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Ortho AM > Crystal arthropathies > Flashcards

Crystal arthropathies Flashcards

1
Q

What is gout?

A

Build up of monosodium urate crystals, caused by hyperuricaemia

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2
Q

What is seen on microscopy with gout?

A

Needle shaped crystals

Strong bifringence

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3
Q

Who gets gout?

A

Men > women

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4
Q

What are the types of causes of gout?

A

Overproduction

Underexcretion

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5
Q

What are the overproduction causes of gout?

A

Malignancy
Severe exfoliative psoriasis
Drugs
Inborn errors of metabolism- HGPRT deficiency

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6
Q

What are the under excretion causes of gout?

A 
Renal impairment
Hypertension
Hypothyroid
Drugs
Exercise 
Starvation or dehydration 
Lead poisoning
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7
Q

What is the presentation of gout?

A

Flare up starts overnight and lasts 7-10 days
Acute pain nd inflammation
Peeling and redness of overlying skin

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8
Q

What is the most common joint affected by gout?

A

1st MTPJ

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9
Q

What is Lesch Nyan syndrome?

A

Genetic X linked HPGRT deficiency

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10
Q

What are the features of Lesch Nyan syndrome?

A 
Intellectual disability 
Aggressive and impulsive 
Self mutilation
Gout
Renal disease
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11
Q

How is gout diagnosed?

A

Aspiration

  • gram stain to rule out infection
  • Polarising microscopy= needle shaped crystals
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12
Q

What is the acute management of gout?

A
  1. NSAIDs
  2. Colchicine- if NSAIDs contraindicated
  3. Steroids
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13
Q

When is it indicated to treat hyperuricaemia?

A 
2nd attack of gout in 1 year 
Prophylaxis in certain maliganncy
Symptomatic 
1st attack but 1 of
-renal insufficiency
-urate calculi 
-polyarticular gout
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14
Q

What is the 1st line in management of hyperuricaemia?

A

Allopurinol- xanthine oxidase inhibitor

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15
Q

What crystals are involved in pseudo gout?

A

Calcium pyrophosphate dehydrate CPPD

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16
Q

Who is pseudo gout normally seen in?

A

Elderly females

17
Q

What are the triggers of pseudo gout?

A

Trauma

Intercurrent illness

18
Q

What is the presentation of pseudo gout?

A

Bouts of joint pain and swelling with fluid build up

19
Q

What is the commonly affected joint with pseudo gout?

A

Knee

20
Q

What is the appearance of CPPD crystals on polarising microscopy?

A

Rhomboid shaped

Weak bifringence

21
Q

What is the management of pseudo gout?

A

NSAIDs

Steroids

Ortho AM (23 decks)

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