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MSK Biweekly 3 > Al-Mehdi Gout > Flashcards

Al-Mehdi Gout Flashcards

1
Q

more prevalent in men and most are asymptomatic for hyperuricemia

A

gout

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2
Q

hyperuricemia leads to what

A

gout

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3
Q

3 causes of hyperuricemia:

A
  1. decrease in renal excretion of uric acid
  2. increase in production from xanthine oxidase pathway
  3. increase ingestion of purines
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4
Q

examples of dietary purines

A

red meat, shellfish, beer

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5
Q

a serum uric acid of >6.8 means what

A

gout

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6
Q

these crystals deposit in joints to cause inflammation (gout)

A

monosodium urate (MSU)

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7
Q

normal amount of uric acid filtered load that stays in urine

A

10%

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8
Q

transporter for urate

A

urate transporter 1 (URAT1)

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9
Q

reabsorption happens in what sections of proximal convoluted tubule

A

S1 and S3

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10
Q

probenecid MoA

A

blocks URAT1 (inhibits reabsorption of urate, so increasing urate excretion)

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11
Q

segment of proximal convoluted tubule that deals with urate secretion

A

S2

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12
Q

role of NLRP3 inflammasome in pathogenesis of gout

A

activates caspase that ultimately produces IL-1beta (inflammatory)

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13
Q

Anakinra and Rilonacept MoA

A

inhibit IL-1beta action

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14
Q

stage of gout that deals with asymptomatic hyperuricemia

A

stage I

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15
Q

stage of gout where there is an acute gouty flare and interval period gout

A

stage II

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16
Q

stage of gout where there’s both gouty flares and tophi gout

A

stage III

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17
Q

rapid onset and pain on first MTP usually; extreme tenderness; self-limiting

A

acute attack of gout

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18
Q

joint swelling and tenderness

A

gouty arthritis

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19
Q

monosodium urate deposition in fingers and ears

A

tophi

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20
Q

signs of this include tophi in fingers, ears, and joints, and recurrent bouts of infection due to acute increase in uric acid

A

chronic gout

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21
Q

tophi over PIP NOT DIP and also along ears and fingers

A

diagnose gout

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22
Q

needle aspiration of joint fluid to diagnose gout:

A

negatively birefringent
blue when perpendicular
yellow when parallel

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23
Q

urate crystal ingested by neutrophils sign of what

A

gout

24
Q

crystals over hyaline cartilage sign of what

A

gout

25
Q

2 complications of gout

A

uric acid kidney stones (nephrolithiasis)
end stage renal disease

26
Q

what do you treat in acute gout

A

INFLAMMATION

27
Q

what do you treat in chronic gout

A

level of uric acid (want to reduce it)

28
Q

to treat acute gout:

A

NSAIDs, colchicine, glucocorticoids, anakinra

29
Q

drug to use for prophylaxis of gout attacks in interval (intercritical) period

A

colchicine

30
Q

microtubule disruptor – inhibits neutrophil migration) (first line for acute gout)

A

Colchicine

31
Q

to treat chronic gout

A

allopurinol, probenecid

32
Q

specific anti-inflammatory drug used to treat acute gout

A

Ibuprofen

33
Q

side effect of colchicine

A

diarrhea

34
Q

drug used to treat chronic gout that inhibits xanthine oxidase and has SE of hepatic/renal failure

A

Allopurinol

35
Q

drug used to treat chronic gout and inhibits xanthine oxidase and has cardiac SE

A

Febuxostat

36
Q

drug used to treat chronic gout and increases uric acid excretion by inhibiting URAT1 (so no reabsorption)

A

Probenecid

37
Q

best prophylaxis of gout

A

DIET

38
Q

x-linked recessive; mutation of HGPRT; self-mutilation and uric acid orange colored crystal in urine; gout

A

Lesch-Nyhan syndrome

39
Q

type of calcium pyrophosphate disease that has occasional inflammatory attacks in the knee

A

Pseudo-osteoarthritis

40
Q

type of calcium pyrophosphate disease that has onset not as abrupt as gout and attacks last longer; blood in joint fluid!!!!!; also mainly in knee

A

Pseudogout

41
Q

positively birefringent
yellow when perpendicular
blue when parallel

A

Pseudogout

42
Q

too much calcium in joint

A

CPPD (pseudogout)

43
Q

to treat acute CPPD

A

aspirate joint and inject glucocorticoids

44
Q

to treat chronic CPPD

A

prophylaxis (Colchicine)

45
Q

sites of apatite deposition for this disease includes knees and shoulders

A

calcium hydroxyapatite disease

46
Q

to treat calcium hydroxyapatite disease

A

NSAIDs and Colchicine

47
Q

diagnostic for what disease

A

calcium oxalate deposition disease

48
Q

autoimmune; pain in shoulder and hips; temporal arteritis (headaches) can lead to blindness

A

polymyalgia rheumatica

49
Q

to treat polymyalgia rheumatica

A

prednisone

50
Q

most common cause of musculoskeletal pain in women aged 20-55

A

fibromyalgia

51
Q

resembles neuropathic pain

A

fibromyalgia

52
Q

amplified pain perception seen in fibromyalgia

A

hyperalgesia

53
Q

pain brought on by nonpainful stimuli seen in fibromyalgia

A

allodynia

54
Q

duloxetine, venlaflaxine, pregabalin, and tramadol used to treat what

A

fibromyalgia

55
Q

If the ESR is above 100 mm/hr, what is the DDx?

A

temporal arteritis, polymyalgia rheumatica, osteomyelitis

MSK Biweekly 3 (5 decks)

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