iBSc: Question 5

By Alan McLeod

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!

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)

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)

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)

Question 5

The pain is inflammatory in

cause in rheumatoid arthritis

Q5.7• List four other

symptoms / signs of inflammation (2)

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)

The Answers

View these on ‘note view’ rather than on full screen – additional

notes are provided for some slides

Gate Control Theory

A, C

A

AnxietyWorry

DepressionEtc.

HappinessOptimismRelaxation

Etc.

Meds

Gate Control Theory

vb

vb

vb

vb

Red: Red: A/C ‘small’ fibreBlack: A ‘large’ fibre

Blue: InterneuroneYellow: Yellow: Projection neurone

BRAIN

Opening and Closing the Gate

Open ClosePhysical Injury Medication

Emotional

Anxiety WorryTension Depression

HappinessRelaxationOptimism

Behavioural Focussing on pain boredom

Distraction Concentration Other activities

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

Video Link

Synovial Joint

CollagenSynthesis

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

Inflammation Features

• Rubor (redness)

• Calor (heat)

• Dolor (pain)

• Tumor (swelling)

• Loss of Function

IgG

Heavy chain

LightLightchainchain

FAB

Hinge region

Fc

Variable region

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.