Gout

Question 1

Pathophysiology of gout

Answer 1

• overproduction of uric acid
• hyperuricaemia occurs
• causes urate crystals to form and deposit in the joints
• inflammatory cells are activated
• cytokines are then released which causes more inflammatory mediators
• causes an acidic environment meaning more urate cystals

Question 2

Risk factors of gout

Answer 2

Alcohol
Hyperuricaemia
Age
Gender
Medication

Question 3

What should not be given during gout?

Answer 3

Aspirin
Diuretics
Cyclosporine (medication for rheumatoid arthritis, psoriasis)

Question 4

What is the pharmacology of colchicine and allupurinol for gout

Answer 4

Colchicine inhibits the proliferation only anti-inflammatory pathways
Allopurinol inhibits xanithine oxidase which converts hypoxanthine to xanithine a component in uric acid

Question 5

Lifestyle advice for gout (acute attack and prophylaxis )

Answer 5

Acute attack
-Ice to reduce inflammation
- R.E.S.T

Prophylaxis
-weight loss
-avoid dehydration
-Alcohol

Question 6

How does bendeoflunethiazide cause gout

Answer 6

It can increase the levels of uric acid

Question 7

when should a follow up be considered?

Answer 7

4-6 weeks after a flare up

Question 8

when to refer gout

Answer 8

if septic arthritis is suspected