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Question 1

Rheumatoid Arthritis

Answer 1

• formation of pannus ( proliferative granulation tissue) which erodes articular cartilage and bone
• Predisposing factors : HLD-DR4, Smoking, RF ( IgM antibody that targets Fc Region , Anti- cyclic citrullinated peptide antibody is more specific
• symmetric join involvement, fever, fatigue weight loss, extrarticular manifestation common
• MCP, PIP, wrist, juxtaposed artiuclarosteopenia, subchondral cyst, joint space narrowing , swan neck boutonniere , srevical subluxation , synovial fluid inflammatory
  treat: NSAID, glucocorticoids, DMA(metates, sulfasal, leflunomide, TNF-a

Question 2

Osteoarthritis

Answer 2

articular cartilage damage. inflammation with bad repair, chondrocytes mediate degradation

• pain in weight bearing joints, end of day. improve with rest, asymmetric join involvement , knee cartilage loss
• DIP (herberden nodes ) PIP ( Bouchard) 1st cmc,
  joint space narrowing, subchondral sclerosis and cyst,
• treat: activity medication, acetaminophen, NSAID, intra articular steroids.

Question 3

Pseudomonas aeruginosa

Answer 3

cat + gram - rod. non lactose fermenting oxidase +
Mucopolysacc capsule may contribute to chronic pneumonia in cystic fibrosis due to biofilm formation

produces PEEP
P-phopholipase C ( degrades cell membrane )
E- endotoxin ( fever shock)
E-Exotoxin A ( inactivates EF 2)
Pigments; pyoverdine and pyocyanin, and ROS