Introduction to pathology Homework 1 Dr H Awad 2016

There are two passages , first in slide 3 and another in slide 6 There are two passages , first in slide 3 and another in slide 6. please read both and answer the questions related to each passage. Please hand in your answers at the beginning of the next lecture. Thank you

GOUT Gout is a form of arthritis affecting mainly the big toe but also other joints like the knee. It is an inflammatory condition caused by deposition of uric acid crystals . Uric acid(C5H4N4O3 ) is a product of the metabolic breakdown of purine nucleotide. Xanthine and hypoxanthine, which are produced from purines are catalyzes by the enzyme xanthine oxidase to uric acid which is excreted in urine. The diseases is treated by non- steroidal anti-inflammatory drugs, colchicine which inhibit neutrophil motility, steroids, allopurinol which is a xanthine oxidase inhibitor and Probenecid

Questions 1. what symptoms do you expect patients with gout to suffer from? 2. as part of their investigations, patients with gout usually have aspiration of joint fluid, what do you expect to see when the fluid is examined under the microscope? 3. eating too much red meat is an important risk factor to develop gout , why is that? 4. can you predict the solubility of uric acid in water.. Is it low or high and why? 5. with your knowledge of how gout occurs, list the possible ways that can be used to treat or prevent gout.

Questions 6.which of the drugs mentioned in the text ( in slide 3) provide symptomatic treatment? 7. Google Probenecid to find out how it acts to treat gout.

IL1 receptor inhibitors Anakinra is a man-made form of the IL-1 receptor protein. Anakinra blocks the interaction between IL-1 and the cell to stop inflammation that occurs through that pathway. The standard dose is 100 mg per day injected under the skin

Questions 1. why Anakinra is administered as an injection rather than orally? 2. one side effect of Anakirana is increseaed risk of bacterial infection, why is that? 3. is treatment with Anakinra symptomatic or curative, why?