Gout

Question 1

Gout is

Answer 1

Crystal arthropathy

Question 2

The underlying cause of gout is the chronic blood build up of

Answer 2

Uric acid

Question 3

Gouty tophi is

Answer 3

Subcutaneous deposits of U acid in joints

Question 4

Cytokines cause inflammation in hyperurecaemia (gout) due to

Answer 4

Leucocyte immigration to clear u acid

Question 5

Pseudogout is

Answer 5

Ca pyrophosphate within joints

Question 6

Vulnerable groups for pseudogout

Answer 6

• elderly
• large joints
• osteoarthritis

Question 7

Examples of purine rich diet that cause gout

Answer 7

• sea food

- red meat

Question 8

Examples of pathological states that lead to reduced clearance of uric acid

Answer 8

• dehydration

- CKD

Question 9

Why do chemotherapy/radiotherapy lead to gout

Answer 9

Dead cells release purine

Question 10

Drugs that cause gout

Answer 10

• thiazide/loop diuretics
• aspirin
• ACEi

Question 11

Is gout more common in males or females

Answer 11

Males (FH)

Question 12

Description of joint in gout attack

Answer 12

Single, acute, hot, swollen and painful

Question 13

Most affected joints in gout and which particular toe

Answer 13

DIPJs of 1st toe

Question 14

Other joints affected in gout

Answer 14

• CMTJs
• MTPJs
• wrists

Question 15

Aspiration findings in gout that exclude bacterial presence

Answer 15

No bacteria on aspiration

Question 16

Shape of crystals in gout

Answer 16

Needle shaped

Question 17

Is gout -ve or +ve on polarised light

Answer 17

-very birefringent

Question 18

Type of urate crystals found in gout aspiration

Answer 18

Monosodium

Question 19

describe space between joints in XR

Answer 19

Maintained

Question 20

Describe lesions in bones on XR

Answer 20

Lytic

Question 21

Describe erosions on XR

Answer 21

Punched out

Question 22

Describe the borders or erosions on XR

Answer 22

Sclerotic w/ overchanging edges

Question 23

1st line med in acute flare

Answer 23

NSAIDs

Question 24

2nd line med in acute flare

Answer 24

Colchicine

Question 25

3rd line med in acute flare

Answer 25

Steroids

Question 26

Prophylaxis med

Answer 26

Allopurinol

Question 27

How does allopurinol reduce uric acid levels

Answer 27

Xanthine oxidase inhibitor

Question 28

When to initiate allopurinol in relation to acute attackers

Answer 28

After acute attacks has settled

Question 29

Indications for colchicine use

Answer 29

• NSAIDs inappropriate
• renal impairment
• significant HD

Question 30

Side effects of colchicine

Answer 30

• GI upset

- diarrhoea

Question 31

What does colchicine depend on

Answer 31

Dose dependent