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13 Cards in this Set

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Tophi
accumulation of crystal aggregates in soft tissue
uric acid has a pka of?
5.7, only in part of urinary tract where pH is less than 5.7 is uric acid found
more common in men or women?
more common in men(by 5 times)
Hyperuricemia needs how many mg/dl in men vs women
men 7 mg/dl need less than this
women 6mg/dl
podagra
gout effecting great toe
what cells are recruited to urate crystals?
neutrophils, chemotactic to proteins on urate crystals, eat them and are lysed
urolithiasis
uric acid stones seen at chronic tophaceous gout stage
Primary gout
decreased excretion, idiopathic(unknown),
defects increase PRPP
- super synthetase X linked, makes PRPP from R-5-P
- HGPRT quasi deficiency
Secondary gout
gout is subordinate manifestation of an unferlying disorder

total deficiency of HGPRT - lesch nyhan
increased cell turnover - cancer etc
alcohol - increase ATP to AMP
two ways to degrade AMP
AMP -> IMP -> insosine -> HX

AMPdeaminase nucleotidase PNP
or

AMP-> adenosine -> inosine ->HX

nucleotidase, ADA , PNP
Antiinflammatory agents for gout
colchicine - depoles MT's to inhibit neutrophil phago, causes diahhrea naseau vomiting

corticosteroids

non-steroidal agents NSAID's
-indomethacin, NOT ASPIRIN, competes with urate for excretion
GI bleeding
Uricosuric Agents
properties
ex
increase renal excretion, inhibit proximal tubular reabsorption of urate

Probenecidad
what are the small bumps found near the ear?
tophi, urate crystal accumulation in soft tissue