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Musculoskeletal > Crystal Arthritis > Flashcards

Crystal Arthritis Flashcards

Dr K Vinod

1
Q

what is gout?

A

inflammation in the joint triggered by uric acid crystals

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2
Q

what are the 2 causes of uric acid build up?

A

excess consumption

under excretion

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3
Q

name the 2 causes of hyperuricaemia

A

increased rate production

reduced urate excretion

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4
Q

what causes increased urate production?

A 
inherited enzymes defects
psoriasis
alcohol
haemolytic disorders
high purine intake - red meat, seafood and corn syrup
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5
Q

what causes reduced urate excretion?

A 
chronic renal impairment
heart failure
hypothyroidism
diuretics
cytotoxics
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6
Q

what is the mmol/l threshold in OA?

A

0.42 mmol/l

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7
Q

what sex is gout more common in?

A

male

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8
Q

who is gout very rare in?

A

women before menopause

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9
Q

what does acute gout most commonly affect?

A

1st MTP > ankle > knee
abrupt onset
overnight

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10
Q

how long is it till acute gout settles?

A

10 days without treatment

3 days with treatment

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11
Q

what drug is chronic tophaceous gout associated with?

A

diuretics

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12
Q

what is seen in chronic tophaceous gout?

A

high serum uric acid

top

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13
Q

explain the investigations and findings in gout

A

raised inflammatory markers
raised serum uric acid

polarising microscopy shows needle shaped crystals in synovial fluid

X-rays

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14
Q

name the treatment in acute gout

A

NSAIDs
Colchicine
steroids

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15
Q

name the prophylaxis in gout

A

allopurinol
febuxostat
start 2-4 weeks after acute attack
require cover with NSAID

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16
Q

what does calcium pyrophosphate deposition disease affect in body? and in who more commonly?

A

fibrocartilage of knees, wrists and ankles

elderly

17
Q

what does chondrocalcinosis increase with?

A

age

18
Q

name the 2 types of calcium pyrophosphate deposition disease

A

Calcium pyrophosphate (pseudogout)

Calcium hydroxy appatite crystals

19
Q

what are acute attacks of calcium pyrophosphate deposition disease due to?

A

calcium pyrophosphate crystals (pseudogout)

20
Q

what shape are calcium pyrophosphate crystals? (pseudogout)

A

rhomboid

21
Q

name the treatment in calcium pyrophosphate deposition disease

A

NSAIDs
Colchicine
Steroids
rehydration

22
Q

hydroxyapatite crystal deposition in or around the joint of the shoulder is also called what?

A

Milwaukee shoulder

23
Q

what does hydroxyapatite in Milwaukee shoulder release?

A

collagenases

IL-1

24
Q

Milwaukee shoulder has acute and rapid deterioration in females 50-60 years

true or false?

A

true

25
Q

what is the treatment in Milwaukee shoulder?

A

NSAIDs

intra-articular steroid injection

physiotherapy

partial or total arthroplasty

Musculoskeletal (37 decks)

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