Crystalline arthropathies

Question 1

What is the most common type of inflammatory arthritis

Answer 1

Gout

Question 2

Which gender does gout effect more

Answer 2

male

Question 3

Patient comes in with a red, swollen, painful firth MTP joint. What is this presentation called?

Answer 3

Podagra

Question 4

Which molecules are metabolized into uric acid for gout

Answer 4

Nucleic acid

Question 5

What does a build up of uric acid precipitate

Answer 5

Crystal formation in the joints and soft tissue

Question 6

What are the two main forms of gout

Answer 6

Acute
Chronic

Question 7

If there is rapid onset joint pain, swelling that occurred but clears up in 3-10 days. What is the likely diagnosis

Answer 7

Acute gout

Question 8

If there is deposition of MSU in tissues following acute gout attacks, what is the most likely diagnosis

Answer 8

Chronic gout

Question 9

If a patient presents with acute onset of monoarticular joint pain with erythema and edema. Pain that is out of proportion to exam, and has decreased range of motion. What is the most likely diagnosis

Answer 9

Acute gout attack

Question 10

What is tophaceous gout

Answer 10

Chronic joint deformity with edema. No erythema or pain. With chalky white deposits

Question 11

What is the gold standard to identify crystals in the synovial fluid

Answer 11

Arthrocentesis

Question 12

What type of imaging evidence is supportive to a gout diagnosis

Answer 12

Punched out lesions (Rat bite)
Overhanging sclerotic borders
Soft tissue tophi

Question 13

What are the best drug options for an acute gout attack

Answer 13

Indomethacin (NSAID- first line)
Colchicine
Steroids

Question 14

When is colchicine used in an acute gout attack

Answer 14

When there is renal disease, GI disease, or elderly

Question 15

When are steroids used in acute gout and what forms are used

Answer 15

When unable to take NSAIDS

Can take oral if polyarticular
Intra-articular injection is monoarticular

Question 16

When are prevention drugs for gout introduced in treatment

Answer 16

When a person has had > 2 attacks in a year
High uric acid levels
Tophi present
Failure of symptomatic treatment

Question 17

What is the first line drug for in chronic gout prevention

Answer 17

Allopurinol

Question 18

What needs to be given along side allopurinol when initially starting treatment

Answer 18

Co-adminiter with either indomethacin or colchicine to prevent an acute attack

Question 19

What are the options for treatment of chronic gout

Answer 19

Allopurinol
Colchicine
Febuxostat
Probenicid
PEGylated

Question 20

Which gender is more likely to have pseudogout

Answer 20

Females

Question 21

Where does pseudo gout generally occur

Answer 21

Large joints

Question 22

What is the difference in crystals between regular gout and pseudo gout

Answer 22

Regular= spear
Pseudogout= Rhomboid

Question 23

Who is at high risk for pseudogout

Answer 23

Herparathyroidism
Hemochromatosis
Hypomagnesemia
Hypophosphatemia
Certain autoimmune disorders (SLE/RA)

Question 24

There is a patient that presents with acute onset of monoarticular joint pain and tenderness in the knees and wrists. What is the likely diagnosis

Answer 24

Pseudogout

Question 25

What is the gold standard for diagnosing pseudogout

Answer 25

CPP crystals in the synovial fluid