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16 Cards in this Set
- Front
- Back
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What is gout caused by?
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The deposition of uric acid crystals and usually associated with hyperuricemia.
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What does gout usally begin as?
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An intermittent, acute monarthritis, especially of the first metatarsophalangeal joint.
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What happens as gout progresses overtime?
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Attacks become more frequent, less intense and involve mor joints.
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How is gout diagnosed?
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By demonstrating uric acid crystals in joint fluid?
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What are some extra-articular manifestations of gout?
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Tophi and renal stones.
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What is the definition of hyperuricemia (an increased total body urate pool)?
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Serum urate concentration more than 7.0 mg/dL.
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Is hyperuricemia alone sufficient for the diagnosis of gout?
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No, hyperuricaemia alone is not sufficient for the diagnosis of gout and asymptomatic hyperuricaemia is not a disease. It appears that clinical gout will develop in few than one in four hyperuricemia persons at any point.
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When and in what sex is gout most common?
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Gout presents predominantly in men with a peak age of onset in the fifth decade. The incidence of gout in women approaches that of men only after they have reached age 60 years.
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What are the two mechanisms that can result in hyperuriceamia?
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1) Decreased uric acid excretion by the kidneys.
2) Increased uric acid production. They excrete more than 800 mg or uric acid ni their urine during a 24-hour period. |
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What are some causes of urate overproduction?
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Primary: idiopathic, complete or partial deficiency of HGPRT, superactivity of PRPP synthetase.
Secondary: excessive purine consumption, myeloproliferative or lymphoproliferative disorders, haemolytic diseases, psoriasis, glycogen storage diseases. |
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What are some causes of uric acid underexcretion?
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Primary: idiopathic
Secondary: decreased renal function, metabolic acidosis, dehydration, diuretics, hypertension, hyperparathyroidism, lead nephropathy. Drugs: cyclosporine, pyrazinamide, ethambutol, low-dose salicyclates. |
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What are some causes of overproduction and underexcretion (combined) or uric acid?
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Alcohol use, G6PD-deficiency,
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What are the three stages of the natural history of gout?
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1) Asymptomatic hyperuricaemia.
2) Acute and intermittent gout. 3) Chronic tophaceous gout. |
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What joints are typically involved in the early stages of gout?
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MTP, midfoot, ankle, heel, knee.
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What joints are typically involved in the later stages of gout?
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Wrist, fingers, elbows.
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What associated signs/symptoms may accompany gout?
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Fever, chills, malaise.
Cutaneous erythema. Deqsuamation of the skin may occur as the attack resolves. |
