crystal induced arthritis

Question 1

most common inflammatory disease

Answer 1

gout

Question 2

essential for the development of gout

Answer 2

hyperuricemia

Question 3

hyperuricemia clinical definition

Answer 3

> 7.0 mg/dL

Question 4

uric acid about 7.0 favors

Answer 4

crystal deposition in tissues

Question 5

the worse the hyperuricemia the

Answer 5

worse the gout

Question 6

causes of hyperuricemia

Answer 6

• uric acid overproduction

- or underexcretion

Question 7

gout is more commonly seen in

Answer 7

men in 5th decade

Question 8

early onset gout is associated often with ____

Answer 8

disease of inborn error of metabolism

Question 9

common risk factors for gout

Answer 9

• obesity
• alcohol use
• glucose intolerance
• diabetes
• diurectics/ cyclosporin/low dose aspirin

Question 10

initial presentation of gout

Answer 10

acute mono arthritis with podagra of the 1st MTP

Question 11

pain gout occurs

Answer 11

very acute in the MORNING, bed sheets cant even touch toe

Question 12

the first couple of gout attacks are often

Answer 12

self limiting lasting 7-10 d

Question 13

the only way to make a definitive diagnosis for gout

Answer 13

test synovial fluid

Question 14

gout in synovial fluid

Answer 14

• inflammatory! WBC >5000 but usually much higher

- fluid may appear purulent and raise concern for septic arthritis

Question 15

type of crystals in gout

Answer 15

monosodium urate crystals

Question 16

hallmark of the disease gout

Answer 16

monosodium urate crystals

Question 17

description of MSU crystals

Answer 17

needle shaped and strongly negative birefringence on polarized light

Question 18

goal of uric acid in gout

Answer 18

<6 mg/dL

Question 19

mainstay treatment of gout

Answer 19

NSAIDS - indomethacin

Question 20

contraindications for NSAIDS in gout

Answer 20

if peptic ulcer disease or renal insufficiency

Question 21

colchicine therapeutic window

Answer 21

narrow

Question 22

colchicine toxicity

Answer 22

diarrhea, marrow suppression

Question 23

colchicine MOA

Answer 23

inhibits neutrophil function

• does not alter URATE LEVELS

Question 24

amount of colchicine given in acute gout

Answer 24

1.2 mg po followed by 0.6 mg 1 hr later

high doses NOT recommended

Question 25

urate lowering therapies

Answer 25

• xanthine oxidase inhibitors
• URAT1 inhibitor
• uricosuric agents

Question 26

drug which is at risk for kidney stones in gout

Answer 26

probenecid

Question 27

chronic gout therapies

Answer 27

pegloticase IV (uricase)

Question 28

pegloticase toxicity

Answer 28

anaphylaxis and bite cells?

Question 29

CPPD arthropathy

Answer 29

pseudogout - calcium pyrohostpate deposition in joints

Question 30

major risk factor for CPPD

Answer 30

age

Question 31

crystals in CPPD

Answer 31

weakly positive birefringence and rhomboid and blue shaped

Question 32

treatment for CPPD

Answer 32

acute is same as GOUT,

chronic is methotrexate or hydroxychloroquine