Case Study 3.doc - Case Study 3 Glucocorticoid Agents A 40-year-old woman has had rheumatoid arthritis for 5 years She has been on multiple NSAIDS with

Case Study 3.doc - Case Study 3 Glucocorticoid Agents A...

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Case Study 3 Glucocorticoid Agents A 40-year-old woman has had rheumatoid arthritis for 5 years. She has been on multiple NSAIDS with some symptomatic relief. On a few occasions she has taken corticosteroids for severe exacerbations. She feels that her disease is getting worse. She has more stiffness and swelling in her hands and wrists. She is currently taking the recommended maximum dosage of ibuprofen, but admits to taking more than she should on bad days. On examination, the nurse notes active synovitis of both wrists and all of her metacarpal joints. There is a subtle ulnar deviation of all of her fingers. The Physician assesses her as having an acute exacerbation of rheumatoid arthritis, prescribes a short course of corticosteroids and starts her on methotrexate. 1. What is the mechanism of the immune response mediated by glucocorticoids? (25 pts.) The mechanisms of action of glucocorticoids upon the various effector cells of the
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