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15 Cards in this Set
- Front
- Back
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Name 3 crystals that can induce arthritis, starting with most common one.
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1. Monosodium urate
2. Calcium pyrophosphate dehydrate (CPPD) 3. hydroxy apatite |
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Define hyperuricemia in terms of serum level. Differentiate the level in male and female.
Is hyperuricemia diagnostic of gout? |
Male: > 7mg/dl
Female: > 6mg/dl Hyperuricemia is NOT diagnostic of gout. Many people are hyperuricemic yet don't have gout. |
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What is the most common joint affected by acute gout?
What is the special name for acute gout in this joint? |
First MTP joint.
Podagra |
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What is tophus?
Is it present in acute or chronic gout? or both? |
Tophus - extracellular soft tissue with urate crystal deposits surruonded by giant cells and MNCs.
ONLY present in CHRONIC gout |
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What is the gold standard diagnostic technique of gout?
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arthrocentesis --> looking for urate crystals in the synovial fluid
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How are urate crystals different from CCPD crystals?
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Urate crystals - needle shaped, strong, negative birefringence
CPPD crystals - small rod-like (rhomboids) ; weak, positive birefringence |
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Where would you find the urate crystals in acute gout in relation to neutrophils?
How about in chronic gout? |
acute gout - in the synovial fluid within the neutrohpils
Chronic gout -extracellular and free within the synovial fluid |
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What is URAT-1? where is it?
What is its function? What substances increase activities of URAT-1? What is the consequence of these substances? |
URAT-1 - renal-urate on the luminal membrane of proximal tubule in the kidney.
function - reabsorption of urate Drugs that increase anions increase URAT-1 activity --> increased reaborption of urate |
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List 3 conditions associated with gout?
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HTN, insulin resistance, obesity
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What are the hallmark cells of acute gout?
Name 3 cytokines that trigger influx of these cells. |
Neutrophils
IL-1, IL-8, and TNF |
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Define chondrocalcinosis.
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Calcification of hyaline or articulo-fibrocartilage due to accumulation of CPPD.
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What is the most common joint in pseudogout?
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Knee
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A male patient is diagnosed with CPPD and pseudogout in the knee. His lab shows that he has elevated liver enzymes.
What is the next step in diagnosis? |
Look for liver hemochromatosis because pseudogout is associated with hemochromatosis.
MENTIONED IN CLASS. |
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Radiographic findings of a patient shows calcification of mesci and hyaline cartilage in the knee.
Is it gout or pseudogout? |
Pseudogout.
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What is the safest/cheapest way to manage gout?
Name 2 medications for acute gout? Name 1 medication for chronic gout? |
Lifestyle modification (weight control, exercise, limit on red meat and alcohol) is the cheapest/safest way to manage gout.
acute gout medication - colchicine and NSAIDs (no aspirin b/c it increases anions) chornic gout - allopurinol (xanthine oxidase inhibitor) |
