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GP Conditions Year 4 > Crystal arthropathy > Flashcards

Crystal arthropathy Flashcards

1
Q

Gout

A

crystal arthropathy associated with high blood uric acid levels

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2
Q

What kind of crystals gout?

A

monosodium urate

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3
Q

What are gouty tophi?

A

subcutaneous deposits of uric acid affecting small joints and connective tissue of hands, elbows and ears
DIPJ

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4
Q

How does gout present?

A

Single acute, hot, swollen and painful joint

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5
Q

Important differential diagnosis - gout

A

septic arthritis

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6
Q

Risk factors - gout

A 
male
obesity 
high purine diet eg meat
alcohol 
diuretics 
CVD or CKD
FH
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7
Q

Typical joints - gout

A

base of big toe - MTPJ
wrists
base of thumb

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8
Q

Diagnosis of gout

A

clinically

aspirating fluid from joint

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9
Q

joint aspiration in gout will show..

A

no bacterial growth
needle shaped crystals
negative birefringent
monosodium urate crystal

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10
Q

x-ray findings gout

A

lytic lesions in bone

punched out erosions

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11
Q

Managing acute flare gout

A

NSAIDs
colchicine
steroids

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12
Q

who is colchicine used for?

A

patients inappropriate for NSAIDs eg renal impairment

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13
Q

Prophyaxis of gout

A

allopurinol

lifestyle changes

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14
Q

Allopurinol

A

xanthine oxidase inhibitor

reduces uric acid level

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15
Q

What is pseudogout?

A

crystal arthropathy caused by crystal deposition in joints

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16
Q

crystals in pseudogout

A

calcium pyrophosphate

17
Q

presentation of pseudogout

A

older adult

hot, swollen, stiff, painful knee

18
Q

joints commonly affected - pseudogout

A

knee

shoulders, wrists and hips

19
Q

diagnosing pseudogout

A

aspirate synovial fluid

x-ray

20
Q

aspirated fluid - pseudogout

A

calcium pyrophosphate crystals
positive birefringent of polarised light
no bacterial growth

21
Q

pathopneumonic x-ray change - pseudogout

A

chondrocalcinosis

thin white line in middle of joint space caused by calcium deposition

22
Q

x-ray changes - pseudogout

A

loss of joint space
osteophytes
subarticular sclerosis
subchondral cysts

23
Q

managing pseudogout

A 
NSAIDs
colchicine 
joint aspiration 
steroid injections 
oral steroids 
joint washout

GP Conditions Year 4 (72 decks)

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