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*MSK > Crystal Arthropathy > Flashcards

Crystal Arthropathy Flashcards

1
Q

What joint deposit is seen in gout?

A

Monosodium urate

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2
Q

What joint deposit is seen in pseudogout?

A

Calcium pyrophosphate dihydrate

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3
Q

What joint deposit is seen in calcific arthritis/tendonitis?

A

Basic calcium phosphate hydroxy-apatite

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4
Q

What is the origin of uric acid?

A

Breakdown of purines

Diet

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5
Q

Where is uric acid excreted?

A

70% at kidney

Rest at biliary tree

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6
Q

What are the causes of hyperuricaemia due to overproduction?

A 
Malignancy
Severe exfoliative psoriasis
Drugs
Errors of metabolism
HGPRT deficiency
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7
Q

What are the causes of hyperuricaemia due to undersecretion?

A 
Renal impairment
Hypertension
Hypothyroidism
Drugs
Exercise 
Dehydration
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8
Q

What is Lesch Nyan syndrome?

A 
HGPRT deficiency
X-linked recessive
Aggressive behaviour
Gout
Renal disease
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9
Q

How is an acute flare of gout managed?

A

NSAIDs
Colchicine
Steroids

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10
Q

How is hyperuricaemia treated?

A

Only treat if GOUT found

Do not treat asymptomatic hyperuricaemia

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11
Q

How is uric acid lowered?

A

Allopurinol
Febuxostat
Uricosuric agents

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12
Q

What are the roles for lowering uric acid levels?

A

Wait until attack has settled

Prophylactic NSAIDs until normal

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13
Q

How is Gout managed?

A

Lower Uric acid levels
Treat Gout
Address CV/lifestyle factors

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14
Q

What lifestyle factors can be changed for gout?

A 
Weight loss
Diabetes 
HTN
Smoking
High purine foods
Alcohol
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15
Q

What is pseudogout?

A

Knee gout
Seen in elderly females
Erratic flares triggered by trauma, illness

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16
Q

How is pseudogout managed?

A

NSAIDs

I/A steroids

17
Q

What is polymyalgia rheumatica?

A

Inflammatory condition in the elderly with a relationship to giant cell arthritis and high ESR anaemia

18
Q

How does polymyalgia rheumatica present?

A 
Sudden onset shoulder/pelvic girdle stiffness
50 - 70yrs 
Female x2 
Elevated ESR
Anaemia
Malaise, fever, weight loss
Arthralgia
19
Q

How is polymyalgia rheumatica diagnosed?

A

History
Age >50
ESR >50
Dramatic response to steroids

20
Q

What is the differential diagnosis of polymyalgia rheumatica?

A 
Myalgic onset inflammatory joint disease
Malignancy 
Inflammatory muscle disease
Thyroid disease
Bilateral shoulder capsulitis
Fibromyalgia
21
Q

How is polymyalgia rheumatica treated?

A

Prednisolone

*MSK (25 decks)

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