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36159 Unknown

A 50-year-old man presents with complaints of bilateral morning stiffness in his wrists and knees and painful joints on exercise. On physical examination, the joints are slightly swollen. The rest of the examination is unremarkable. His laboratory findings are also negative except for slight anemia, elevated erythrocyte sedimentation rate, and positive rheumatoid factor. X-ray of B/L knee was done. The patient was staed on weekly methotrexate to control the inflammation. What is the principle mechanism of action here?

AInhibition of Dihydrofolate reductase enzyme
BIncreased extracellular levels of adenosine
CInhibition of assembly of microtubules in neutrophils impairing chemotaxis
DInhibition of cyclooxygenase enzyme
Unknown
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