Gout

Question 1

What is gout?

Answer 1

Type of crystal arthropathy associated with chronically high blood uric levels

Question 2

What are deposited on joints in gout?

Answer 2

Urate crystals

Question 3

What are gouty tophi?

Answer 3

Subcutaneous deposits of uric acid usually affecting small joints & connective tissues of hands, elbow and ears

Question 4

Which joint is most commonly affected in the hands?

Answer 4

DIP joints

Question 5

What joints are affected by gout?

Answer 5

• Base of big toe
• Wrists
• Base of thumb
• Sometimes knee & ankle

Question 6

Risk factors for gout?

Answer 6

Male 
Obese 
High purine diet 
Alcohol 
Diuretics 
Fam History 
Existing CVS/Kidney disease

Question 7

Diagnosis of gout?

Answer 7

Clinical or by joint fluid aspiration

Question 8

What will aspirated fluid show in gout?

Answer 8

• No bacterial growth
• Needle shaped crystals
• Negative birefringent of polarised light
• Monosodium urate crystals

Question 9

Joint x-ray would show what in gout?

Answer 9

• Typically the joint space is maintained
• Lytic lesions on bone
• Punched out erosions
• Erosions can have sclerotic boarders with overhanging edges

Question 10

1st line management of an acute flare of gout?

Answer 10

NSAIDs

Question 11

2nd line management of an acute flare of gout?

Answer 11

Colchicine

Question 12

What is 3rd line management of an acute flare of gout?

Answer 12

Roids

Question 13

Side effect of colchicine?

Answer 13

Diarrhoea

Question 14

Prophylaxis of gout?

Answer 14

Allopurinol

Eg xanthine oxidase inhibitor

Question 15

What does allopurinol do?

Answer 15

Reduces uric acid