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Musculoskeletal > Crystal Arthropathy > Flashcards

Crystal Arthropathy Flashcards

1
Q

What is a typhus?

A

Accumulation of uric acid

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2
Q

Where are the common areas to find tophi?

A

Over bony prominences (hands, elbows and feet)

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3
Q

What are the origins of the body’s urate pool?

A

Purines

Dietary

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4
Q

How is uric acid normally removed by the body?

A

Excreted via the kidneys

Remainder eliminated into biliary tract and converted by colonic bacterial uricase to allantoin

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5
Q

What could be causes of hyperuricaemia?

A 
Malignancy 
Severe exfoliative psoriasis 
Drugs (ethanol, cytotoxic syndrome) 
Inborn errors of metabolism 
HGPRT deficiency
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6
Q

What could be causes of hypouricaemia?

A 
Renal impairment 
Hypertension 
Hypothyroidism 
Drugs (alcohol, aspirin, diuretics, cyclosporin) 
Exercise, starvation, dehydration 
Lead poisoning
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7
Q

What is Lesch Nyan syndrome?

A

X linked recessive HGPRT deficiency

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8
Q

What are the signs and symptoms or Lesch Nyan syndrome?

A 
Intellectual disability 
Agressive and impulsive behaviour 
Self mutilation 
Gout 
Renal disease
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9
Q

What are the main risk factors of gout?

A

Excess consumption of red meat, seafood and beer
Diuretics
Dehydration
Male

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10
Q

What are the investigations for gout?

A

Examination

Joint aspiration and microscopy

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11
Q

What is the microscopic appearance of gout?

A

Needle shaped negatively bio fringent crystals

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12
Q

What is the management for gout?

A

NSAIDs
Colchicine
Steroids
Address lifestyle factors

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13
Q

What drugs are used to lower uric acid?

A

Xanthine oxidase inhibitors (Allopurinol)
Febuxostat
Uricosuric agents (sulphinpyrazone, probenecid, benzbromarone)
Canakinumab

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14
Q

What are the triggers of pseudogout?

A

Trauma

Intercurrent illness

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15
Q

What is the microscopic appearance of pseudogout?

A

Rhomboid shaped positive biofringent crystals

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16
Q

What is the management of pseudogout?

A

NSAIDs

I/A steroids

17
Q

What is the common presentation of polymyalgia rheumatica?

A

Sudden onset of shoulder and/or pelvic girdle stiffness

18
Q

What are the other signs and symptoms associated with polymyalgia rheumatica?

A 
High ESR 
Anaemia 
Malaise 
Weight loss 
Fever 
Depression 
Arthalgia
19
Q

What is the differential diagnosis for polymyalgia rheumatica?

A 
Myalgic onset inflammatory joint disease 
Underlying malignancy 
Inflammatory muscle disease 
Hypo/hyperthyroidism 
Bilateral shoulder capsulitis 
Fibromyalgia
20
Q

What is the management of polymyalgia rheumatica?

A

Prednisolone

Bone prophylaxis

Musculoskeletal (27 decks)

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