Crystal Arthropathies Flashcards

1
Q

What are gout nodules made of?

A

monosodium urate

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2
Q

what are pseudogout nodules made of?

A

calcium pyrophosphate dihydrate (CPPD)

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3
Q

which crystal is present in calcific periarthritis/tendonitis?

A

basic calcium phosphate hydroxyapatite (BCP)

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4
Q

what can cause overproduction of uric acid?

A
malignancy e.g. lymphoproliferative, tumour lysis syndrome
severe exfoliative psoriasis
drugs e.g. ethanol, cytotoxic drugs
inborn errors of metabolism
HGPRT deficiency
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5
Q

what can cause under excretion of uric acid?

A
renal impairment
hypertension
hypothyroidism
drugs e.g. alcohol, low dose aspirin, diuretics, cyclosporin
exercise, starvation, dehydration
lead poisoning
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6
Q

what is lesch nyhan syndrome

A
deficiency of hgprt
x linked recessive
intellectual disability
aggressive and impulsive behaviour
self mutilation
gout 
renal disease
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7
Q

why is gout so rare in younger women?

A

oestrogen has a uricosuric effect but after the menopause urate levels rise and gout becomes more common

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8
Q

how do you treat acute gout

A

NSAIDs
colchicine
steroids

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9
Q

how do you treat asymptomatic hyperuricaemia

A

u dont

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10
Q

should you treat hyperuricaemia

A

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

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11
Q

what is first line treatment for hyperuricaemia

A

allopurinol

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12
Q

where does gout usually occur

A

toes

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13
Q

where does pseudogout usually occur

A

knee

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14
Q

what are the signs and symptoms of polymyalgia rheumatica

A
sudden onset of shoulder +/- pelvic girdle stiffness
anaemia
malaise
weight loss
fever
depression
occasionally arthralgia/synovitis
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