studies, and lab tests to rule out other diseases.
    • Treatment involves medications (NSAIDs), intermittent hot and cold packs, physical/exercise therapy, and weight loss

    Gout

    • Gout is a group of disorders characterized by increased serum uric acid and urate crystal deposits in kidneys and joints.
    • Uric acid is the end product of purine metabolism (from adenine and guanine).
    • Primarily affects older men.
    • Gout is diagnosed by the presence of a high uric acid level (>6.8 mg/dL) and the presence of uric acid crystals in affected joints.
    • Gout has four phases: Asymptomatic hyperuricemia, Acute gout arthritis, Intercritical gout, and Chronic tophaceous gout.

    Systemic Lupus Erythematosus (SLE)

    • SLE is a chronic inflammatory disease impacting many organ systems, including the musculoskeletal system.
    • The etiology is unknown, but is thought to be linked to autoantibodies and immune complexes.
    • Treatment involves nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarial drugs, corticosteroids, and immunosuppressants.

    2- Neoplasia

    • Neoplasia involves uncontrolled cell growth.
    • Tumors can be benign or malignant.
    • Benign tumors remain localized, lacking invasive capacity and with slow growth
    • Malignant tumors are invasive, potentially fatal, and grow rapidly.
    • Benign and malignant tumors each have surrounding rims of connective tissue capsules.
    • Benign tumor capsules often facilitate surgery, assisting containment and separation.
    • Neoplasms have different types from malignant solid tumors to hematologic cancers.

    Cell Proliferation

    • Cell proliferation is the process of increasing cell numbers through mitotic cell division.
    • Normal tissue regulation involves maintaining a balance between dividing cells and cells undergoing apoptosis.

    Physiology of Cell Proliferation

    • There are three main groupings of cells in terms of their proliferation capabilities.
    • Well-differentiated cells like neurons and cardiac muscle cells divide rarely.
    • Progenitor cells repeatedly divide and reproduce, including blood, skin, and liver cells.
    • Undifferentiated stem cells can rapidly divide and produce progenitor cells when needed.

    3- Diabetes Mellitus and the Metabolic Syndrome

    • Insulin's Role: Insulin is the primary hormone regulating blood glucose:

      • Promotes glucose uptake by cells and storage as glycogen
      • Prevents glycogen and fat breakdown
      • Inhibits gluconeogenesis and promotes protein synthesis

    • Diabetes Diagnosis:

      • Fasting Plasma Glucose (FPG): Glucose level after 8 hours of fasting. Normal <100 mg/dL, Impaired Fasting Glucose 100-125 mg/dL, Diabetes ≥126 mg/dL
      • Casual Blood Glucose Test: Glucose level at any time. ≥200 mg/dL is suggestive of diabetes, particularly when combined with symptoms like polyuria, polydipsia, polyphagia, and blurred vision.
      • Oral Glucose Tolerance Test (OGTT): Glucose level after drinking a glucose solution.
      • Glycosylated hemoglobin (A1C): Reflects average blood glucose levels over the past 2-3 months.
      • Urine test: No longer a routine method for diabetes diagnosis due to the limitations of the test.

    • Classification of Diabetes:

      • Type 1: Autoimmune destruction of beta cells in the pancreas, requiring insulin therapy.
      • Type 1A: Immune-mediated type 1 diabetes.
      • Type 1B: Idiopathic type 1 diabetes.
      • Type 2: Insulin resistance and relative deficiency in pancreatic insulin secretion; often associated with obesity.
      • Gestational diabetes: Diabetes diagnosed during pregnancy.

    • Stages of Diabetes: The stages of diabetes are based on different blood testing levels.

    • Acute Complications of Diabetes:

      • Diabetic ketoacidosis (DKA): Caused by extremely high blood glucose levels and a lack of insulin. Characterized by high glucose, abnormal ketone production, and metabolic acidosis.
      • Hyperosmolar hyperglycemic state (HHS): High blood glucose without significant ketone production, frequently seen in type 2 diabetes and is more life-threatening than DKA.
      • Hypoglycemia: Extremely low blood sugar.

    • Dyslipidemia: Serum total cholesterol (TC) has a composite of LDL cholesterol.HDL cholesterol and VLDL cholesterol levels. TC/HDL ratio serves as a predictor for CVD risk.

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