Gout Flashcards

1
Q

what is gout

A

a form of arthritis

caused by deposition of monosodium urate crystals in and around the joints

most commonly in the metatarsophalangeal joint (MTPJ)

really acutely painful

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2
Q

who gets gout

A

old men

higher prevalence in developed countries

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3
Q

what is the cause of gout

A

uric acid crystals get deposited in the joint

causes an acute inflammatory response

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4
Q

what are the risk factors for gout

A

obese, hypertension, diabetes

old

male

FH

certain medications e.g. thiazide diuretics

renal impairment so do GFR to investigate

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5
Q

how does gout present

A

excruciating, sudden burning pain in the affected joint

swelling, red, stiff, warmth in the affected joint

mild fever

tachycardia as a sympathetic response

usually presents in the metatarsophalangeal joint

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6
Q

how do you investigate gout

A

Arthrocentesis (joint aspiration) to analyse the synovial fluid

GFR as more common in renal impairment

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7
Q

how do you manage gout acutely and long term

A

Acutely:

  • high dose NSAIDs- indomethacin
  • colchicine as alternative to NSAIDs
  • steroids (intra-articular injection)

long term control:
- ALLOPURINOL- decreases blood uric acid levels

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8
Q

what do you give people with recurrent acute attacks of gout (2 or more in a year)

A

allopurinol to lower urate levels in the blood

only when renal function allows

only start them on it when their acute attack has settled

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