Icm Rheum 03: Gout

Front 1

6 causes of acute arthritis

Back 1

rheumatic fever
septic arthritis
gout
pseudogout
FMF
lyme disease

Front 2

4 causes of chronic arthritis

Back 2

RA
SLE
psoriatic arthropathy
ankylosing spondylitis

Front 3

pain of acute arthritis is moderate/severe

Back 3

severe

Front 4

in soft tissue arthropathy there is a discrepancy between ___ and ___

Back 4

range of active motion
range of passive motion

Front 5

articular arthritis is local to ___ (3), whereas periarticular is local to ___ (4).

Back 5

synovium
cartilage
capsule
tendon
bursa
ligament
muscle
bone

Front 6

pain of articular/periarticular has a focal point

Back 6

periarticular

Front 7

swelling is common in articular/periarticular

Back 7

articular

Front 8

pain of articular/periarticular is present in both active and passive motion

Back 8

articular

Front 9

pain of articular/periarticular is present in a few planes and only when active

Back 9

periarticular

Front 10

inflammatory arthropathy is characterized by ____

Back 10

morning stiffness

Front 11

T/F: polyarticular diseases can present as monoarticular

Back 11

true

Front 12

2 joint problems attributable to steroids

Back 12

infection
osteonecrosis

Front 13

most important diagnostic for evaluating monoarthritis

Back 13

synovial fluid aspiration

Front 14

2 mandatory exams on SF

Back 14

gram stain
polarized LM (crystals)

Front 15

incidence and mean age of onset of gout is lower in men/women. this is due to ___

Back 15

women
more efficient excretion

Front 16

gout attack before age ___ suggests ___.

Back 16

30
genetic metabolic disorder

Front 17

xanthine oxidase takes hypoxanthine to ___, and that to ___.

Back 17

xanthine
uric acid

Front 18

2 contributors to uric acid pool

Back 18

diet
nucleotide turnover

Front 19

90% of gout is due to ___. the rest is due to ___.

Back 19

underexcretion
uric acid overproduction

Front 20

2 iatrogenic causes of underexcretion

Back 20

diuretics
aspirin

Front 21

2 toxins which can cause underexcretion

Back 21

ethanol
Pb

Front 22

endocrine disorder which can cause underexcretion

Back 22

hypothyroidism

Front 23

2 enzyme deficiencies which can cause overproduction

Back 23

HGPRT
G6PD

Front 24

enzyme hyperactivity which can cause overproduction

Back 24

PRPP synthetase

Front 25

blood condition causing overproduction

Back 25

myeloproliferative disorders

Front 26

4 stages of gout

Back 26

asymptomatic hyperuriciemia
acute gouty arthritis
intercritical gout
chronic tophaceous gout

Front 27

only steps ___ normally occur nowadays

Back 27

1 and 2

Front 28

3 risk factors for primairy gout

Back 28

obesity
hyperlipidemia
DM

Front 29

3 risk factors for secondary gout

Back 29

alcoholism
drugs (iatrogenic)
MPD

Front 30

___% of people with hyperuricemia do not get gout

Back 30

90

Front 31

T/F: hemorrhage can precipitate gout

Back 31

true

Front 32

acute gouty arthritis usually subsides within ___

Back 32

3-10 days

Front 33

as long as a woman is menstruating, she will not develop ___

Back 33

primary gout

Front 34

negative birefringence occurs when crystals appear ___ when illumination is parallel and ___ when illumination is perpendicular. positive is the opposite.

Back 34

yellow
blue

Front 35

urate crystals have ___ birefringence, and pseudogout crystals, which are made of ___, have ___ birefringence.

Back 35

negative
calcium pyrophosphate
positive

Front 36

gout crystals are ___ shaped. pseudogout crystals are typically ___ or ___ shaped

Back 36

needle
rod
rhomboid

Front 37

chronic gouty arthritis develops in ___% of patients

Back 37

25

Front 38

tophi take at least ____ years after onset of gout to develop

Back 38

10

Front 39

T/F: tophi are irreversible

Back 39

false

Front 40

in acute gout, first choice treatment is ___, second choice is ___, third choice is ___.

Back 40

high dose NSAIDs
steroids
colchicine

Front 41

in acute gout first treat ___, then treat ___.

Back 41

symptoms
hyperuricemia

Front 42

treatment for chronic gout is ___. duration of treatment is ___.

Back 42

allopurinol
for life

Front 43

to prevent attacks, chronic gout patients initially receive ___ for ___ months

Back 43

colchicine
6 months

Front 44

allopurinol ____s by inhibiting ___.

Back 44

lowers plasma uric acid
xanthine oxidase

Front 45

uric acid is kept below ___ to prevent attacks

Back 45

6 mg%

Front 46

hyperuricemic males aged ___ are prone to ___

Back 46

30-40
metabolic syndrome

Front 47

in hyperuricemics, increased insulin can cause ___. this in turn causes ___.

Back 47

increased renal Na+ reabsorption
reduced uric acid excretion

Front 48

T/F: in gout patients, urate crystals are present only in symptomatic joints

Back 48

false

Front 49

asymptomatic joints show ___ infiltration whereas symptomatic joints show ___ infiltration

Back 49

mononuclear
neutrophil

Front 50

2 primary joints affected in pseudogout

Back 50

knee
wrist

Front 51

pseudogout is rarely seen in patients below ___ y.o.

Back 51

50

Front 52

you get a probable diagnosis of pseudogout from ___ and ___ signs. a definitive diagnosis comes from ___.

Back 52

clinical
radiological
synovial fluid aspiration

Front 53

unlike in gout, chronic treatment for pseudogout doesn't ___.

Back 53

reduce crystal deposition

Front 54

chronic treatment for pseudogout

Back 54

colchicine 1-1.5 mg PO