BL- CRYSTALS Flashcards
CRYSTAL ARTHRITIS
a heterogeneous group of diseases in which tissue deposition of monosodium urate (MSU) crystals occurs due to hyperuricemia
-MSU supersaturation of extracellular fluids
recurrent attacks of severe acute or chronic articular and periarticular inflammation.
Gouty arthritis:
aggregated deposits of MSU occurring in joints, bones, and soft tissue.
Tophi:
renal interstitial, glomerular, and/or tubular deposition of MSU crystals.
Gouty nephropathy:
(kidney stones).
Uric acid nephrolithiasis
_____usually refers to acute or chronic arthritis secondary to MSU crystals. Hyperuricemia without symptoms is referred to as “asymptomatic hyperuricemia,” not gout.
Gout
Elevated serum uric acid level without gouty arthritis, tophi, or uric acid nephrolithiasis. A serum urate level is elevated when it exceeds the limit of solubility of MSU in serum. At 37 C, the saturation value of MSU in serum is 7.0 mg/dl; a value above this represents supersaturation of MSU.
Asymptomatic hyperuricemia
Abrupt onset of an exquisitely painful, warm, red, swollen joint often during the night or early morning. The metatarsophalangeal (MTP) joint of the great toe is involved most often (termed podagra) followed by the insteps, ankles, heels, knees, wrists, fingers, and elbows. Early attacks often spontaneously resolve over 3-10 days.
Acute Gouty Arthritis
Gout usually refers to acute or chronic arthritis secondary to MSU crystals. Hyperuricemia without symptoms is referred to as________ not gout.
“asymptomatic hyperuricemia”
The asymptomatic intervals between acute attacks of gout
Intercritical gout
Development of subcutaneous, synovial, or subchondral bone deposits of MSU crystals. Tophi commonly occur on the digits of the hands and feet, olecranon bursa, extensor surface of the forearm, Achilles tendon, and less commonly, the antihelix of the ear.
Chronic Tophaceous Gout
Gout is predominantly a disease of adult men typically occurring after the age of 30 with a peak incidence in the fifth decade. In females, gout occurs after_________ .
menopause
Hyperuricemia can result from:
increased production
decreased renal excretion of urate
The majority of patients (90%) with primary gout are underexcretors of _____
uric acid
Urinary uric acid excretion occurs through a four compartment model
glomerular filtration
pre-secretory reabsorption
secretion back into the tubule
post-secretory reabsorption