Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
275 Cards in this Set
- Front
- Back
|
Question
|
Answer
|
|
|
3 types of crystalline arthritis
|
"- Gout
|
|
|
Types of clinical manifestations of gout
|
"- Recurrent attacks of acute arthritis
|
|
|
Most common form of gout
|
Acute gout (podagra)
|
|
|
Most common location of acute gout
|
Foot (especially first MTP joint)
|
|
|
Clinical presentation of acute gout
|
Intense, severe inflammation of a single joint
|
|
|
[?] gout can resemble rheumatoid arthritis due to its nodular appearance
|
Tophaceous
|
|
|
Renal complications of gout
|
"- Renal failure (tubular involvement)
|
|
|
- [Common or rare] in post-menopausal women; why?"
|
"- 50s
|
|
|
Uric acid is the natural breakdown product of [?] metabolism
|
purine
|
|
|
[Enzyme] catalyzes the conversion of [molecule] to uric acid
|
"- Xanthine oxidase
|
|
|
Most uric acid is derived from [diet or breakdown of cellular nucleotides]
|
breakdown of cellular nucleotides
|
|
|
Most uric acid is excreted by the [gut or kidneys]
|
kidneys
|
|
|
Describe the renal handling of uric acid
|
"- Filtration
|
|
|
2 general mechanisms of hyperurecemia
|
"- Overproduction of urate (10%)
|
|
|
Disorders that can cause hyperurecemia
|
"- Myeloproliferative/lymphoproliferative diseases
|
|
|
Drugs that can cause undersecretion of urate
|
"- Diuretics
|
|
|
Limit of solubility of urate in serum is [#] mg/dL
|
6.8
|
|
|
Why does urate often precipitate in the extremities?
|
The periphery is at decreased temperature, which decreases urate solubility
|
|
|
Pathogenesis of gouty arthritis
|
Urate crystals in the joint cause intense inflammation --> release of inflammatory mediators
|
|
|
3 stages of gouty arthritis
|
"- Acute gouty arthritis
|
|
|
- Resolves in [#] days"
|
"- First MTP joint; also ankle, foot, knee
|
|
|
Triggers of acute gouty arthritis
|
"- Trauma
|
|
|
T/F: Crystals can be detected in the synovial fluid in acute gouty arthritis
|
T
|
|
|
- Occur anywhere except the [location]"
|
"- Subcutaneous urate masses
|
|
|
How do tophi cause damage?
|
Erode into cartilage and bone
|
|
|
Draining tophi yields "[?]"
|
milk of urate
|
|
|
Diagnosis of tophaceous gout
|
"- Identification of monosodium urate crystals in synovial fluid or tophi
|
|
|
Appearance of gout crystals under polarized light
|
"- Negative birefringence
|
|
|
In negative birefringence, the object is [blue or yellow] when parallel to the first-order red compensator
|
yellow
|
|
|
In positive birefringence, the object is [blue or yellow] when parallel to the first-order red compensator
|
blue
|
|
|
Appearance of tophaceous erosions on x-ray
|
"- Punched out erosion with overhanging osteophyte
|
|
|
Treatment of acute gout
|
"- Colchicine
|
|
|
- Mechanism"
|
"- crystalline arthritis
|
|
|
Prophylactic treatment of acute gout
|
"- Avoidance of alcohol, diuretics, low-dose aspirin
|
|
|
Urate-lowering medications (and general mechanism)
|
"- Uricosurics (promote urate excretion)
|
|
|
Goal of treatment with urate-lowering medications
|
Reduction of serum urate below limit of solubility (< 6 mg/dL)
|
|
|
How do uricosurics promote urate excretion?
|
Inhibit renal tubular resorption of urate at a post-secretory site
|
|
|
Problems associated with uricosurics
|
"- Urate nephrolithiasis
|
|
|
How does allopurinol prevent the formation of urate?
|
Inhibits xanthine oxidase
|
|
|
In what types of patients/conditions is allopurinol the only good treatment?
|
"- Overexcretors
|
|
|
Problems associated with allopurinol
|
"- Hypersensitivity
|
|
|
What is the paradox of treatment with agents that reduce urate levels?
|
Reducing urate levels can initially precipitate an acute attack (use prophylactic NSAIDs or colchicine during the first few months of treatment)
|
|
|
Diseases caused by calcium pyrophosphate deposition
|
"- Asymptomatic chondrocalcinosis
|
|
|
What is chondrocalcinosis?
|
Deposition of calcium pyrophosphate crystals in articular cartilage and fibrocartilage
|
|
|
- Men vs. women"
|
"- Knee, wrist
|
|
|
Diseases associated with chondrocalcinosis
|
"- Hyperparathyroidism
|
|
|
Diagnosis of calcium pyrophosphate deposition disease
|
"- Radiographic chondrocalcinosis
|
|
|
Describe calcium pyrophosphate crystals
|
"- Weak, positive birefringence
|
|
|
Treatment of pseudogout
|
Same as for gout, but there is no role for agents that reduce serum urate
|
|
|
Diseases associated with basic calcium phosphate
|
"- Acute arthritis
|
|
|
Locations of acute periarthritis, secondary to basic calcium phosphate
|
"- Shoulder
|
|
|
Clinical presentation of Milwaukee shoulder
|
"- ""Shoulder pad sign"" (large effusion in shoulder joint)
|
|
|
Diagnosis of basic calcium phosphate disease
|
"- Radiographs
|
|
|
Treatment of basic calcium phosphate disease
|
Same as for pseudogout, except no role for colchicine in Milwaukee shoulder (is okay for calcific periarthritis)
|
|
|
Question
|
Answer
|
|
|
3 types of crystalline arthritis
|
"; Gout
|
|
|
Types of clinical manifestations of gout
|
"; Recurrent attacks of acute arthritis
|
|
|
Most common form of gout
|
Acute gout (podagra)
|
|
|
Most common location of acute gout
|
Foot (especially first MTP joint)
|
|
|
Clinical presentation of acute gout
|
Intense, severe inflammation of a single joint
|
|
|
[?] gout can resemble rheumatoid arthritis due to its nodular appearance
|
Tophaceous
|
|
|
Renal complications of gout
|
"; Renal failure (tubular involvement)
|
|
|
; [Common or rare] in post;menopausal women; why?"
|
"; 50s
|
|
|
Uric acid is the natural breakdown product of [?] metabolism
|
purine
|
|
|
[Enzyme] catalyzes the conversion of [molecule] to uric acid
|
"; Xanthine oxidase
|
|
|
Most uric acid is derived from [diet or breakdown of cellular nucleotides]
|
breakdown of cellular nucleotides
|
|
|
Most uric acid is excreted by the [gut or kidneys]
|
kidneys
|
|
|
Describe the renal handling of uric acid
|
"; Filtration
|
|
|
2 general mechanisms of hyperurecemia
|
"; Overproduction of urate (10%)
|
|
|
Disorders that can cause hyperurecemia
|
"; Myeloproliferative/lymphoproliferative diseases
|
|
|
Drugs that can cause undersecretion of urate
|
"; Diuretics
|
|
|
Limit of solubility of urate in serum is [#] mg/dL
|
6.8
|
|
|
Why does urate often precipitate in the extremities?
|
The periphery is at decreased temperature, which decreases urate solubility
|
|
|
Pathogenesis of gouty arthritis
|
Urate crystals in the joint cause intense inflammation ;;> release of inflammatory mediators
|
|
|
3 stages of gouty arthritis
|
"; Acute gouty arthritis
|
|
|
; Resolves in [#] days"
|
"; First MTP joint; also ankle, foot, knee
|
|
|
Triggers of acute gouty arthritis
|
"; Trauma
|
|
|
T/F: Crystals can be detected in the synovial fluid in acute gouty arthritis
|
T
|
|
|
; Occur anywhere except the [location]"
|
"; Subcutaneous urate masses
|
|
|
How do tophi cause damage?
|
Erode into cartilage and bone
|
|
|
Draining tophi yields "[?]"
|
milk of urate
|
|
|
Diagnosis of tophaceous gout
|
"; Identification of monosodium urate crystals in synovial fluid or tophi
|
|
|
Appearance of gout crystals under polarized light
|
"; Negative birefringence
|
|
|
In negative birefringence, the object is [blue or yellow] when parallel to the first;order red compensator
|
yellow
|
|
|
In positive birefringence, the object is [blue or yellow] when parallel to the first;order red compensator
|
blue
|
|
|
Appearance of tophaceous erosions on x;ray
|
"; Punched out erosion with overhanging osteophyte
|
|
|
Treatment of acute gout
|
"; Colchicine
|
|
|
; Mechanism"
|
"; crystalline arthritis
|
|
|
Prophylactic treatment of acute gout
|
"; Avoidance of alcohol, diuretics, low;dose aspirin
|
|
|
Urate;lowering medications (and general mechanism)
|
"; Uricosurics (promote urate excretion)
|
|
|
Goal of treatment with urate;lowering medications
|
Reduction of serum urate below limit of solubility (< 6 mg/dL)
|
|
|
How do uricosurics promote urate excretion?
|
Inhibit renal tubular resorption of urate at a post;secretory site
|
|
|
Problems associated with uricosurics
|
"; Urate nephrolithiasis
|
|
|
How does allopurinol prevent the formation of urate?
|
Inhibits xanthine oxidase
|
|
|
In what types of patients/conditions is allopurinol the only good treatment?
|
"; Overexcretors
|
|
|
Problems associated with allopurinol
|
"; Hypersensitivity
|
|
|
What is the paradox of treatment with agents that reduce urate levels?
|
Reducing urate levels can initially precipitate an acute attack (use prophylactic NSAIDs or colchicine during the first few months of treatment)
|
|
|
Diseases caused by calcium pyrophosphate deposition
|
"; Asymptomatic chondrocalcinosis
|
|
|
What is chondrocalcinosis?
|
Deposition of calcium pyrophosphate crystals in articular cartilage and fibrocartilage
|
|
|
; Men vs. women"
|
"; Knee, wrist
|
|
|
Diseases associated with chondrocalcinosis
|
"; Hyperparathyroidism
|
|
|
Diagnosis of calcium pyrophosphate deposition disease
|
"; Radiographic chondrocalcinosis
|
|
|
Describe calcium pyrophosphate crystals
|
"; Weak, positive birefringence
|
|
|
Treatment of pseudogout
|
Same as for gout, but there is no role for agents that reduce serum urate
|
|
|
Diseases associated with basic calcium phosphate
|
"; Acute arthritis
|
|
|
Locations of acute periarthritis, secondary to basic calcium phosphate
|
"; Shoulder
|
|
|
Clinical presentation of Milwaukee shoulder
|
"; ""Shoulder pad sign"" (large effusion in shoulder joint)
|
|
|
Diagnosis of basic calcium phosphate disease
|
"; Radiographs
|
|
|
Treatment of basic calcium phosphate disease
|
Same as for pseudogout, except no role for colchicine in Milwaukee shoulder (is okay for calcific periarthritis)
|
|
|
Question
|
Answer
|
|
|
3 types of crystalline arthritis
|
"; Gout
|
|
|
Types of clinical manifestations of gout
|
"; Recurrent attacks of acute arthritis
|
|
|
Most common form of gout
|
Acute gout (podagra)
|
|
|
Most common location of acute gout
|
Foot (especially first MTP joint)
|
|
|
Clinical presentation of acute gout
|
Intense, severe inflammation of a single joint
|
|
|
[?] gout can resemble rheumatoid arthritis due to its nodular appearance
|
Tophaceous
|
|
|
Renal complications of gout
|
"; Renal failure (tubular involvement)
|
|
|
; [Common or rare] in post;menopausal women; why?"
|
"; 50s
|
|
|
Uric acid is the natural breakdown product of [?] metabolism
|
purine
|
|
|
[Enzyme] catalyzes the conversion of [molecule] to uric acid
|
"; Xanthine oxidase
|
|
|
Most uric acid is derived from [diet or breakdown of cellular nucleotides]
|
breakdown of cellular nucleotides
|
|
|
Most uric acid is excreted by the [gut or kidneys]
|
kidneys
|
|
|
Describe the renal handling of uric acid
|
"; Filtration
|
|
|
2 general mechanisms of hyperurecemia
|
"; Overproduction of urate (10%)
|
|
|
Disorders that can cause hyperurecemia
|
"; Myeloproliferative/lymphoproliferative diseases
|
|
|
Drugs that can cause undersecretion of urate
|
"; Diuretics
|
|
|
Limit of solubility of urate in serum is [#] mg/dL
|
6.8
|
|
|
Why does urate often precipitate in the extremities?
|
The periphery is at decreased temperature, which decreases urate solubility
|
|
|
Pathogenesis of gouty arthritis
|
Urate crystals in the joint cause intense inflammation ;;> release of inflammatory mediators
|
|
|
3 stages of gouty arthritis
|
"; Acute gouty arthritis
|
|
|
; Resolves in [#] days"
|
"; First MTP joint; also ankle, foot, knee
|
|
|
Triggers of acute gouty arthritis
|
"; Trauma
|
|
|
T/F: Crystals can be detected in the synovial fluid in acute gouty arthritis
|
T
|
|
|
; Occur anywhere except the [location]"
|
"; Subcutaneous urate masses
|
|
|
How do tophi cause damage?
|
Erode into cartilage and bone
|
|
|
Draining tophi yields "[?]"
|
milk of urate
|
|
|
Diagnosis of tophaceous gout
|
"; Identification of monosodium urate crystals in synovial fluid or tophi
|
|
|
Appearance of gout crystals under polarized light
|
"; Negative birefringence
|
|
|
In negative birefringence, the object is [blue or yellow] when parallel to the first;order red compensator
|
yellow
|
|
|
In positive birefringence, the object is [blue or yellow] when parallel to the first;order red compensator
|
blue
|
|
|
Appearance of tophaceous erosions on x;ray
|
"; Punched out erosion with overhanging osteophyte
|
|
|
Treatment of acute gout
|
"; Colchicine
|
|
|
; Mechanism"
|
"; crystalline arthritis
|
|
|
Prophylactic treatment of acute gout
|
"; Avoidance of alcohol, diuretics, low;dose aspirin
|
|
|
Urate;lowering medications (and general mechanism)
|
"; Uricosurics (promote urate excretion)
|
|
|
Goal of treatment with urate;lowering medications
|
Reduction of serum urate below limit of solubility (< 6 mg/dL)
|
|
|
How do uricosurics promote urate excretion?
|
Inhibit renal tubular resorption of urate at a post;secretory site
|
|
|
Problems associated with uricosurics
|
"; Urate nephrolithiasis
|
|
|
How does allopurinol prevent the formation of urate?
|
Inhibits xanthine oxidase
|
|
|
In what types of patients/conditions is allopurinol the only good treatment?
|
"; Overexcretors
|
|
|
Problems associated with allopurinol
|
"; Hypersensitivity
|
|
|
What is the paradox of treatment with agents that reduce urate levels?
|
Reducing urate levels can initially precipitate an acute attack (use prophylactic NSAIDs or colchicine during the first few months of treatment)
|
|
|
Diseases caused by calcium pyrophosphate deposition
|
"; Asymptomatic chondrocalcinosis
|
|
|
What is chondrocalcinosis?
|
Deposition of calcium pyrophosphate crystals in articular cartilage and fibrocartilage
|
|
|
; Men vs. women"
|
"; Knee, wrist
|
|
|
Diseases associated with chondrocalcinosis
|
"; Hyperparathyroidism
|
|
|
Diagnosis of calcium pyrophosphate deposition disease
|
"; Radiographic chondrocalcinosis
|
|
|
Describe calcium pyrophosphate crystals
|
"; Weak, positive birefringence
|
|
|
Treatment of pseudogout
|
Same as for gout, but there is no role for agents that reduce serum urate
|
|
|
Diseases associated with basic calcium phosphate
|
"; Acute arthritis
|
|
|
Locations of acute periarthritis, secondary to basic calcium phosphate
|
"; Shoulder
|
|
|
Clinical presentation of Milwaukee shoulder
|
"; ""Shoulder pad sign"" (large effusion in shoulder joint)
|
|
|
Diagnosis of basic calcium phosphate disease
|
"; Radiographs
|
|
|
Treatment of basic calcium phosphate disease
|
Same as for pseudogout, except no role for colchicine in Milwaukee shoulder (is okay for calcific periarthritis)
|
|
|
Question
|
Answer
|
|
|
3 types of crystalline arthritis
|
"; Gout
|
|
|
Types of clinical manifestations of gout
|
"; Recurrent attacks of acute arthritis
|
|
|
Most common form of gout
|
Acute gout (podagra)
|
|
|
Most common location of acute gout
|
Foot (especially first MTP joint)
|
|
|
Clinical presentation of acute gout
|
Intense, severe inflammation of a single joint
|
|
|
[?] gout can resemble rheumatoid arthritis due to its nodular appearance
|
Tophaceous
|
|
|
Renal complications of gout
|
"; Renal failure (tubular involvement)
|
|
|
; [Common or rare] in post;menopausal women; why?"
|
"; 50s
|
|
|
Uric acid is the natural breakdown product of [?] metabolism
|
purine
|
|
|
[Enzyme] catalyzes the conversion of [molecule] to uric acid
|
"; Xanthine oxidase
|
|
|
Most uric acid is derived from [diet or breakdown of cellular nucleotides]
|
breakdown of cellular nucleotides
|
|
|
Most uric acid is excreted by the [gut or kidneys]
|
kidneys
|
|
|
Describe the renal handling of uric acid
|
"; Filtration
|
|
|
2 general mechanisms of hyperurecemia
|
"; Overproduction of urate (10%)
|
|
|
Disorders that can cause hyperurecemia
|
"; Myeloproliferative/lymphoproliferative diseases
|
|
|
Drugs that can cause undersecretion of urate
|
"; Diuretics
|
|
|
Limit of solubility of urate in serum is [#] mg/dL
|
6.8
|
|
|
Why does urate often precipitate in the extremities?
|
The periphery is at decreased temperature, which decreases urate solubility
|
|
|
Pathogenesis of gouty arthritis
|
Urate crystals in the joint cause intense inflammation ;;> release of inflammatory mediators
|
|
|
3 stages of gouty arthritis
|
"; Acute gouty arthritis
|
|
|
; Resolves in [#] days"
|
"; First MTP joint; also ankle, foot, knee
|
|
|
Triggers of acute gouty arthritis
|
"; Trauma
|
|
|
T/F: Crystals can be detected in the synovial fluid in acute gouty arthritis
|
T
|
|
|
; Occur anywhere except the [location]"
|
"; Subcutaneous urate masses
|
|
|
How do tophi cause damage?
|
Erode into cartilage and bone
|
|
|
Draining tophi yields "[?]"
|
milk of urate
|
|
|
Diagnosis of tophaceous gout
|
"; Identification of monosodium urate crystals in synovial fluid or tophi
|
|
|
Appearance of gout crystals under polarized light
|
"; Negative birefringence
|
|
|
In negative birefringence, the object is [blue or yellow] when parallel to the first;order red compensator
|
yellow
|
|
|
In positive birefringence, the object is [blue or yellow] when parallel to the first;order red compensator
|
blue
|
|
|
Appearance of tophaceous erosions on x;ray
|
"; Punched out erosion with overhanging osteophyte
|
|
|
Treatment of acute gout
|
"; Colchicine
|
|
|
; Mechanism"
|
"; crystalline arthritis
|
|
|
Prophylactic treatment of acute gout
|
"; Avoidance of alcohol, diuretics, low;dose aspirin
|
|
|
Urate;lowering medications (and general mechanism)
|
"; Uricosurics (promote urate excretion)
|
|
|
Goal of treatment with urate;lowering medications
|
Reduction of serum urate below limit of solubility (< 6 mg/dL)
|
|
|
How do uricosurics promote urate excretion?
|
Inhibit renal tubular resorption of urate at a post;secretory site
|
|
|
Problems associated with uricosurics
|
"; Urate nephrolithiasis
|
|
|
How does allopurinol prevent the formation of urate?
|
Inhibits xanthine oxidase
|
|
|
In what types of patients/conditions is allopurinol the only good treatment?
|
"; Overexcretors
|
|
|
Problems associated with allopurinol
|
"; Hypersensitivity
|
|
|
What is the paradox of treatment with agents that reduce urate levels?
|
Reducing urate levels can initially precipitate an acute attack (use prophylactic NSAIDs or colchicine during the first few months of treatment)
|
|
|
Diseases caused by calcium pyrophosphate deposition
|
"; Asymptomatic chondrocalcinosis
|
|
|
What is chondrocalcinosis?
|
Deposition of calcium pyrophosphate crystals in articular cartilage and fibrocartilage
|
|
|
; Men vs. women"
|
"; Knee, wrist
|
|
|
Diseases associated with chondrocalcinosis
|
"; Hyperparathyroidism
|
|
|
Diagnosis of calcium pyrophosphate deposition disease
|
"; Radiographic chondrocalcinosis
|
|
|
Describe calcium pyrophosphate crystals
|
"; Weak, positive birefringence
|
|
|
Treatment of pseudogout
|
Same as for gout, but there is no role for agents that reduce serum urate
|
|
|
Diseases associated with basic calcium phosphate
|
"; Acute arthritis
|
|
|
Locations of acute periarthritis, secondary to basic calcium phosphate
|
"; Shoulder
|
|
|
Clinical presentation of Milwaukee shoulder
|
"; ""Shoulder pad sign"" (large effusion in shoulder joint)
|
|
|
Diagnosis of basic calcium phosphate disease
|
"; Radiographs
|
|
|
Treatment of basic calcium phosphate disease
|
Same as for pseudogout, except no role for colchicine in Milwaukee shoulder (is okay for calcific periarthritis)
|
|
|
Question
|
Answer
|
|
|
3 types of crystalline arthritis
|
". Gout
|
|
|
Types of clinical manifestations of gout
|
". Recurrent attacks of acute arthritis
|
|
|
Most common form of gout
|
Acute gout (podagra)
|
|
|
Most common location of acute gout
|
Foot (especially first MTP joint)
|
|
|
Clinical presentation of acute gout
|
Intense, severe inflammation of a single joint
|
|
|
[?] gout can resemble rheumatoid arthritis due to its nodular appearance
|
Tophaceous
|
|
|
Renal complications of gout
|
". Renal failure (tubular involvement)
|
|
|
. [Common or rare] in post.menopausal women. why?"
|
". 50s
|
|
|
Uric acid is the natural breakdown product of [?] metabolism
|
purine
|
|
|
[Enzyme] catalyzes the conversion of [molecule] to uric acid
|
". Xanthine oxidase
|
|
|
Most uric acid is derived from [diet or breakdown of cellular nucleotides]
|
breakdown of cellular nucleotides
|
|
|
Most uric acid is excreted by the [gut or kidneys]
|
kidneys
|
|
|
Describe the renal handling of uric acid
|
". Filtration
|
|
|
2 general mechanisms of hyperurecemia
|
". Overproduction of urate (10%)
|
|
|
Disorders that can cause hyperurecemia
|
". Myeloproliferative/lymphoproliferative diseases
|
|
|
Drugs that can cause undersecretion of urate
|
". Diuretics
|
|
|
Limit of solubility of urate in serum is [#] mg/dL
|
6.8
|
|
|
Why does urate often precipitate in the extremities?
|
The periphery is at decreased temperature, which decreases urate solubility
|
|
|
Pathogenesis of gouty arthritis
|
Urate crystals in the joint cause intense inflammation ..> release of inflammatory mediators
|
|
|
3 stages of gouty arthritis
|
". Acute gouty arthritis
|
|
|
. Resolves in [#] days"
|
". First MTP joint. also ankle, foot, knee
|
|
|
Triggers of acute gouty arthritis
|
". Trauma
|
|
|
T/F: Crystals can be detected in the synovial fluid in acute gouty arthritis
|
T
|
|
|
. Occur anywhere except the [location]"
|
". Subcutaneous urate masses
|
|
|
How do tophi cause damage?
|
Erode into cartilage and bone
|
|
|
Draining tophi yields "[?]"
|
milk of urate
|
|
|
Diagnosis of tophaceous gout
|
". Identification of monosodium urate crystals in synovial fluid or tophi
|
|
|
Appearance of gout crystals under polarized light
|
". Negative birefringence
|
|
|
In negative birefringence, the object is [blue or yellow] when parallel to the first.order red compensator
|
yellow
|
|
|
In positive birefringence, the object is [blue or yellow] when parallel to the first.order red compensator
|
blue
|
|
|
Appearance of tophaceous erosions on x.ray
|
". Punched out erosion with overhanging osteophyte
|
|
|
Treatment of acute gout
|
". Colchicine
|
|
|
. Mechanism"
|
". crystalline arthritis
|
|
|
Prophylactic treatment of acute gout
|
". Avoidance of alcohol, diuretics, low.dose aspirin
|
|
|
Urate.lowering medications (and general mechanism)
|
". Uricosurics (promote urate excretion)
|
|
|
Goal of treatment with urate.lowering medications
|
Reduction of serum urate below limit of solubility (< 6 mg/dL)
|
|
|
How do uricosurics promote urate excretion?
|
Inhibit renal tubular resorption of urate at a post.secretory site
|
|
|
Problems associated with uricosurics
|
". Urate nephrolithiasis
|
|
|
How does allopurinol prevent the formation of urate?
|
Inhibits xanthine oxidase
|
|
|
In what types of patients/conditions is allopurinol the only good treatment?
|
". Overexcretors
|
|
|
Problems associated with allopurinol
|
". Hypersensitivity
|
|
|
What is the paradox of treatment with agents that reduce urate levels?
|
Reducing urate levels can initially precipitate an acute attack (use prophylactic NSAIDs or colchicine during the first few months of treatment)
|
|
|
Diseases caused by calcium pyrophosphate deposition
|
". Asymptomatic chondrocalcinosis
|
|
|
What is chondrocalcinosis?
|
Deposition of calcium pyrophosphate crystals in articular cartilage and fibrocartilage
|
|
|
. Men vs. women"
|
". Knee, wrist
|
|
|
Diseases associated with chondrocalcinosis
|
". Hyperparathyroidism
|
|
|
Diagnosis of calcium pyrophosphate deposition disease
|
". Radiographic chondrocalcinosis
|
|
|
Describe calcium pyrophosphate crystals
|
". Weak, positive birefringence
|
|
|
Treatment of pseudogout
|
Same as for gout, but there is no role for agents that reduce serum urate
|
|
|
Diseases associated with basic calcium phosphate
|
". Acute arthritis
|
|
|
Locations of acute periarthritis, secondary to basic calcium phosphate
|
". Shoulder
|
|
|
Clinical presentation of Milwaukee shoulder
|
". ""Shoulder pad sign"" (large effusion in shoulder joint)
|
|
|
Diagnosis of basic calcium phosphate disease
|
". Radiographs
|
|
|
Treatment of basic calcium phosphate disease
|
Same as for pseudogout, except no role for colchicine in Milwaukee shoulder (is okay for calcific periarthritis)
|
