Crystal Arthritis Flashcards
What is meant by gout?
Form of arthritis due to excess uric acid in bloodstream.
What’s the difference between pseudogout and gout?
Pseudogout affects larger joints e.g. knees. Pseudogout is the build up of calcium pyrophosphate dihydrate crystals in your joint, gout is build up of urate crystals. Pseudogut affects more than one joint.
What is pseudogout?
Type of arthritis that causes painful swelling in one/more joints.
State the two steps to produce uric acid?
Hypoxanthine - xanthine - uric acid.
State 3 risk factors for hyperuricaemia.
Obesity. High alcohol consumption. Age (20-30 increase age). Genetic. Male sex.
State 2 clinical features of gout.
Always single joint. Severe pain. Rapid onset. Warm/swollen joint. Reduced range of motion.
Where would high urate levels be found in a diet?
Shellfish. Marmite. Red meat. Alcohol (reducess fractional clearance of waste).
What are the crystal deposits underneath the skin known as?
Tophi.
What colour do urate crystals appear under an X-ray?
Grey.
What colour do pyrophoshate crystals appear under an X-ray?
Opaque.
State 2 medications used to treat gout.
Glucocorticoids. NSAIDs e.g. naproxen, indomethacin. Colchicine (inhibits leukocyte migration).
State 2 ways to manage and prevent gout.
Xanthine oxidase (XO) inhibitors e.g. allopurinol, febuxostat (inhibits enzyme to increase urate production). Uricosuric medications e.g. probenecid (increases urate excretion at kidney). Uricase medications e.g. rasburicase (mimic enzyme that catalase urate conversion into allantoin). Diet modification (limit red meat/seafood).
State 2 risk factors for calcium pyrophosphate disease (pseudogut).
Advancing age. Prior joint trauma. Haemochromatosis (disorder where too much iron builds up in your body).
State 2 ways gout is diagnosed.
CT scan - imaging findings become more likely with disease duration. X-ray - radiolucent uric acid nephrolithiasis.
Why is vitamin D essential for muscsuloskeletal health?
Enables Ca absorption from the bowel. Enables mineralisation of newly formed osteoid tissue.
