crystal arthropathies Flashcards
how to diagnose gout
needle aspiration of acutely or chronically involved joitns or tophaceous deposits
what can limit the value of serum uric acid for diagnosis?
serum urric acid levels can be nl or low during attack, as inflammatory cytokines can be uriosuric and effective initiation of hypouricemic therapy can precipitate attacks
treatment of acute gouty arthritis
NSAIDs, colchicine, or steroids
controlling hyperuricemia through simple means
control of body weight, low-purine diet, increase in liquid intake, limitation of ethanol use, decreased use of fructose-containing foods and beverages, and avoidance of diuretics
hypouricemic therapy
probenecib, allopurinol, febuxostat
most serious side effects of allopurinol
life-threatening toxic epidermal necrolysis, systemic vasculitis, bone marrow suppression, granulomatous hepatitis, renal failure
conditions ass. w/ calcium pyrophosphate dihydrate disease
aging
disease-associated (primary hyperparathyroidism, hemochromatosis, hypophosphatasia, hypomagnesemia, chronic gout, postmeniscectomy, gitelman’s syndrome)
epiphyseal dysplasias
what is apatite?
primary mineral of nl bone and teeth
- abnl accumulation of basic calcium phosphates, largely carbonate substituted apatite, can occur in areas os tissue damage (dystrophic calcification), hypercalcemic or hyperparathyroid states (metastatic calcification
what is another word for apatite arthropathy?
basic calcium phosphate disease
treatment for calcium apatite deposition disease
nsaids, colchicine, steroids
cause of calcium oxalate deposition disease
primary (metabolic disorder, rare)
secondary (end-stage renal disease)
what kind of supplement can increase oxalate?
ascorbic acid (metabolized to oxalate), which is inadequately cleared in uremia and by dialysis
pathophysiology of gout
acute and chronic arthritis caused by deposition of MSU crystals in joints and connective tissue tophi and the risk for deposition in kidney interstitium or uric acid nephrolithiasis