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26 Cards in this Set
- Front
- Back
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187. What are the two uricosuric drugs?
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1. Probenecid
2. Sulphinpyrazone |
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188. MOA of allopurinol?
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a. Allopurinol is a xanthine oxidase inhibitor-it decreases uric acid synthesis.
b. Use once daily dosing. It is well-tolerated. |
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189. Contraindication for allopurinol?
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a. Never give allopurinol for acute gout-it makes it worse.
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190. How should you decide whether to use a uricosuric agent (Probenecid or sulfinpyrazone) or allopurinol?
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a. The choice depends on how much uric acid is excreted in the urine in a 24-hour period.
b. If the uric acid excretion is less than 800 mg per day, this indicates under excretion of urate and a uricosuric agent (Probenecid or sulfinpyrazone) should be used. c. If a 24-hour urine uric acid is greater than 800 mg per day, this indicates overproduction and allopurinol may be used. |
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191. Contraindications for using uricosuric agents (Probenecid and sulfinpyrazone)?
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a. Use them only in patients with normal renal function.
b. They are contraindicated if the patient has a history of renal stones |
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192. What 2 medications should be avoided with acute gout?
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a. Aspirin- it can aggravate the problem.
b. Acetaminophen-has no anti-inflammatory properties. |
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193. What does pseudogout represent a deposition of?
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a. Calcium pyrophosphate crystals in joints, leading to inflammation.
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194. Risk factors for pseudogout (calcium pyrophosphate disease)?
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a. Deposition increases with age and with OA of the joints. Therefore, pseudogout is common in elderly patients with degenerative joint disease.
b. Other conditions that may increase crystal deposition include: 1. Hemochromatosis 2. Hyperparathyroidism 3. Hypothyroidism 4. Bartter’s syndrome |
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195. Clinical features of pseudogout (calcium pyrophosphate deposition disease)?
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a. Most commonly affects knees and wrists.
b. Is classically monoarticular, the can be polyarticular as well. |
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196. What is required for definitive diagnosis of pseudogout?
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a. Joints aspirate
b. it demonstrates weekly positive birefringent, rod shaped and rhomboid crystals in synovial fluid (calcium pyrophosphate crystals). |
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197. What may radiographs demonstrate with pseudogout?
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a. Chondrocalcinosis (cartilage calcification)
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198. Treatment of pseudogout?
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a. Treat the underlying disorder (if identified)
b. Symptomatic management is similar to that for gout (NSAIDs, colchicine, intra-articular steroid injections) c. Total joint replacement is appropriate if symptoms are debilitating. |
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199. Common locations for OA?
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a. Weight-bearing joints (knees, hips, lumbar/cervical spine), hands.
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200. Common locations for RA?
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a. Hands (PIP, MCP)
b. Wrists c. Ankles d. Knees |
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201. Common locations for Gouty Arthritis?
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a. Great toe
b. Ankles c. Knees d. Elbows |
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202. Presence of inflammation w/OA?
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a. NO
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203. Presence of inflammation w/RA?
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a. Yes
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204. Presence of inflammation w/Gouty Arthritis?
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a. Yes
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205. Radiographic changes w/OA?
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a. Narrowed joint space
b. Osteophytes c. Subchondral sclerosis d. Subchondral cysts |
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206. Radiographic changes w/RA?
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a. Narrowed joint space
b. Bony erosions |
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207. Radiographic changes w/Gouty Arthritis?
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a. Punched-out erosions w/overhanging rim of cortical bone.
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208. Laboratory changes w/OA?
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a. None
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209. Laboratory changes w/RA?
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a. Elevated ESR
b. RF c. Anaemia |
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210. Laboratory changes w/Gouty Arthritis?
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a. Crystals
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211. Systemic findings in OA vs. RA?
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a. No systemic findings in OA
b. RA has extra-articular manifestations, ulnar deviation, swan-neck and boutonniere deformity. |
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212. Extra-articular findings w/Gouty Arthritis?
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a. Tophi
b. Nephrolithiasis. |
