Crystal Arthropathies

Question 1

What is the salt found in gout?

Answer 1

Monosodium urate monohydrate

Question 2

What gender is more affected by gout?

Answer 2

Males

Question 3

What are some risk factors for gout?

Answer 3

• Obesity
• Metabolic Syndrome
• Diet
• Thiazide Diuretics

Question 4

Gout

Answer 4

• Supersaturation of uric acid
• Crystal formation which activate immune system
• Trigger complement cascade which
  recruits neutrophils
• Phagocytosis by monocytes activates intracellular inflammasome

Question 5

What is the most likely cause of gout, overproduction or under excretion?

Answer 5

Underexcretion

Question 6

What are the 2 important enzymes on the urate synthesis pathway?

Answer 6

• Deaminase

- Xanthine Oxidase

Question 7

Podagra

Answer 7

Typical pain of gout found in the big toe - acute involvement of 1st MTP

Question 8

Calcium Pyrophosphate Deposition Disease is AKA….

Answer 8

Pseudogout

Question 9

What are the joints most often involved in pseudo gout?

Answer 9

Knees and wrist

Question 10

What population is pseudo gout seen in?

Answer 10

Older people

Question 11

Chondrocalcinosis

Answer 11

Calcium crystal deposition in meniscus of the knee and triangular cartilage of the wrist

Question 12

Milwaukee Shoulder

Answer 12

• Hydroxypatite associated destructive arthritis

- Elderly females with destruction of rotator cuff and glenohumeral joint

Question 13

Polymyalgia Rheumatica

Answer 13

Autoimmue disorder that causes pain and stiffness in proximal joints and muscles
- Shoulders and hips, neck muscles can be affected

Question 14

What disease is polymyalgia rheumatica associated with?

Answer 14

Giant Cell Arteritis

Question 15

What gender is more affected by polymyalgia rheumatica?

Answer 15

Females

Question 16

Fibromyalgia

Answer 16

Chronic widespread pain with 11 or more tender points - more likely in women

Question 17

Tenosynovial Giant Cell Tumor

Answer 17

Most common benign neoplasm of the synovium and is associated with translocation fusing the promoter of the collagen 6A3 gene to the coding sequence of M-CSF - can be localized or diffuse

Question 18

Synovial Chondromatosis

Answer 18

Multiple nodules of hyalgine cartilage within subsynovial connective tissue with the knee most commonly affected - benign

Question 19

What are foods to avoid for gout patients?

Answer 19

• Red meat
• Beer
• Shellfish
• Beans

Question 20

Allopurinol MOA

Answer 20

Xanthine oxidase inhibitor - decreases the uric acid generated

Question 21

What is poodagra indicative of?

Answer 21

Gout

Question 22

What is positive birefringence indicative of?

Answer 22

CPPD - pseudogout

Question 23

What is negative birefringence indicative of?

Answer 23

Gout

Question 24

What biologic anti-inflammatory can be used in pseudo gout?

Answer 24

Anti-IL1

Question 25

Where can hydroxyapatite also be found?

Answer 25

In the tendons

Question 26

What is the treatment for polymyalgia rheumatica?

Answer 26

Corticosteroids

Question 27

What is a major trigger/cause of fibromyalgia?

Answer 27

Lack of sleep - decreases pain tolerance

Question 28

What is the joint most likely affected by Tenosynovial Giant Cell Tumor?

Answer 28

Knee

Question 29

What is seen on histology of tenosynovial giant cell tumors?

Answer 29

Multiple hemosiderin-laden

macrophages, osteoclast-like giant cells