Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Senior - Rhuem Chart > Crystal Induced > Flashcards

Crystal Induced Flashcards

1
Q

What is included in crystal induced arthritis?

A

Gout
Calcium pyrophosphate dihydrate deposition disease
Osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Who gets gout?

A 
<65 = men
>65 = men and women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the MCC of inflammatory arthritis in men >40?

A

Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is gout?

A

Not an autoimmune
Heterogenous metabolic disorder associated with hyperuricemia cause by:
1. Underexcretion of uric acid
2. Overproduction of uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is uric acid?

A

A product of purine metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MC cause of gout>?

A

Underexcretion of uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute inflammation gout gets better in?

A

10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Chronic inflammatory gout is:

A

Response leading to continued crystal deposition (tophi)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are acute intermittent gout and chronic gouty arthritis?

A

Acute intermittent gout&raquo_space; chroinic gouty arthritis

Takes 10 yrs
Joints become uncomfortable and swollen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What affects urate overproduction and underexcretion?

A 
ETOH
G6PD
Fructose 1-PAD
HCTZ
Niacin
ASA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clinical manifestations of gout?

A

Nephrolithiasis (radiolucent)

Tophaceous gout

Skin desquamation

Podagra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnostic levels for gout”?

A

Hyperuricema
- uric acid >/= 6.8 mg/dL
Uric acid nephrolitthiasis
- uric acid >13 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

X rays for gout?

A

“Rat bite” lesions (late sign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical diagnosis for gout?

A

Acute monoarticular arthritis

  • night pain
  • big toe (usually)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hyperuricemia responds to?

A

NSAIDS

Colchicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Clinical stages of gout?

A

Stage I: asymptomatic
Stage II: gouty arthritis
Intercriical gout: after attack
Stage III: chronic tophaceous gout

17
Q

Definitive diagnosis of gout?

A

Uric acid crystals in joint fluid

Polarized microscopy show NEGATIVELY bifringent and needle-like Na urate crystals

18
Q

Uric acid level goal (therapy)

A

= 6

19
Q

What is the most important aspect of gout tx?

A

How rapidly tx is initiated

W/in min of flare it may halt progression

20
Q

Gout tx meds?

A
  1. NSAIDS (indomethacin)
  2. Colchicine
  3. Glucocorticoids (3rd line)

Continue tx 48-72hrs after to reduce risk of relapse

21
Q

How is indomethacin given?

A

Start at max dose

22
Q

Who gets glucocorticoids (gout)

A

Reserved for pts who have contraindications to nSAIDS/Colchicine
or
NSAIDS/colchicine are ineffective

23
Q

During an acute gout attack?

A

Do not start chronic urate lowering drugs during a gout attack

24
Q

Intercrtical treatment of gout?

A

ULT or cholchicine propolaysis

25
Q

ULT?

A

Urate lowering drugs (therapy maybe)

Xanthine oxidase inhibitors
- allopurinol/febuxostat

Uricosuric (2nd line)
- probenecid&raquo_space; nephrolitiasis

26
Q

Indications for ULT?

A

Tophi
2+ attacks/yr
CKD stage 2+
Urolithiasis

27
Q

Pseudogout is aka?

A

Calcium pyrophosphate dihydrate deposition disease

28
Q

Who gets pseudogout?

A

MC >60y/o

29
Q

What causes pseudogout?

A

Calcium salt deposits in cartilage (chondrocalcinosis) that precipitate in a joint and cause painful arthritis

30
Q

S/s of pseudogout?

A

Acute monarticular/oligoarticular arthritis lasting days - 2 weeks

31
Q

Always suspect pseudogout in:

A

Elderly hospitalized pt with NEW ACUTE MONOARTHRITIS

32
Q

Types of pseudogout?

A

Primary

  • idiopathic (aging)
  • hereditary

Secondary

  • hyperparathyroidism
  • hemochromatosis
  • hypothyroidism
  • hypo Mg2_ and PO4-
33
Q

Lab findings for pseudogout?

A

Normal serum uric acid

Joint aspirate: ca pyrophosphate crystals w POSITIVE bifringence on polarized microscopy

34
Q

Gout vs pseudogout aspirate?

A

Gout:

  • negatively bifringent
  • needle like Na urate crystals

Pseudogout:

  • positive bifringence
  • Ca pyrophosphate crystals
35
Q

Radiographs for pseudogout?

A

Calcifications-chondrocalcinosis in knees

Signs of degenerative changes (OA)

36
Q

Tx for pseudogout?

A

NSAIDS/COX2 (1st line)
(Same as gout)
Corticosteroids (low dose w taper)

Colchicine (2nd line)

Resistant cases - methotrexate

Senior - Rhuem Chart (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions