Crystal Arthropathies Flashcards
What are gout nodules made of?
monosodium urate
what are pseudogout nodules made of?
calcium pyrophosphate dihydrate (CPPD)
which crystal is present in calcific periarthritis/tendonitis?
basic calcium phosphate hydroxyapatite (BCP)
what can cause overproduction of uric acid?
malignancy e.g. lymphoproliferative, tumour lysis syndrome severe exfoliative psoriasis drugs e.g. ethanol, cytotoxic drugs inborn errors of metabolism HGPRT deficiency
what can cause under excretion of uric acid?
renal impairment hypertension hypothyroidism drugs e.g. alcohol, low dose aspirin, diuretics, cyclosporin exercise, starvation, dehydration lead poisoning
what is lesch nyhan syndrome
deficiency of hgprt x linked recessive intellectual disability aggressive and impulsive behaviour self mutilation gout renal disease
why is gout so rare in younger women?
oestrogen has a uricosuric effect but after the menopause urate levels rise and gout becomes more common
how do you treat acute gout
NSAIDs
colchicine
steroids
how do you treat asymptomatic hyperuricaemia
u dont
should you treat hyperuricaemia
1st attack not treated unless
- single attack of polyarticular gout
- tophaceous gout
- urate calculi
- renal insufficiency
treat if 2nd attack within 1 year
prophylactically prior to treating certain malignancies
do not treat asymptomatic hyperuricaemia
what is first line treatment for hyperuricaemia
allopurinol
where does gout usually occur
toes
where does pseudogout usually occur
knee
what are the signs and symptoms of polymyalgia rheumatica
sudden onset of shoulder +/- pelvic girdle stiffness anaemia malaise weight loss fever depression occasionally arthralgia/synovitis
