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18 Cards in this Set

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  • Back
What are clinical manifestations of gout?
• acute & chronic arthritis
• deposits of uric acid in and around joints and skin
• hyperuricemia
• renal stones
What portion of the population is mainly affect by gout?
• men
• post-menopausal women (to a lesser extent)
Uric acid is the breakdown product of what?
purines (adenine & guanine)
Generally, what are 2 causes of hyperuricemia?
• decreased urate excretion
• increased urate production
What are causes of decreased urate excretion?
• acidosis
• dehydration
• drugs
• hypothyroidism
• impaired renal function
What are drugs that can cause decreased urate excretion?
• cyclosporine
• diuretics
• ethambutol
• levodopa
• nicotinic acid
• pyrazinamide
What is a tophus?
grossly visible nodular deposit of monosodium urate monohydrate crystals
What is the most important stimulus to uric acid production?
alcohol
How can you distinguish gout from septic joint disease?
• septic joint disease has a more insidious onset
• more systemically ill
• chills & sweats accompanying fever
• peripheral leukocytosis
What will examination of synovial fluid of patients with gout show?
• intracellular, needle-shaped, negatively birefringent crystals
• pathognomonic of acute gout arthritis
What are treatment options of acute gout?
• Colchicine
• corticosteroids
• Adrenocorticotropic hormone
• NSAIDS (ex. Indomethacin)
What patients have indications for long-term treatment of gout?
pts with:
• tophi
• polyarticular disease
• renal stones
What are treatment options for intercritical gout?
• colchine
• probenecid (uricosuric agent)
• allopurinol (xanthine oxidase inhibitor)
What is pseudogout?
calcium pyrophosphate deposition in articular cartilage and fibrocartilage
What areas are most commonly affected by pseudogout?
• menisci of the knee
• triangular fibrocartilage of the wrist
• pubis symphysis
What conditions increases the incidence of pseudogout?
• diabetes
• gout
• hemochromatosis
• hyperparathyroidism
What is seen on synovial fluid analysis in patients with pseudogout?
intracellular, positively birefringent, rhomboid-shaped crystals
What is chondrocalcinosis?
the presence of calcium-containing salts in articular cartilage