Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year Two - Rheumatology > Gout > Flashcards

Gout Flashcards

1
Q

What is gout?

A

It is defined as a crystal arthropathy in which there is deposition of monosodium urate monohydrate in the synovium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the pathophysiological cause of gout?

A

It is related to chronic hyperuricaemia, with uric acid levels > 0.45 mmol/l.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What joint is most commonly affected by gout?

A

First metatarsophalangeal (MTP) joint, which is the base of the big toe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the three other joints commonly affected by gout?

A

Wrist joint

Knee Joint

Ankle joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What eleven risk factors are associated with gout?

A

Middle Aged, 30 – 50 Years Old

Male Gender

Family History

Chronic Kidney Disease

Lesch Nyan Syndrome

Psoriasis

High Purine Diet

Obesity

Alcoholism

Thiazide Diuretic Administration

Chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Lesch Nyhan syndrome?

A

It is defined as a congential condition, in which there is hypoxanthine-guanine phosphoribosyl transferase (HGPRTase) deficiency

This leads to purine breakdown, leading to hyperuricaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the inheritance of Lesch Nyhan syndrome?

A

X-linked recessive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the four clincal features of Lesch Nyhan syndrome?

A

Gout

Renal Failure

Neurological Deficits

Learning Difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the six clinical features of gout?

A

Severe Joint Pain

Joint Swelling

Joint Erythema

Joint Warmth

Joint Tophi

Reduced Joint Function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are tophi?

A

They are subcutaneous deposits of uric acid, which present on small joints and connective tissues of the hands, elbows and ears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What three investigations are used to diagnose gout?

A

Blood Tests

Joint X-Ray

Joint Fluid Aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When are blood tests used to diagnose gout? Why?

A

They should be conducted once the acute episode has settled, usually two weeks following

This is due to the fact that during an acute attack the uric acid level may be increased, normal or decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What blood test result indicates gout?

A

Increased Uric Acid Levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the five features of gout on joint x-ray?

A

Normal Joint Space

Joint Effusion

Lytic Bone Lesions

Punched Out Erosions

Soft Tissue Tophi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the puched out erosions of gout on joint x-rays

A

They have sclerotic boarders with overhanding edges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the four features of gout on joint fluid aspiration?

A

No Bacterial Growth

Needle Shaped Crystals

Negative Birefringent of Polarised Light

Monosodium Urate Crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the three pharmacologcial management options of acute gout attacks?

A

NSAIDs

Colchicine

Corticosteroids

18
Q

When are NSAIDs used to manage acute gout attacks?

A

They are the first line management option

19
Q

Name two NSAIDs used to manage acute gout attacks

A

Ibuprofen

Naproxen

20
Q

When is colchicine used to manage acute gout attacks?

A

It is the second line management option of acute gout attacks, in which NSAIDs are contraindicated – such as renal impairment, heart disease, and peptic ulcers, etc

21
Q

What is the mechanism of action of colchicine?

A

It is an anti-inflammatory drug, which inhibits microtubule polymerisation by binding to tubulin, interfering with mitosis

22
Q

What is a contraindication of colchicine?

A

Renal Impairment, eGFR < 10ml/min

The dose should be reduced when the eGFR is between 10 - 15ml/min

23
Q

What is a side effect of colchicine?

A

Diarrhoea

24
Q

When are corticosteroids used to manage acute gout attacks?

A

They are the third line management option

25
Q

Name a corticosteroid used to manage acute gout attacks

A

Prednisolone

26
Q

When is prophylactic management of gout recommended?

A

It should be offered to all individuals who present with their first attack of gout

27
Q

In which five circumstances is prophylactic management of gout particualrly recommended?

A

> 2 Gout Attacks In 12 Months

Gout Tophi

Chronic Kidney Disease

Uric Acid Renal Stones

Thiazide Diuretic Administration

28
Q

What are the three prophylactic conservative management options of gout?

A

Reduce Alcohol Intake

Weight Loss

Low Purine Diet

29
Q

When should prophylactic pharmacological management option of gout be commenced? Why?

A

When the inflammation has settled, and the patient is no longer in pain – usually 2- 4 weeks after the initial attack

This is due to the fact that starting pharmacological prophylaxis too early may precipitate a further attack

30
Q

Do we continue prophylactic pharmacological management of gout during acute attacks when already administered?

A

Yes

31
Q

What are the three prophylactic pharmacological management options of gout?

A

Allopurinol

Febuxostat

Urate Oxidase

32
Q

When is allopurinol used to prophylactically manage gout?

A

It is the first line pharmacological management option

33
Q

What is the mechanism of action of allopurinol?

A

It is a xanthine oxidate inhibitor, which means that it blocks uric acid production

34
Q

How do we administer allopurinol to manage gout prophylactically?

A

It is initially commenced 100mg once daily, with gradual titration until a serum uric acid of 360umol/l is obtained

35
Q

In which three circumstances should the target uric acid level be lowered to <300umol/l?

A

Gout tophi

Chronic gouty arthritis

Recurrent gout flares

36
Q

What should allopurinol initially be administered with?

A

Colchicine cover

When colchicine is not tolerated, NSAIDs can alternatively be used

37
Q

What drug does allopurinol interact with? What adverse reaction occurs?

A

Azathioprine

Azathioprine Toxicity

38
Q

What are the four clinical features of azathioprine toxicity?

A

Bone Marrow Suppression

Depression

Nausea & Vomiting

Pancreatitis

39
Q

When is febuxostat used to prophylactically manage gout?

A

It is the second line pharmacological management option

40
Q

What is the mechanism of action of febuxostat?

A

It is a xanthine oxidate inhibitor, which means that it blocks uric acid production

41
Q

When is urate oxidase used to prophylactically manage gout?

A

It is the third line pharmacological management

42
Q

What is the mechanism of action of urate oxidase?

A

It is an enzyme which catalyses the conversion of urate to the degradation product allantoin

Year Two - Rheumatology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions