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MSK > Gout > Flashcards

Gout Flashcards

1
Q

What is gout?

A

Type of crystal arthropathy associated with high blood uric acid levels

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2
Q

What is the pathology of gout?

A

Urate crystals are deposited in the joint causing it to become swollen, hot and painful

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3
Q

What is the name of the subcutaneous uric acid deposits?

A

Gouty tophi

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4
Q

Which joints are most affected by tophi?

A

Small joints of hands, elbows and ears
DIP joints are most affected in the hands

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5
Q

What is the typical presentation of gout?

A

Single acute hot, swollen and painful joint

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6
Q

What is the most obvious differential for gout?

A

Septic arthritis

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7
Q

What are the risk factors for gout?

A

Male
Obesity
high purine diet
Alcohol
Diuretics
FH

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8
Q

Which joints are typically affected by gout?

A

Base of big toe (MTP)
Wrists
Base of thumb (CMC)
Knee
Ankle

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9
Q

What is the investigation of choice for gout?

A

Aspiration

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10
Q

What will gout aspiration show?

A

No bacterial growth
Needle shaped crystals
Monosodium urate crystals

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11
Q

What will gout x ray show?

A

Lytic lesions in bone
Punched out erosions with sclerotic borders

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12
Q

What is the management of an acute gout flare?

A

NSAIDs are first line
Colchicine is second line
Steroids are third line

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13
Q

What is a common side effect of colchicine?

A

Diarrhoea

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14
Q

What is the prophylaxis of gout?

A

Allopurinol- reduces uric acid level
Lifestyle changes- lose wait, stay hydrated, minimise alcohol consumption

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15
Q

When should allopurinol be administered?

A

After acute gout attack has settles

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16
Q

What is pseudogout?

A

A crystal arthropathy caused by calcium pyrophosphate crystals

17
Q

What is the typical presentation of pseudogout?

A

Older adult with a hot, swollen, stiff. painful knee

18
Q

What needs to be excluded in the presentation of hot, painful, swollen joint?

A

Septic arthritis- aspirate!

19
Q

What does aspiration in pseudogout show?

A

No bacterial growth
Calcium pyrophosphate crystals
Rhomboid shape crystals

20
Q

What is the diagnostic for pseudogout on x ray?

A

Chondrocalcinosis- thin white line in the middle of the joint space caused by calcium deposition

21
Q

What is the management of pseudogout?

A

NSAIDs
Colchicine
Joint aspiration
Steroid injections
Oral steroids

MSK (20 decks)

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