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Q1: Recognition & definition (2 min)
A patient with psoriasis develops an inflammatory arthritis with nail dystrophy and a sausage digit. Define psoriatic arthritis and explain why it is classified as a seronegative spondyloarthropathy. State the entry requirement and point threshold of the CASPAR criteria.
Q2: Pathophysiology & genetics (3 min)
Discuss the genetic predisposition (HLA-Cw6 versus HLA-B27), the role of the IL-23/Th17/IL-17 axis and TNF, and the Koebner phenomenon. Explain the concept of paradoxical bone remodelling and how it distinguishes psoriatic from rheumatoid arthritis on imaging.
Q3: Clinical patterns & differential (2 min)
Describe the five Moll and Wright patterns and the hallmark features (dactylitis, enthesitis, nail disease, DIP involvement). How do you distinguish psoriatic arthritis from rheumatoid arthritis and osteoarthritis?
Q4: Management & complications (3 min)
Outline the treat-to-target strategy from NSAIDs through conventional DMARDs to biologic agents (TNF inhibitors, IL-17 and IL-23 inhibitors, JAK inhibitors). What screening is mandatory before biologics? Discuss comorbidity (cardiovascular, metabolic) and the red flags of septic arthritis and uveitis.