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Detailed clinical learning notes for a medical student on the following topics Mechanism of Autoimmunity Connective Tissue Diseases Inflammatory Arthritis / Osteoarthritis Crystal Arthropathies

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These notes are now complete and sourced from multiple authoritative medical textbooks. Here's a quick overview of what's covered:

What's in Your Notes

Topic 1 - Mechanism of Autoimmunity
  • Central vs. peripheral tolerance mechanisms (thymic deletion, Tregs, CTLA-4/PD-1, anergy)
  • Why tolerance fails: genetic susceptibility (HLA), molecular mimicry, bystander activation, epitope spreading
  • Four hypersensitivity mechanisms driving autoimmune disease
  • High-yield autoantibody table for all major CTDs
Topic 2 - Connective Tissue Diseases
  • SLE: pathogenesis (TLRs, IFN-α, nuclear debris), ACR 11 criteria, all organ system manifestations (nephritis classes, APLS, Libman-Sacks), treatment ladder
  • Sjögren Syndrome: primary vs secondary, diagnostic criteria, lymphoma risk
  • Systemic Sclerosis: limited (CREST/anti-centromere) vs diffuse (anti-Scl-70), Raynaud's, scleroderma renal crisis
  • Polymyositis/Dermatomyositis: Gottron's papules, heliotrope rash, anti-Jo-1, malignancy screening
Topic 3 - Inflammatory Arthritis / OA
  • RA: pannus formation, HLA-DR4, ACR criteria, classic deformities, extra-articular features, treat-to-target DMARDs → biologics → JAK inhibitors
  • Seronegative spondyloarthropathies: AS (bamboo spine, HLA-B27), psoriatic arthritis (DIP/dactylitis), reactive arthritis (Reiter triad)
  • OA: pathogenesis, risk factors, Heberden's/Bouchard's nodes, X-ray findings, full treatment pyramid
Topic 4 - Crystal Arthropathies
  • Gout: hyperuricaemia staging, NLRP3 inflammasome, 4 clinical stages, podagra, negatively birefringent needle crystals, acute management vs ULT (allopurinol/febuxostat), lifestyle
  • Pseudogout (CPPD): metabolic associations, knee > 1st MTP, positively birefringent rhomboid crystals, chondrocalcinosis on X-ray
  • Side-by-side comparison tables for quick revision
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