Crystal Related Joint Diseases Flashcards

1
Q

Gout:

A
  • Deposition of Monosodium Urate Crystals in tissue at physiologic pH
  • Uric acid at pH 7.4 is in Urate form
  • Two causes: Over production of urate or Decreased excretion of urate
  • Loop Diuretics and Thiazide Diuretics are Not to be Used
  • Pre-pubertal children and Pre-menopausal women cannot get gout
  • Acute onset
  • Podegra: Great toe at MPJ
  • Erosions/PUNCH OUT LESIONS on bones
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2
Q

Purine Degradation pathway:

A

Purine -> Inosine -> Hypoxanthine -> Xanthine -> Uric Acid

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3
Q

Two reactions catalyzed by Xanthine Oxidase:

A

Hypoxanthine -> Xanthine

Xanthine -> Uric Acid

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4
Q

High fructose corn syrup and gout:

A

Increase Production of AMP causing increase in purines

Decreased excretion -> Lactic Acid is a by-product of metabolism and lactic acid decreases urate excretion

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5
Q

Drugs associated with hyperuricemia:

A
Cytotoxic chemotherapy
Low-dose aspirin
Ethanol
Niacin
Diuretics
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6
Q

Tophi:

A

Uric acid deposition in soft tissue

  • EXTENSOR AREA OF LIMBS
  • Ears
  • Achilles tendon
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7
Q

Gout treatment:

A

NSAIDs to control immune response-> Indomethacin
Colchine: anti-inflammatory agent that inhibits neutrophil activation in MSU presence
Uricosuric Agents: Probenecid -> Inhibit URAT transporter bringing Uric acid back into blood
Xanthine Oxidase inhibitors: Allopurinol (Thiazide diuretics interfere with excretion of allopurinol increasing toxicity)

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8
Q

Calcium Pyrophosphate Dihydrate/Pseudogout:

A
  • Deposits in hyaline and fibrocartilage of joints
  • Most commonly the knee
  • Larger joints affected than gout
  • Also know it affects MCP joint
  • Do a metabolic screening as it occurs with metabolic diseases
  • If ONLY ONE OR TWO JOINTS AFFECTED ASPIRATE
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