E4: LOOK GOUT!

Question 1

Gout is a form of arthritis which is caused by the accumulation of _________ in joints

Answer 1

uric acid crystals

Question 2

Chronic gout may also cause joint destruction and decreased ______ function…It is often related to an _______ abnormality in the body’s ability to process uric acid

Answer 2

KIDNEY….inheritied

Question 3

Uric acid is a breakdown product of _______

Answer 3

PURINES

Question 4

The state of elevated levels of uric acid in the blood without symptoms is referred to as asymptomatic __________…a precursor state to developing gout

Answer 4

hyperuricemia

Question 5

What are the 2 types of GOUT?

Answer 5

1.exessive production of uric acid 2.reduced secretion of uric acid

Question 6

AVOID _______-rich foods!! Shellfish and organ meats such as liver, brains, kidneys, and sweetbreads ….AHHH no more liver?!!?

Answer 6

purine

Question 7

AVOID 3 drinks: _______ and _____ are particularly strong factors….fructose from the corn syrup in _______ also increases the risk of gout

Answer 7

beer and liquor…soft drinks

Question 8

_________ can be helpful in lowering the risk of recurrent attacks of gout

Answer 8

Weight reduction

Question 9

Intensely painful condition, which mostly affects only one joint (monoarthritis) at a time, most commonly the ______

Answer 9

BIG TOE

Question 10

Patients with longstanding hyperuricemia can have uric acid crystal deposits called _____ in other tissues as well, e.g. the helix of the ear

Answer 10

TOPHI—-get it TOE PHI!?

Question 11

What are the 4 stages of GOUT?

Answer 11

1.Asymptomatic 2.Acute 3.Intercritical 4.Chronic

Question 12

What drug? One indication only: treatment

of acute attack of gout…How does it work?

Answer 12

COL-CHICINE….CALL IN THE COLONEL!!! inhibition of neutrophil migration and phagocytic activity in inflamed joints,

Question 13

What is the main side effect of colchicine?

Answer 13

GI toxicity

Question 14

Drug: Management of chronic gout by inhibits the synthesis of uric acid….mech?

Answer 14

ALLO-PURIN-OL…..xanthine oxidase inhibitor that inhibits the synthesis of uric acid

Question 15

What is the other indication for allopurinol that we discussed? Whats a side effect?

Answer 15

chemo…hepatotoxic

Question 16

DRUG: Management of chronic gout by increases the excretion of uric acid = uricosuric agent

Answer 16

PRO-ben-ecid (for BENS future)

Question 17

Low dose aspirin interferes with uricosuric action of which drug?

Answer 17

probenecid…dont give aspirin to BEN

Question 18

What does proBENecid do to penicillin?

Answer 18

increases blood level of penicillin (competes for excretion)

Question 19

Can NSAIDS be used to manage gout?

Answer 19

YES! but not with proBENacid!