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20 Cards in this Set
- Front
- Back
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Hyperuricemia is an independent risk factor for _ |
atherosclerosis |
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If someone presents with episodic or attacks of joint pain, think… |
Gout or psuedogout |
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Acute Gouty Arthritis Classically occurs in who
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middle aged males |
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You will never see an attack of gout in a _ female, unless they are on _ |
pre-menopausal |
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The first attack is called “_”
& is characterized by abrupt onset of monoarthritis |
podagra
(*always think septic first when you have monoarthritis**, rule out, then check for gout) |
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gout is the deposition of _crystals in joint (usually feet & ankles) |
monosodium urate (MSU) |
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_seems to be the best predictor of acute gout |
. A change in serum uric acid
*ANYTHING that changes uric acid level (up or down) can induce gout attack**** |
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Most patients are (underexcretors/overproducers) |
underexcretors |
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Over production of uric acid is most commonly due to _
What are indicative of chronic urate overload? |
beer consumption
tophi (macro-deposits of crystals) |
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The best diagnostic for gout... |
needle aspiration of inflammed joint--> microscopy of fluid reveals negatively birefringent MSU crystals |
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Drugs used to lower uric acid levels are _ or _. |
Allopurinol/febustat |
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When should you use urate lowering drugs? when should you NOT? |
indications: tophi disease nephrolithiasis- stones recurrent gout attacks prevent tumor lysis syndrome (prophylactic for chemo)
contrindications: during acute gout attack!!!!! (lowering (changing) uric acid will further precipitate) |
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What should you give during an acute gout attack? |
steroid* (best) NSAIDs (common choice) |
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An elderly individual that presents w episodic joint pain involving multiple joints (oligoarthritis), esp in the knee, shoulder, wrist, & MCPs......would likely have? |
Calcium pyrophosphate deposition disease (CPPD)
=psuedogout |
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CPPD is Less _ and a little more _ than gout |
inflammatory |
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What x ray findings would you see with CPPD? |
linear or stippled calcification in xrays
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Histologically CPPD crystals are _ shaped
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rhomboid- shaped, weakly postivively birefringent |
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____________ is a diagnostic x-ray finding in CPPD |
chondrocalcinosis |
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Colchicine should be used solely for _ |
prophylaxis |
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What is the most important tool in dx & tx of crystal disease? |
arthrocentesis |
