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Rheumatology > Crystal arthropathies > Flashcards

Crystal arthropathies Flashcards

1
Q

What is gout?

A

Deposition of urate crystals in a joint

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2
Q

What is pseudogout?

A

Deposition of calcium pyrophosphate crystals in a joint or soft tissues - most commonly cartilage

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3
Q

What causes gout?

A

Hyperuricaemia

  • decreased excretion of uric acid - renal failure, diuretics
  • increased consumption of red meat, seafood, alcohol
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4
Q

Three common triggers of gout?

A

Trauma
Dehydration
Surgery

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5
Q

Which joint is classically affected in gout?

A

1st MTP

ankle and knee also commonly affected

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6
Q

Signs and symptoms of gout

A

Intensely painful, hot, red, swollen joint
may mimic septic arthritis
Gouty tophi

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7
Q

What are gouty tophi?

A

Painless, white, accumulations of urate crystals in the soft tissues which may occasionally burst through the skin

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8
Q

Acute gout treatment?

A

NSAIDs
Corticosteroids
Colchicine for those intolerant of NSAIDs

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9
Q

Chronic gout treatment?

A

Allopurinol

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10
Q

What is important about administering allopurinol?

A

Must wait until an acute attack has passed otherwise it may cause a further flare up

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11
Q

How does colchicine work?

A

Inhibits monosodium urate induced activation of neutrophils

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12
Q

How does allopurinol work?

A

Decreases the breakdown of purines and uric acid formation

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13
Q

Describe the crystals in gout

A

Urate
Negatively birefringent
Needle shaped

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14
Q

Describe the crystals in pseudogout

A

Calcium pyrophosphate
Positively birefringent
Rhomboid shaped

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15
Q

Which joints does pseudogout tend to affect?

A

Knees
Wrists
Ankles

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16
Q

Pseudogout aetiology

A 
Cause unknown but associated with
Hypothyroidism
Hyperparathyroidism
Haemochromatosis
Wilsons disease
Renal osteodystrophy
17
Q

Acute pseudogout treatment

A

NSAIDs
Corticosteriods
Occasionally colchicine
No prophylactic treatment

Rheumatology (8 decks)

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