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Understanding Arthritis: Pain Theories and Joint Diseases

This guide covers essential aspects of arthritis, focusing on Mrs. McCartney's symptoms and implications. Key topics include the gate-control theory of pain, distinguishing between rheumatoid and osteoarthritis, and exploring joint structures. The content examines the pathology of synovial joints and provides insights into collagen formation and inflammation signs. Drawings and labeling practices of IgG molecules are also discussed to enhance your understanding of the body's immune response in arthritis. This comprehensive overview aims to aid exam preparation and improve marks.

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Understanding Arthritis: Pain Theories and Joint Diseases

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  1. iBSc: Question 5 By Alan McLeod

  2. Getting the best marks Read the whole question – a latter section may give you a clue about an earlier one. To see how many points you need look at the marks allocated – for example a 3 point question is generally looking for 3 salient points If giving a list answer put the best answers first – examiners will not usually mark answers too far down a list Always write something – it may get you part of a mark and is anonymised so no one will think you are stupid! If you genuinely have no clue then re-write the question to see if this sparks some ideas. If not then move on and come back at the end. And remember – always write something. Good luck!

  3. Question 5 Mrs McCartney, a 52 year old woman has been getting pains in her finger joints. She think it may be ‘arthritis, like my mum had’ Q5.1 • Outline the gate-control theory of pain (6) Q5.2 • Compare rheumatoid and osteoarthritis in terms of the joints affected (5)

  4. Question 5 This disease affects synovial joints Q5.3 • What part of the joint does Rheumatoid arthritis affect (1) Q5.4 • Draw and label a synovial joint (5)

  5. Question 5 One of the essential components of a synovial joint is cartilage which is made from collagen Q5.5 • Describe how collagen is formed (8)

  6. Question 5 The pain is inflammatory in cause in rheumatoid arthritis Q5.7 • List four other symptoms / signs of inflammation (2)

  7. Question 5 Rheumatoid factor has prognostic value in patients with rheumatoid arthritis. It is an antibody against the Fc portion if IgG Q5.8 • Draw and label the structure of an IgG molecule including the Fc portion (6)

  8. The Answers View these on ‘note view’ rather than on full screen – additional notes are provided for some slides

  9. Gate Control Theory Meds Ab Ad, C Anxiety Worry Depression Etc. Happiness Optimism Relaxation Etc.

  10. Gate Control Theory vb BRAIN vb vb vb Red: Ad/C ‘small’ fibre Black: Ab ‘large’ fibre Blue: Interneurone Yellow: Projection neurone

  11. Opening and Closing the Gate

  12. Osteo and Rheumatoid Osteoarthritis • Disease of cartilage • No immune component • M=F • Rheumatoid factor -ve • Assymetric joints • Large > small joints • DIP Joints Rheumatoid arthritis • Disease of synovium • Autoimmune • M<F (approx 1 : 3-4) • Rheumatoid factor 80% • Symmetrical • Small > large joints • MCP + PIP Joints

  13. Synovial Joint Video Link

  14. CollagenSynthesis http://depts.washington.edu/bonebio/ASBMRed/collagen/collagen.swf

  15. Inflammation Features • Rubor (redness) • Calor (heat) • Dolor (pain) • Tumor (swelling) • Loss of Function

  16. IgG Variable region FAB Light chain Hinge region Heavy chain Fc

  17. The End The slides here should allow you to mark your own work – remember 1 mark per answer* up to the maximum for the question. Multiply by 3 to get percentage points. I assume a 60% pass mark. Sorry but I am unable to give further advice on answers due to time constraints.

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