crystals

Question 1

gout basic description

Answer 1

mono arthritis

Question 2

pathophys gout

Answer 2

increase in uric acid concentration leads to precipitaion in joint space

Question 3

cells in joint

Answer 3

PMNs/Mphages trigger immune response, increase WBC, TNF, lysosomal enzymes, mast cells

Question 4

diag

Answer 4

synovial fluid! must rule out infection! yellow/parallel crystals, monosodium urate, serum uric acid greater than 7 is high

Question 5

why high uric acid?

Answer 5

production (enzyme issue), diet, renal extortion (lead, diuretics)

Question 6

treat acute gout

Answer 6

manage inflam, NSAIDS, colcjocome, glucocortocoids

Question 7

treat chronic gout

Answer 7

liftestyle, decrease uric aci

Question 8

urocosuric drugs

Answer 8

increase uric renal secretion

Question 9

xanthine oxidase inhibitors

Answer 9

allopurinol, prevent uric acid formation

Question 10

pegloticase

Answer 10

enzume

Question 11

bridge for current attack with high levels

Answer 11

cholc. to treat acute plus allopurinol to prevent future

Question 12

pseudogout

Answer 12

calcium pyrophosphate dehydrate, knee/wrist, linear blue rhomboid calcification

Question 13

treat pseudogout

Answer 13

same as acute, cholc. is preventative in this case. No drugs to remove crystals from joint (like allopurinol)

Question 14

Most gout patients are what kind of Uris acid metabolizer?

Answer 14

Underexcretors (90%)

Renal failure, lead, idiopathic, other drugs (speed, cyclosporin )

Question 15

Four stages of gout

Answer 15

SYMOTOMATIC HYPER URICEMIA, ACUTE, INTERCRITICAL GOUT, CHRONIC TOPHUS GOUT

Question 16

Renal manifestations

Answer 16

Acute nephropathy: chemo, chronic: rare, hypertensive

Question 17

Risk of multiple attacks?

Answer 17

Damaging arthritis

Question 18

When would you auto treat

Answer 18

Renal issues, to pho, Uris acid above 12

Question 19

Issue with allopurinol treatment

Answer 19

Hla b5801- allergy