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