Exam 4: Gout

Question 1

Chronic gout may cause what?

Answer 1

Joint destruction

Decreased Kidney function

Question 2

What is Asymptomatic hyperuricemia

Answer 2

The state of elevated levels of uric acid in the blood without symptoms of gout

Question 3

2 types of gout

Answer 3

1. Excessive production of uric acid

2. Reduced excretion of uric acid

Question 4

Symptoms of Gout

Answer 4

1. Affects one joint at a time, most commonly big toe
2. Sudden pain, swelling, redness, warmth and stiffness
3. Low-Grade fever may be present
4. Skin over joint is swollen, tender and sore

Question 5

Gout has what 4 distinct stages

Answer 5

1. Asymptomatic - high levels of uric acid but no joint complaints
2. Acute - acute complaints occur for a brief period
3. Intercritical - No pain or swelling of joints. Patient is relatively symptom-free
4. Chronic - Gout attacks may become frequent. Tophi formation may be seen.

Question 6

Indication of colchicine (Colcrys)

Answer 6

treatment of acute attack of gout

Question 7

Mechanism of colchicine

Answer 7

inhibition of neutrophil migration and phagocytic activity in inflamed joints, which in turn inhibits neutrophil engulfment of uric acid crystals, preventing release of destructive lysosomal enzymes into extracellular environment.

Question 8

indication of allopurinol (Zyloprim)

Answer 8

1. used to prevent formation of excessive uric acid, and lower blood and urine concentrations
   
   • not for asymptomatic hyperuricemia
2. Also used during chemo and radiation because death of many cells results in large amounts of uric acid prescursors

Question 9

Mechanism of action for probenecid (Benemid)

Answer 9

Increases the excretion of uric acid = uricosuric agent

Question 10

Indication of probenecid

Answer 10

Management of chronic gout

acute gout attacks increase in frequency or severity

Question 11

What non-opioid pain relievers may be used in management of gout

Answer 11

NSAIDS
- short-term use
Relieve pain, tenderness and swelling of affected joints